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Mckenzie Versus William Exercise for Non Specific Low Back Pain in Adolescents

Not Applicable
Conditions
Non Specific Low Back Pain
Interventions
Procedure: MCKENZIE exercises
Procedure: WILLIAM'S exercises
Registration Number
NCT05340894
Lead Sponsor
Cairo University
Brief Summary

MCKENZIE EXERCISE VERSUS WILLIAMS EXERCISE ON DECREASING PAIN IN ADOLESCENT WITH NON SPECIFIC LOW BACK PAIN

Low back pain is uncommon in the first decade of life,but prevalence increases steeply during the teenage years; around 40% of 9-18-year olds in high-income, medium-income, and low-income countries report having had low back pain. NSLBP represents about 85% of LBP patients seen in primary care. Non-specific low back pain is one of the most common health problems and is the leading cause of disability in young adults. During school age, the overall risk of low back pain is similar to adults, with prevalence rates as high as 70% to 80% by the age of 20 years old Non-specific low back pain is defined as low back pain not attributable to a recognisable, known specific pathology.

Understanding back pain in adolescents is crucial to obtain timely diagnosis and determine appropriate treatment. Proper treatment and management of LBP in the adolescent years can minimize back pain lasting into adulthood Non pharmacological treatments are emphasised over pharmacological interventions in the management of persistent non-specific low back pain.

natinal institute for health and care excellence(NICE) 2016 draft guideline endorses self-management, exercise, manual therapy, psychological therapies, combined physical and psychological programmes, return-to-work programmes, and radiofrequency denervation.

Back exercises can be an inexpensive and easy option of treatment for NSLBP and proven to be effective. McKenzie extension exercise and William flexion exercise are the most common types of back exercises.

Selection the appropriate treatment method is important. So this study will be aimed to compare between Mckenzie and William's exercises in order to find which method has better effect on adolescents with NSLBP.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
Male
Target Recruitment
30
Inclusion Criteria
  • Age range from 14 to 18 years.
  • Diagnosed as non-specific low back pain.
  • Medically and clinically stable.
  • All participants are within normal range weight and height.
Exclusion Criteria

Adolescents have one or more of the followings will be excluded:

  • Any spinal deformities.
  • History of spinal or pelvic surgery.
  • Specific spinal pathologies as cauda equina syndrome, cord compression, infection, fracture, neoplasm, inflammatory disease, whiplash associated disorders and vertebro-basilar insufficiency.
  • Any visual or auditory problems that interfere with the rehabilitation program.
  • Children with significant mental or psychological problems that interfere with understanding instructions.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Mckenzie groupMCKENZIE exercises* adolescents will receive 4 weeks Mckenzie exercise program * Follow-up:pre-test (Baseline), 2 weeks post-test and 4 weeks post-test.
William's groupWILLIAM'S exercises* adolescents will receive 4 weeks William's exercise program * Follow-up:pre-test (Baseline), 2 weeks post-test and 4 weeks post-test.
Primary Outcome Measures
NameTimeMethod
Visual Analogue Scale (VAS)changes in pain at 4 weeks

This will be used to determine the intensity of pain.The VAS is a valid and reliable measure of chronic pain intensity . It is the amount of pain that a patient feels ranges across a continuum from none to an extreme amount of pain. Operationally, a VAS is usually a horizontal line, 100 mm in length, anchored by word descriptors at each end The patient will mark on the line at the point that he feels which represents his perception of the current state.The VAS score is determined by measuring in millimeters from the left hand end of the line to the point that the child marks .

Secondary Outcome Measures
NameTimeMethod
ModifiedSchober's Test(MSchober test)changes in back flexibility in 4 weeks

The mSchober test is frequently used method for assessing lumbar flexion range of motion (ROM).

Test will be done as follows:

* The participant will stand in neutral erect position without shoes.

* The assessor will marks 1 point 5 cm below and 1 point 10 cm above the lumbosacral junction(dimples of Venus), that is, 15 cm in upright position.

* The participant will be asked to make 2 attempts to bend forward as far as possible, the first will be a trial attempt, and the assessor measured the distance between the marks on the second attempt

* The increase in distance between the marks was then calculated as the measure of lumbar flexion ROM.

* In general, the measure should increase by at least 6 cm to 21 cm. An increase of less than 6 cm suggests decreased lumbar spinal mobility.

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