Effects of Muscle Energy Technique and Pilates Exercises on Pain and Physical Function in Patients With Nonspecific Low Back Pain

NCT07458776 | Completed

• 1 other identifier: UOL/IREB/25/09/0044
• Study Type: interventional
• Target: 72
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized clinical trial aimed to compare the effects of Muscle Energy Techniques (METs) and Pilates exercises on pain and physical function in individuals with nonspecific low back pain. A total of 72 participants aged between 20 and 50 years were recruited from the University of Lahore Teaching Hospital, Lahore. Participants were randomly allocated into two groups: one group received Muscle Energy Techniques and the other group performed Pilates exercises. Each intervention session lasted 60 minutes, conducted four days per week for six weeks. Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS), while physical function was evaluated using the Roland Morris Disability Questionnaire (RMDQ). The results were analyzed to determine the comparative effectiveness of the two interventions in reducing pain and improving functional ability among patients with nonspecific low back pain.

Conditions

Nonspecific Low Back Pain

Keywords

Low Back Pain; Pilates Exercises; Physical Therapy; Rehabilitation; Pain Management

Outcome Measures

Primary Outcomes (1)

• Pain Intensity

  Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS), an 11-point scale ranging from 0 (no pain) to 10 (worst imaginable pain).

  Baseline and after 6 weeks of intervention

Secondary Outcomes (1)

• Physical Function

  Baseline and after 6 weeks of intervention

Study Arms (2)

Muscle Energy Technique Group

EXPERIMENTAL

Participants in this group received Muscle Energy Techniques including post-isometric relaxation and reciprocal inhibition techniques targeting the iliopsoas, quadratus lumborum, and erector spinae muscles. Each treatment session lasted 60 minutes and was conducted four times per week for six weeks.

Other: Muscle Energy Technique

Pilates Exercise Group

ACTIVE COMPARATOR

Participants in this group performed a structured Pilates exercise program including core strengthening, flexibility exercises, and postural control activities for 60 minutes per session, four times per week for six weeks.

Behavioral: Pilates Exercises

Interventions

Muscle Energy Technique OTHER

Muscle Energy Technique is a manual therapy intervention where the patient performs voluntary muscle contractions against therapist resistance followed by stretching to improve muscle flexibility, reduce pain, and enhance joint mobility.

Muscle Energy Technique Group

Pilates Exercises BEHAVIORAL

Pilates exercises are structured physical exercises focusing on core muscle strengthening, flexibility, posture improvement, and body awareness to enhance functional movement and reduce musculoskeletal pain.

Pilates Exercise Group

Eligibility Criteria

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

You may qualify if:

• Individuals aged 20-50 years
• Both males and females
• Pain lasting for at least 2-3 months
• Pain score greater than 3 on Numeric Pain Rating Scale
• Participants who had not received physiotherapy treatment for low back pain

You may not qualify if:

• History of lumbar radiculopathy
• Use of painkiller medications
• Spinal pathologies such as prolapsed disc, spinal stenosis, spondylolisthesis, vertebral fractures, or spinal infections
• Systemic diseases such as rheumatoid arthritis, ankylosing spondylitis, fibromyalgia, or malignancy
• Pregnant women
• Neurological conditions such as stroke or multiple sclerosis
• Heart conditions or psychological disorders

Sponsors & Collaborators

• University of Lahore: lead
• University of Lahore Hospital (ULH): collaborator

Study Sites (1)

University of Lahore

Lahore, Pakistan

Location

Related Publications (25)

• Lytras, D., Iakovidis, P., Sykaras, E., Kottaras, A., Kasimis, K., Myrogiannis, I., Barouxakis, A., & Tarfali, G. (2023). Effects of a tailored mat-Pilates exercise program for older adults on pain, functioning, and balance in women with chronic non-specific low back pain: a randomized controlled trial. Aging clinical and experimental research, 35(12), 3059-3071.

  BACKGROUND

• Li, W., Gong, Y., Liu, J., Guo, Y., Tang, H., Qin, S., Zhao, Y., Wang, S., Xu, Z., & Chen, B. (2021). Peripheral and central pathological mechanisms of chronic low back pain: a narrative review. Journal of pain research, 1483-1494.

  BACKGROUND

• Kripa, S., & Kaur, H. (2021). Identifying relations between posture and pain in lower back pain patients: a narrative review. Bulletin of Faculty of Physical Therapy, 26, 1-4.

  BACKGROUND

• Kersten, R., Fikkers, J., Wolterbeek, N., Öner, F., & Van Gaalen, S. (2021). Are the Roland Morris Physical function Questionnaire and Oswestry Physical function Index interchangeable in patients after lumbar spinal fusion? Journal of Back and Musculoskeletal Rehabilitation, 34(4), 605-611.

  BACKGROUND

• Kant, S., Urvashi, K. J., & Raman, R. K. (2024). Effectiveness of Core Stabilization Exercises vs. Traditional Physical Therapy for Chronic Low Back Pain. Journal of Contemporary Clinical Practice, 10, 279-287.

  BACKGROUND

• Jenks, A., Hoekstra, T., van Tulder, M., Ostelo, R. W., Rubinstein, S. M., & Chiarotto, A. (2022). Roland-Morris physical function questionnaire, Oswestry physical function index, and Quebec back pain physical function scale: which has superior measurement properties in older adults with low back pain? Journal of Orthopaedic & Sports Physical Therapy, 52(7), 457-469.

  BACKGROUND

• Hayden, J. A., Ellis, J., Ogilvie, R., Malmivaara, A., & van Tulder, M. W. (2021). Exercise therapy for chronic low back pain. Cochrane Database of Systematic Reviews(9).

  BACKGROUND

• Goudman, L., Pilitsis, J., Billet, B., De Vos, R., Hanssens, K., Billot, M., Roulaud, M., Rigoard, P., & Moens, M. (2024). The level of agreement between the numerical rating scale and visual analogue scale for assessing pain intensity in adults with chronic pain. Anaesthesia, 79(2), 128-138.

  BACKGROUND

• Frota, N. T., Fidelis-de-Paula-Gomes, C. A., Pontes-Silva, A., Pinheiro, J. S., de Jesus, S. F. C., Apahaza, G. H. S., da Silva Souza, C., Avila, M. A., & Dibai-Filho, A. V. (2022). 15-item Roland-Morris Physical function Questionnaire (RMDQ-15): structural and criterion validity on patients with chronic low back pain. BMC musculoskeletal disorders, 23(1), 978.

  BACKGROUND

• Franks, J., Thwaites, C., & Morris, M. E. (2023). Pilates to improve core muscle activation in chronic low back pain: a systematic review. Healthcare,

  BACKGROUND

• Erawan, T., Sudaryanto, S., & Nur, M. a. (2021). Effectiveness Combination Muscle Energy Technique and Strain Counterstrain Lumbar and Functional Changes to The Range of Motion in Patients With Non Specific Low Back Pain. Urban Health, 3(1), 1-10.

  BACKGROUND

• Elahi, A. R., Seidi, F., & Karimi zadeh Ardakani, M. (2021). Effect of 8 Weeks of Selected Corrective Exercises on the Lumbar Lordosis Angle and LowerLimb Function in Non-Athlete Men with Lumbar Hyper Lordosis. Journal of Safety Promotion and Injury Prevention, 9(4), 304-314.

  BACKGROUND

• El Gendy, M. H., Hekal, H. N., Kadah, M. A., Hussein, H. M., & Ewais, N. F. (2022). Pilate mat exercise versus muscle energy technique on chronic non specific low back pain. International Journal of Health Sciences, 6(S5), 3570-3583.

  BACKGROUND

• Du, S., Liu, W., Cai, S., Hu, Y., & Dong, J. (2020). The efficacy of e-health in the self-management of chronic low back pain: a meta analysis. International journal of nursing studies, 106, 103507.

  BACKGROUND

• Childress, M. A., & Stuek, S. J. (2020). Neck pain: initial evaluation and management. American family physician, 102(3), 150-156.

  BACKGROUND

• Chiarotto, A., & Koes, B. W. (2022). Nonspecific low back pain. New England Journal of Medicine, 386(18), 1732-1740.

  BACKGROUND

• Chauhan, P., Khare, K., Vachchani, K., & Kapoor, G. (2022). Effectiveness of muscle energy technique versus positional release therapy on range of motion and pain in non-specific low back pain. Indian Journal of Continuing Nursing Education, 23(1), 54-58.

  BACKGROUND

• Bogduk, N. (2022). Clinical and Radiological Anatomy of the Lumbar Spine: Clinical and Radiological Anatomy of the Lumbar Spine-E-Book. Elsevier Health Sciences.

  BACKGROUND

• Bhosale, S. V., & Burungale, M. (2022). Effectiveness of myofascial release, muscle energy technique and stretching of quadrartus lumborum muscle in patients with non-specific low back pain. J Ecophysiol Occup Health, 21, 132-141.

  BACKGROUND

• Bento, T. P. F., dos Santos Genebra, C. V., Maciel, N. M., Cornelio, G. P., Simeão, S. F. A. P., & de Vitta, A. (2020). Low back pain and some associated factors: is there any difference between genders? Brazilian journal of physical therapy, 24(1), 79-87.

  BACKGROUND

• Batıbay, S., Külcü, D. G., Kaleoğlu, Ö., & Mesci, N. (2021). Effect of Pilates mat exercise and home exercise programs on pain, functional level, and core muscle thickness in women with chronic low back pain. Journal of Orthopaedic Science, 26(6), 979-985.

  BACKGROUND

• Arul, J., & R, R. (2025). Effect of muscle energy technique versus Pilates on functional outcomes among physiotherapy students with non-specific neck pain. Bulletin of Faculty of Physical Therapy, 30(1), 8.

  BACKGROUND

• Ali, A., Saleh, M., Abdelaraouf, N., & Elazizi, H. (2022). Effect of core stabilization exercises on lumbar lordotic angle in patients with lumbar disc degeneration. Physiotherapy Quarterly, 30(4), 87-95.

  BACKGROUND

• Akram, A., Imtiaz, K., Maryem, S., Mahmood, W., Mahmood, T., & Babur, M. N. (2024). Comparison of Pilates exercises versus muscle energy technique with Kinesio taping in non-specific low back pain: a randomized controlled trial. Khyber Medical University Journal, 16(1), 3-9.

  BACKGROUND

• Ahmed, U. A., Nadasan, T., Van Oosterwijck, J., & Maharaj, S. S. (2021). Effect of dynamic stabilisation exercise therapy enhanced with muscles energy technique on some selected patients outcomes and trunk muscles function in patients with chronic non-specific low back pain: a study protocol. European Journal of Physiotherapy, 23(6), 344-354.

  BACKGROUND

MeSH Terms

Conditions

Low Back Pain; Agnosia

Interventions

Exercise Movement Techniques

Condition Hierarchy (Ancestors)

Back Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Perceptual Disorders; Neurobehavioral Manifestations; Nervous System Diseases

Intervention Hierarchy (Ancestors)

Physical Therapy Modalities; Therapeutics

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Participants were not informed about the comparative purpose of the interventions to minimize bias.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctor of Physical Therapy Student

Model Details: Two groups were formed. Participants were randomly assigned to receive either Muscle Energy Techniques or Pilates exercises for six weeks, and outcomes were compared between groups.

Study Record Dates

• First Submitted: March 4, 2026
• First Posted: March 9, 2026
• Study Start: June 30, 2025
• Primary Completion: September 25, 2025
• Study Completion: October 12, 2025
• Last Updated: March 9, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)