Comparative Analysis of Different Physiotherapy Interventions on Anterior Pelvic Tilt in Subjects With Non-Specific Low Back Pain: A Randomized Controlled Trial

Anterior pelvic tilt (APT) is a prevalent postural deviation characterized by excessive forward rotation of the pelvis, often resulting in increased lumbar lordosis. This condition is frequently associated with non-specific low back pain (NSLBP), which affects a significant portion of the global population and poses substantial challenges for individuals' well-being and healthcare systems worldwide. NSLBP is a multifactorial condition with various etiological factors, including poor posture, muscle imbalances, sedentary lifestyle, and biomechanical abnormalities such as APT. Understanding and effectively managing APT in the context of NSLBP is crucial for reducing pain, improving functional capacity, and enhancing quality of life for affected individuals.

Despite the prevalence and clinical significance of APT in NSLBP, there is a lack of comprehensive research comparing the effectiveness of different therapeutic interventions. Various approaches have been proposed, including core stability exercises, soft tissue release with manual therapy, stretching and flexibility exercises, and postural correction exercises. However, the relative efficacy of these interventions remains uncertain, hindering evidence-based decision-making in clinical practice.

Therefore, this study aims to address this gap in the literature by conducting a randomized controlled trial (RCT) to compare the effectiveness of core stability exercises, soft tissue release with manual therapy, stretching and flexibility exercises, and postural correction exercises in individuals with APT and NSLBP. By rigorously evaluating these interventions and their impact on APT, pain levels, functional capacity, and quality of life, this research seeks to provide valuable insights for clinicians and researchers, informing the selection and implementation of optimal treatment strategies for individuals with APT-related NSLBP.

Etiology and Biomechanics of Anterior Pelvic Tilt: The development of APT is multifactorial, involving a complex interplay of musculoskeletal factors, including muscle imbalances, joint stiffness, ligamentous laxity, and postural habits. Biomechanically, APT alters the alignment of the spine and pelvis, leading to increased stress on lumbar structures such as the intervertebral discs, facet joints, and surrounding musculature. This malalignment can contribute to aberrant movement patterns, decreased stability, and eventually, the onset of NSLBP.

Therapeutic Interventions for Anterior Pelvic Tilt and Non-Specific Low Back Pain: A variety of therapeutic interventions have been proposed for managing APT and NSLBP, aiming to address underlying biomechanical imbalances, improve musculoskeletal function, and alleviate pain. Core stability exercises, focused on strengthening the deep stabilizing muscles of the spine and pelvis, have shown promise in improving postural alignment and reducing NSLBP symptoms. Soft tissue release techniques, such as manual therapy and myofascial release, target tight and restricted muscles associated with APT, promoting relaxation and improved range of motion. Stretching and flexibility exercises aim to elongate tight musculature, particularly in the hip flexors and lumbar extensors, thereby reducing excessive pelvic tilt and alleviating NSLBP. Additionally, postural correction exercises focus on retraining optimal alignment and body mechanics, promoting a more neutral pelvic position and reducing strain on the lumbar spine.