Comparison of Physiotherapy Methods Applied To The Diaphragm In Chronic Low Back Pain

NCT07022132 | Completed

• 1 other identifier: IMUFTR01
• Study Type: interventional
• Target: 44
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study was to compare the effects of conservative treatment with diaphragmatic myofascial release (DMR) and abdominal hypopressive exercise (AHE) technique added to conservative treatment in chronic low back pain.

Conditions

Low Back Pain

Outcome Measures

Primary Outcomes (1)

• Pain intensity (Visual Analogue Scale)

  The Visual Analogue Scale (VAS) will be used to assess the level of pain at rest and during movement. The VAS is a self-reported scale consisting of a horizontal or vertical line, usually 100 millimetres long, with two verbal descriptors indicating pain status at the extremes. The patient is asked to indicate where on this line his/her condition fits by drawing a line, putting a dot or pointing.

  6 weeks

Secondary Outcomes (3)

• Hamstring flexibility (The Active Knee Extension Test)

  6 weeks

• Chest wall mobility (a tape measure)

  6 weeks

• Pelvic floor muscle activity

  6 weeks

Study Arms (2)

Diaphragmatic myofascial release (DMR) group

ACTIVE COMPARATOR

This group will receive DMR in addition to conservative treatment consisting of stretching and strengthening exercises.

Other: Diaphragmatic myofascial release (DMR); Other: Conservative treatment

Abdominal hypopressive exercise (AHE) group

ACTIVE COMPARATOR

This group will receive AHE in addition to conservative treatment consisting of stretching and strengthening exercises.

Other: Abdominal hypopressive exercise (AHE); Other: Conservative treatment

Interventions

Diaphragmatic myofascial release (DMR) OTHER

The physiotherapist, positioned on the head side of the supine patient, makes bilateral contact with the pisiform, hypothenar region and the underside of the 7th-10th costal cartilages with the last three fingers. During the inspiration phase, he/she pulls the contact points cephalically and slightly laterally with both hands, accompanying the elevation of the costae. During expiration, it deepens the contact towards the inner costal margin, maintaining resistance. In subsequent breathing cycles, it gradually increases the depth of contact inside the costal margin. The application is performed in 2 sets of 10 deep breaths with 1 minute between them.

Diaphragmatic myofascial release (DMR) group

Abdominal hypopressive exercise (AHE) OTHER

Each session consists of 6 hypopressive abdominal exercises with a 2-minute recovery period in between, and each exercise is repeated 3 times. This manoeuvre consists of expelling all air until the reserve volume is reached, then holding the breath (expiratory apnoea) and pulling the abdominal wall inwards and cranially by opening the costae without allowing air to enter. Exercises are performed in 6 different positions.

Abdominal hypopressive exercise (AHE) group

Conservative treatment OTHER

It consists of lumbar flexion and extension, stretching and strengthening exercises for the waist, back and abdominal region.

Abdominal hypopressive exercise (AHE) group; Diaphragmatic myofascial release (DMR) group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Experiencing low back pain for at least 12 weeks
• To be between the ages of 18-65

You may not qualify if:

• Pregnancy
• Severe osteoporosis
• Less than 1 year history of abdominal and/or thoracic surgery
• Having an additional disease such as severe coronary artery disease, uncontrolled hypertension, COPD that prevents exercise,
• Difficulty in co-operation
• History of malignancy
• History of lumbar spinal surgery
• Spondylolisthesis, scoliosis, other spinal deformities and congenital malformations
• Radiculopathy
• Systemic inflammatory diseases
• Corticosteroid injection in the last 3 months

Sponsors & Collaborators

• Medipol University: lead

Study Sites (1)

Istanbul Medipol University

Istanbul, Istanbul, 34810, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Low Back Pain

Interventions

Conservative Treatment

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Therapeutics

Study Officials

• Hatice Hümeyra Akıl

  Medipol University

  PRINCIPAL INVESTIGATOR

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: Lecturer

Study Record Dates

• First Submitted: May 28, 2025
• First Posted: June 15, 2025
• Study Start: August 10, 2024
• Primary Completion: June 20, 2025
• Study Completion: June 20, 2025
• Last Updated: January 2, 2026

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)