Effect of Global Postural Reeducation on Low Back Pain Patients With Lower Cross Syndrome

Not Applicable

Completed

• Conditions: Low Back Pain, Postural
• Interventions: Procedure: Global postural reeducation

• Registration Number: NCT05664022
• Lead Sponsor: Cairo University

Brief Summary

This study will be conducted toinvestigate the effect of Global Postural Re-education on low back pain patients with Lower cross syndrome

Detailed Description

Lower cross syndrome is common, with up to 85% of low back pain cases due to long-term postural faults (Lower crossed syndrome) and it has a negative result on our society. Global Postural Re-education (GPR) is an intervention that is used frequently for chronic low pain to improve pain and function. 50 low back pain patients with lower cross syndrome will be assigned randomly into 2 groups, Group A will receive a Global Postural Re-education approach and consists of 15 treatment sessions of Global Postural Re-education approach, performed 2times/week for 1 hour including patient education. Each treatment is individualized for every patient and for his/her pain-related limitation. Each session includes only 2-3 postures to increase the standardization of treatment. Group B will receive the conventional treatment in form of exercise program of (abdominal and pelvic floor strengthening) and (stretching exercise of back and hip flexor muscles) to improve pain and function in chronic low back pain patients

Study Timeline

• Study First Submitted: 2022-12-12
• Study First Submitted QC: 2022-12-21
• Study First Posted: 2022-12-23
• Study Start: 2023-01-01
• Status Verified: 2023-06
• Primary Completion: 2023-06-10
• Study Completion: 2023-06-10
• Last Update Submitted: 2023-06-12
• Last Update Posted: 2023-06-15

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

• 50 patients.
• Both sexes will be included.
• Patients' age range will be 25 to 40 years old (Esakowitz., 2014).
• Participants will have to meet the criteria for lower crossed syndrome indicating tight hip flexors and erector spinae together with weak glutei and abdominals with low back pain will be presented three months or longer and level of pain intensity more than 3 on VAS.

Exclusion Criteria

• On other forms of treatment that may interfere with the study including other physical therapy or medication specific to back pain.
• Enrolled in another interventional clinical research trial
• Pregnancy
• Nerve entrapment, bowel or bladder dysfunction and kidney disease.
• Surgery on the back, pelvis or sacrum is indicated or has previously occurred.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Global postural reeducation approach	Global postural reeducation	The patient will receive 15 sessions of the Global Postural Re-education approach performed 2times/week for 1 hour including patient education. Each treatment will be individualized for every patient and for his/her pain-related limitation. Each session includes only 2-3 postures to increase the standardization of treatment.
Conventional treatment	Global postural reeducation	The patient will receive the conventional treatment in form of exercise program of(abdominal and pelvic floor strengthening)and (stretching exercise of back and hip flexor muscles)to improve pain and function in chronic low back pain patients.

Primary Outcome Measures

Name	Time	Method
flexibility of hip flexors muscle	up to twelve weeks	Flexibility of hip flexors muscles will be measured by modified Thomas test. This test is performed with the patient supine and the thigh is over the edge of the examining table. The patient is told to grasp the thigh of the untested limb and pull it toward the chest. Lumbar spine is flat on the plinth and the pelvis is in posterior rotation. Length of iliopsoas is determined by measuring the angle of hip flexion. Measurements will be taken pre and post treatment
anterior pelvic tilting	up to twelve weeks	Anterior pelvic tilt will be measured by software application (iHandy Soft, Inc., New York, USA). This application has the capacity to convert the phone into an inclinometer using a built-in sensitive system.It is a tool for assessing angles of slope (or tilt) using all sides of the device plus the camera. A smartphone with the iHandy app can be used in clinical practice and research as an easy and convenient alternative to an inclinometer.
lumbar lordosis	up to twelve weeks	The lumbar lordosis will be measured by flexible ruler. It is commonly used to measure the degree of spinal curvature of the lumbar lordosis in the sagittal plane. Lumbar lateral X-ray radiography is considered as a golden standard method in lumbar lordosis measurement. However, this method has a number of problems such as being time-consuming and expensive. A flexible ruler is a safe, easy-to-use, and inexpensive tool. Validity between lumbar lordosis measurement with the flexible ruler and the x-ray is 0.91 so the flexible ruler can be used effectively for lumbar lordosis measurements and is a valid, assured, portable and non-invasive tool with high reliability and validity.
pain severity	up to twelve weeks	The pain severity level will be measured via the Visual Analogue Scale (VAS). VAS is a pain rating scale, in which scores are based on self-reported measures of symptoms that are recorded with a single handwritten mark placed at one point along the length of a 10 cm line that represents a continuum between the two ends of the scale "no pain" on the left end (0 cm) of the scale and the "worst pain" on the right end of the scale (10 cm). In this scale, zero represents the absence of pain, 1-3 shows mild pain, 4-6 denotes moderate pain, and 7-10 indicates severe pain
function disability	up to twelve weeks	The disability caused by low back pain will be measured via the The Arabic version of Oswestry Low Back Pain Disability Questionnaire. The patient fills out the questionnaire in about 5 minutes and then the doctor scores it in about 1 minute. The patient marks the most relevant answer for each question as accurately as they can. Scoring is done on a scale of 0-5, starting with the first possible answer in the sequence being '0' and the last answer '5'. The maximum possible score for each section is 5. All the scores are added together and divided by the total number of possible points in order to calculate the total score

Trial Locations

Locations (1)

Damanhour teaching hospital; 🇪🇬 Damanhūr, Egypt