A 8-week Randomized Controlled Trial of Active Mobilization of Hamstring for Non-specific Low Back Pain and Musculoskeletal Discomfort During Prolonged Sitting Among Young People: Study Protocol
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 48
- 试验地点
- 2
- 主要终点
- Pain Intensity
研究概览
简要总结
Hip flexion is a normal part of everyday functional activities, including walking and sitting. The length of the hamstring influences on movement of the pelvis during hip flexion, consequently influencing lumbar lordosis. In most activities, the hamstring muscles are active and it is necessary to keep them at normal length. Sitting posture is responsible for the loss of the natural curvature of the lumbar spine, because the hip flexion and pelvic extension flatten the lumbar vertebrae (i.e., lumbopelvic rhythm). Furthermore tightened hamstring increases posterior pelvic tilt and reduces lumbar lordosis, which can tend to low back pain (LBP). Stretching exercises play an important role in both the prevention and treatment of LBP. One important option will be exercise protocol which will combine the active hamstring flexibility exercises with hip flexion mobilization and the development of the habit of correct hip flexion technique, protecting the lower spine.
The aim of this RCT is to present a protocol for evaluating the effect of 8-week active hamstring flexibility exercises with hip flexion mobilization in reducing LBP and perceived musculoskeletal discomfort during prolonged sitting in young adults with non-specific LBP.
详细描述
Background:
Limited lower extremity muscle flexibility, such as hamstring, iliopsoas, quadriceps, and limited hip range of motion are risk factors for low back pain (LBP) in young people. LBP has increased by 49.8-50.7% over the last twenty years which highlighted the increase in the dominance of LBP especially among young people. Flexibility is an essential factor in physical fitness, which has a significant role in the functional development of the musculoskeletal system and the optimization of muscle work. To prevent pain or perceived musculoskeletal discomfort, various flexibility exercises including exercise stretches of the hamstring muscles have been recommended. Improving the hip flexion technique requires hip power and stability in the lumbar spine. In hamstring flexibility training, we should create an opportunity to practice movement and develop correct patterns using the hip flexion and extension pattern while maintaining the stability of the lumbar spine. Keeping the torso straight while working the hips and knees is one of the basic principles of protecting the spine in the lumbar region. Maintaining a neutral lower spine protects passive tissues and allows for better mobilization of the hips. Stretching exercises play an important role in both the prevention and treatment of LBP. One important option will be exercise protocol which will combine the active hamstring flexibility exercises with hip flexion mobilization and the development of the habit of correct hip flexion technique, protecting the lower spine.
Objective:
This randomized controlled trial aims to investigate the effect of a 8-week intervention involving active hamstring flexibility exercises with hip flexion mobilization on reducing low back pain (LBP) and perceived musculoskeletal discomfort during prolonged sitting in young adults with non-specific LBP.
Methods:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 25 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •students in Physical Education (18-25 years old)
- •with non-specific LBP (defined as pain and discomfort localized below the costal margin and above the inferior gluteal folds), the pain of at least 3 months duration, without radiation to legs
- •without a surgical history due to spinal problems
- •didn't previously continue the hamstring stretches exercises
- •with hamstring muscle shortness
排除标准
- •spinal pathology (eg, tumor, infection, fracture, inflammatory disease
- •disc herniation and leg length discrepancy over 1cm
- •pregnancy
- •nerve root compromise
- •previous spinal surgery
- •major surgery scheduled during treatment or follow-up period
- •presence of any contraindication to exercise
- •medically verified chronic back disorde
- •menstrual pain
结局指标
主要结局
Pain Intensity
时间窗: Change from Pre-Intervention (baseline) compared to Post-Intervention (8 weeks)
The Visual Analogue Scale (VAS) will be used to assess average pain intensity graded from 0 (no pain) up to 10 (unbearable pain). Mild pain or no pain will be defined as VAS 0-3, moderate pain as VAS 4-6, and severe pain as VAS 7-10. Participants will be asked to rate their maximum pain intensity from the last 3 months.
Functional Disability
时间窗: Change from Pre-Intervention (baseline) compared to Post-Intervention (8 weeks)
The Revised Oswestry Low Back Pain Disability Index will be used to assess the level of functional disabilities of participants resulting from LBP. The questionnaire consists of 10 items related to different aspects of function regarding activities of daily living (ADL). Each item will be scored from 0 to 5, with higher values representing greater disability. The total score will be multiplied by 2 and expressed as a percentage.
Perceived musculoskeletal discomfort during prolonged sitting
时间窗: Change from Pre-Intervention (baseline) compared to Post-Intervention (8 weeks)
The Borg CR-10 scale will be used to assess the perceived musculoskeletal discomfort during 1 hour of sitting named as prolonged sitting. The Borg CR-10 scale is presented in such a way that test subjects can indicate in which parts of the body feel discomfort (i.e. neck, shoulder, upper back, lower back, hip/thigh, and knee) and the degree of discomfort they feel (on a scale from 0 to 10, 0 being no discomfort and 10 being extremely uncomfortable).
The global perceived improvement
时间窗: Completion of 8 week intervention
The Global Perceived Effect (GPE) will be used to assess the global perceived improvement. The investigator will ask the student to rate, on a numerical scale, how much their condition has improved or deteriorated since some predefined time point: 1 = completely recovered, 2 = much improved, 3 = slightly improved, 4 = not changed, 5 = slightly worsened, 6 = much worsened and 7 = worse than ever. These ratings will be dichotomized into "improved" (GPE scores 1-2) and "not improved" (GPE scores 3 to 7).
次要结局
- Flexibility of the hamstring(Change from Pre-Intervention (baseline) compared to Post-Intervention (8 weeks))
研究者
Magdalena Plandowska
PhD
Józef Piłsudski University of Physical Education