Post Facilitatiion Stretch and Dry Needling on Hamstring Tightness in Chronic Low Back Pain

NCT07426562 | Not Yet Recruiting

• 1 other identifier: RCRAHS-ISB/REC/MS-PT024437
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this research is to compare the effects of post-facilitation stretch and dry needling on hamstring flexibility, pain, lumbar range of motion, pelvic tilt, and functional status in patients with chronic low back pain. This randomized clinical trial will be conducted at Spine Care Physical Therapy and Rehabilitation Centre (SPRC), Peshawar. The sample size will be 36 participants, who will be randomly divided into two groups: 18 participants in the post-facilitation stretch group and 18 participants in the dry needling group. The study duration will be 3 weeks, with interventions applied three times per week. The sampling technique used will be non-probability purposive sampling, followed by random allocation using the sealed opaque envelope method. Participants aged 20-50 years diagnosed with chronic nonspecific low back pain and having hamstring tightness will be included. Outcome measures used in the study will be Active Knee Extension Test (goniometer) for hamstring flexibility, Numeric Pain Rating Scale (NPRS) for pain, goniometer for lumbar flexion and extension, pelvic inclinometer for pelvic tilt, and Modified Oswestry Disability Index (MODI) for functional disability.

Conditions

Low Back Pain

Keywords

Chronic Low Back Pain; Dry Needling; Post Facilitation Stretch

Outcome Measures

Primary Outcomes (1)

• Hamstring Flexibility (Active Knee Extension Test)

  Changes from baseline hamstring flexibility will be assessed using the Active Knee Extension (AKE) test measured with a universal goniometer. The AKE test evaluates hamstring extensibility by measuring the degree of active knee extension with the hip maintained at 90° flexion. It is a reliable and valid clinical measure for assessing hamstring tightness in individuals with low back pain.

  baseline,1 week, 2 week, 3 week

Secondary Outcomes (4)

• Numeric Pain Rating Scale (NPRS)

  Baseline, 1 week, 2 week, 3 week

• Lumbar Range of Motion

  Baeline ,1 week, 2 week, 3 week

• Pelvic Tilt

  Baeline, 1 week, 2 week, 3 week

• Functional Disability (Modified Oswestry Disability Index MODI)

  Baeline, 1 week, 2 week, 3 week

Study Arms (2)

Dry Needling along with Conventional Therapy

ACTIVE COMPARATOR

Needle retention 30-60 seconds per point. 5 minute moist heat pack applied to posterior thigh before treatment Static hamstring stretches 3 reps × 20 seconds post-session.

Other: Dry Needling along with Conventional Therapy

Post-Facilitation Stretch along with Conventional Physiotherapy

ACTIVE COMPARATOR

maximal isometric contraction for 7-10 seconds, followed by complete relaxation for 1-2 seconds, rapid, controlled stretch for 15-20 seconds 3-5 reps 5-minute moist heat pack Static hamstring stretches 3 reps × 20 seconds post-session.

Other: Post Facilitation Stretch along with Conventional Therapy

Interventions

Dry Needling along with Conventional Therapy OTHER

Patient in prone position with pillow under ankle. After skin antisepsis, a sterile filiform needle (0.25 × 40 mm) will be inserted into identified myofascial trigger points in the hamstrings. Local twitch responses will be elicited with 5-10 positioning movements. Needle retention 30-60 seconds per point for 3 weeks 3 session per week.The patient was positioned in supine lying on the treatment plinth with the contralateral limb extended and the treated limb raised with the knee extended for static hamstring stretching. The pelvis was stabilized to prevent compensatory movements.For the moist heat pack, the patient remained in prone lying, with the heat pack applied over the posterior thigh (hamstring region) and properly secured for comfort and safety

Dry Needling along with Conventional Therapy

Post Facilitation Stretch along with Conventional Therapy OTHER

Post-Facilitation Stretch with Conventional Physiotherapy. Participants in this group will receive post-facilitation stretch combined with conventional physiotherapy. Post-facilitation stretch will be performed with the patient in supine lying. The therapist will passively stretch the hamstring muscle to the point of first resistance, followed by a maximal isometric contraction (100% effort) for 7-10 seconds. After a brief relaxation period of 1-2 seconds, a rapid, controlled stretch will be applied and held for 15-20 seconds. This sequence will be repeated 3-5 times per session. Conventional physiotherapy will include a 5-minute moist heat pack applied to the posterior thigh before treatment, followed by static hamstring stretching (3 repetitions × 20 seconds) after the session. Sessions will be conducted three times per week for 3 weeks, with a total of 9 sessions, each session lasting approximately 30 minutes.

Post-Facilitation Stretch along with Conventional Physiotherapy

Eligibility Criteria

• Age: 20 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Diagnosed with chronic non-specific low back pain of more than 12 weeks' duration.
• Positive Straight Leg Raise (SLR) test or Active Knee Extension Test showing hamstring tightness (\<80° hip flexion with knee extended).

You may not qualify if:

• History of spinal surgery, fracture, or neurological deficit.
• Radiculopathy or red flag signs (tumor, infection, inflammatory disorders).
• Recent steroid injection therapy for low back pain (within 3 months).
• Contraindications to dry needling (bleeding disorders, infection at site, needle phobia).
• Pregnancy.
• Severe needle phobia (for DN group).

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Spine Physical Therapy and Rehabilitation Center

Peshawar, Khyber Pakhtunkhwa, 25000, Pakistan

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

• Muhmmad Affan Iqbal, PhD*

  Riphah International University, Islamabad

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Imran Amjad PT, PhD

CONTACT

03324390125; imran.amjad@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 17, 2026
• First Posted: February 23, 2026
• Study Start: February 2, 2026
• Primary Completion (Estimated): July 31, 2026
• Study Completion (Estimated): August 31, 2026
• Last Updated: February 23, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)