Effects of Post-Isometric Relaxation and Myofascial Release on Low Back Pain With Lower Cross Syndrome

NCT07496099 | Not Yet Recruiting DMC

• 1 other identifier: MPhil-DPT-Hamstring-2026
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial aims to evaluate the combined effects of post-isometric relaxation and myofascial release on pain, flexibility, and functional disability in individuals with low back pain associated with lower cross syndrome. Eligible participants aged 18 to 45 years will be randomly allocated into two parallel intervention groups. One group will receive post-isometric relaxation combined with myofascial release, while the comparison group will receive conventional stretching combined with Therapeutic modalities. Outcomes will be assessed at baseline and after completion of the intervention period. The results of this study are expected to contribute to evidence-based physiotherapy management of low back pain associated with postural imbalance.

Conditions

Low Back Pain, Mechanical; Lower Cross Syndrome; Hamstring Muscle Tightness

Keywords

Hamstring Tightness; Post-Isometric Relaxation with Myofascial Release; low back pain with lower cross syndrome

Outcome Measures

Primary Outcomes (1)

• Hamstring Flexibility

  Hamstring flexibility will be assessed using Active Knee Extension (AKE) test measured in degrees with a goniometer.

  Outcome measures will be assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)

Secondary Outcomes (3)

• pain intensity

  assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)

• functional flexibility

  Outcome measures will be assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)

• posture assesment

  Outcome measures will be assessed at baseline, immediately after the first session, after 36 sessions at 12 weeks (3 months), and after 72 sessions at 24 weeks (6 months)

Study Arms (2)

Post-Isometric Relaxation and Myofascial Release Group

EXPERIMENTAL

Participants in this group will receive post-isometric relaxation combined with myofascial release targeting the hamstring muscles as part of a supervised physiotherapy program.

Other: post isometric relaxation; Other: MYOFASCIAL RELEASE

Conventional Stretching and modalities Group

ACTIVE COMPARATOR

Participants in this group will receive conventional static hamstring stretching combined with therapeutic modalities, including ultrasound or superficial heat, as part of standard physiotherapy care.

Other: Conventional Static Stretching; Other: Therapeutic Modalities

Interventions

post isometric relaxation OTHER

Post-isometric relaxation will be applied to the hamstring muscles. Participants will be positioned supine with the hip flexed to 90 degrees and will perform a submaximal isometric contraction of the hamstrings against therapist resistance for 5 to 8 seconds, followed by a passive stretch of approximately 10 seconds. The procedure will be repeated three times per limb per session.

Post-Isometric Relaxation and Myofascial Release Group

MYOFASCIAL RELEASE OTHER

Myofascial release will be applied to the hamstring muscles with the participant in a prone position. Sustained manual pressure will be applied along the length of the hamstring muscles using the therapist's hands for approximately 30 seconds per application, repeated multiple times per session to improve tissue extensibility.

Post-Isometric Relaxation and Myofascial Release Group

Conventional Static Stretching OTHER

Conventional static stretching of the hamstring muscles will be performed with the participant in a supine position. Each stretch will be held for approximately 30 seconds and repeated three times per limb per session as part of routine physiotherapy management.

Conventional Stretching and modalities Group

Therapeutic Modalities OTHER

Therapeutic modalities, including ultrasound therapy or superficial heat application using a heating pad, will be applied prior to stretching to reduce pain and improve tissue extensibility as part of conventional physiotherapy care.

Conventional Stretching and modalities Group

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Participants aged 18-45 years old
• having low back pain persisting for at least 4 weeks
• with clinical diagnosis of LCS, and hamstring tightness (AKE \>15°)

You may not qualify if:

• Participants with the history of spinal surgery active neurological conditions
• systemic disease affecting connective tissue (Rheumatoid arthritis, Systemic lupus erythematosus)
• recent lower limb or spinal injury (within 6 months)
• pregnancy or inability to lie prone for treatment.

Sponsors & Collaborators

• University of Karachi: lead
• IQRA University: collaborator

Study Sites (1)

Department of Physiotherapy, University of Karachi

Karachi, Sindh, Pakistan

Location

MeSH Terms

Conditions

Low Back Pain

Interventions

Myofascial Release Therapy

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Massage; Therapy, Soft Tissue; Musculoskeletal Manipulations; Complementary Therapies; Therapeutics; Physical Therapy Modalities; Rehabilitation

Study Officials

• Basit Ansari, PhD

  University of Karachi

  STUDY CHAIR

• Bushra Madad Ali Malik, DPT

  University of Karachi

  PRINCIPAL INVESTIGATOR

• Aftab Ahmed Mirza Baig, PhD

  IQRA University

  STUDY DIRECTOR

Central Study Contacts

Bushra Madad Ali Malik, DPT

CONTACT

+92305 2722589; bushramalik0910@gmail.com

Aftab Ahmed Mirza Baig, PhD

CONTACT

+923002739920; dr.aftab@iqra.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: This study will be single-blinded. The outcome assessor will be blinded to group allocation to minimize assessment bias. Due to the nature of the interventions, participants and treating physiotherapists cannot be blinded.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: March 22, 2026
• First Posted: March 27, 2026
• Study Start: March 25, 2026
• Primary Completion (Estimated): September 15, 2026
• Study Completion (Estimated): October 20, 2026
• Last Updated: March 27, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)