Effect of Modified Lumbar Sustained Natural Apophyseal Glide on Postnatal Low Back Pain

NCT06427434 | Completed

• 1 other identifier: P.T.REC/012/004494
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This study will be carried out to evaluate the effect of modified lumbar Sustained Natural Apophyseal Glide on low back pain in postnatal women.

Conditions

Low Back Pain

Outcome Measures

Primary Outcomes (4)

• Pain intenesity

  The visual analogue scale is a 10 cm calibrated line with 0 representing no pain and 10 representing the worst pain; will be used to assess the severity of pain before and after treatment for all participants in both groups.

  within 4 weeks

• Lumbar flexion range of motion

  The modified Schober test will be used to measure the lumbar flexion range of motion (ROM) by using the tape measurement. Each participant will be asked to stand erect with her feet about shoulder-width apart to stabilize the pelvis. Then, the posterior superior iliac spines(PSIS) will be determined by the therapist's both thumbs, and then an ink line will be drawn along the midline of the lumbar spines horizontal to the PSIS to mark the midpoint between the two PSIS. Then tape will be used to identify and mark two points: one is 10 cm superior to the midpoint (A), and another is 5 cm inferior to the midpoint (B). The participant will be instructed to bend forward as much as she can while keeping both knees straight, the new distance between superior and inferior skin marking will be measured in centimeters. The increased distance along the tape due to lumbar flexion is normally about 6-7 cm (less than 5 cm should be considered abnormal).

  within 4 weeks

• Lumbar extension range of motion

  The modified Schober test will be used to measure the lumbar extension range of motion (ROM) by using the tape measurement while the patient is in a standing position. The participant will be instructed to put her hands on her buttocks and bend backward into full lumbar extension and the new distance between the superior and inferior skin markings will be measured in centimeters by the tape measurement. The change in the difference between the marks is used to indicate the amount of lumbar extension. The increased distance along the tape due to the extension of the lumbar spine is normally about 2-3 cm (less than 1 cm should be considered abnormal).

  within 4 weeks

• Lumbar lateral flexion range of motion

  The participant will be asked to stand erect with her feet about shoulder-width apart. Both right and left lateral flexion will be measured by the tape as the distance from the tip of the index finger to the floor at maximal comfortable lateral flexion. The participant will be instructed to bend her trunk laterally as much as she can. The normal value of lateral spinal flexion is 16.2-28.0 cm.

  within 4 weeks

Secondary Outcomes (1)

• Functional disability

  within 4 weeks

Study Arms (2)

Strengthening and stretching exercises

ACTIVE COMPARATOR

The participants will be asked to perform strengthening and stretching exercises to the back and abdominal muscles for 30 min, three times per week for 4 weeks.

Other: Strengthening and stretching exercises to the back and abdominal muscles

Modified Lumbar Sustained Natural Apophyseal Glide

EXPERIMENTAL

The participants will receive Modified Sustained Natural Apophyseal Glide on the affected lumbar level for 30 sec three times per week for 4 weeks. In addition to strengthening and stretching exercises to the back and abdominal muscles for 30 min, three times per week for 4 weeks

Other: Strengthening and stretching exercises to the back and abdominal muscles; Other: Modified Lumbar Sustained Natural Apophyseal Glide

Interventions

Strengthening and stretching exercises to the back and abdominal muscles OTHER

Strengthening and stretching exercises to the back and abdominal muscles will be performed for 30 min, three times per week for 4 weeks.

Modified Lumbar Sustained Natural Apophyseal Glide; Strengthening and stretching exercises

Modified Lumbar Sustained Natural Apophyseal Glide OTHER

Modified Sustained Natural Apophyseal Glide will be applied on the affected lumbar level for 30 sec three times per week for 4 weeks.

Modified Lumbar Sustained Natural Apophyseal Glide

Eligibility Criteria

• Age: 20 Years - 35 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• All participants will be diagnosed as chronic postnatal low back pain.
• Their ages will be ranged from 20 to 35 years old.
• Their body mass index (BMI) will not exceed 30 kg/m2.
• All participants have the same social level.
• All participants have the same lifestyle.
• Their number of parity will be ranged from 2-4 children.

You may not qualify if:

• Spinal fracture or any other neurological disorders.
• Lumbar spinal stenosis from lumbar disc herniation, degenerative joint diseases, or spondylolisthesis.
• Women with BMI \> 30 kg/m2.
• Participants who had pelvic pathology.
• Skin disease interferes with mobilization application.
• Gynecological diseases (chronic pelvic pain, uterine prolapse and retroversion flexion of the uterus).

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Mina Nageb Soliman

Cairo, Egypt

Location

MeSH Terms

Conditions

Low Back Pain

Condition Hierarchy (Ancestors)

Back Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Azza Kassab, professor

  Cairo University

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: May 19, 2024
• First Posted: May 23, 2024
• Study Start: June 1, 2024
• Primary Completion: December 15, 2024
• Study Completion: December 30, 2024
• Last Updated: May 30, 2025

Record last verified: 2024-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL

Locations

EG (1)