Effects of Post Isometric Relaxation in Patients With Quadratus Lumborum Syndrome

NCT07619742 | Not Yet Recruiting

• 1 other identifier: REC/RCR&AHS/24/0143 Barira
• Study Type: interventional
• Target: 32
• Locations: 1 country
• Sites: 1

Brief Summary

The most common musculoskeletal problem in both developed and developing countries is low back pain. Quadratus lumborum syndrome is a common source of low back pain, defined as a myofascial pain syndrome characterized by pain due to spasm and stiffness of the quadratus lumborum muscle. This condition often occurs when weak back muscles are compensated by the quadratus lumborum, leading to painful muscle spasms. This study aims to determine the effects of PIR on pain, muscle endurance, and disability in patients with Quadratus Lumborum Syndrome.

Conditions

Quadratus Lumborum

Keywords

Pain; disability; muscle endurance

Outcome Measures

Primary Outcomes (4)

• low back Pain intensity

  Numeric Pain Rating Scale (NPRS): Patient level of pain will be assessed using the NPRS. It is a tool commonly used to measure pain severity on a 0-10 scale with 0 means no pain, 1-3 means mild pain, 4-6 means moderate pain and 7-10 means severe pain . Patients rate their current level of pain and their worst and least amount of pain in the last 24 hours. The average of the 3 ratings or any single rating may be used to represent the patient's level of pain . The NPRS validity is 0.86 and reliability is 0.96

  upto 4 weeks

• Muscle Endurance

  McGill's Torso Muscular Endurance Test: Muscle endurance of the quadratus lumborum will be assessed using this test. McGill's test assesses core muscle endurance through trunk flexor, trunk extensor, and right and left lateral trunk musculature tests. Participants maintain isometric postures for as long as possible and the time held in each position is recorded. The scores from the subtests are summed for an overall score. The McGill test has shown excellent reliability (ICC = 0.97-0.99).

  upto 4 weeks

• Functional Disability

  Oswestry Disability Index (ODI) Urdu Version: The ODI is a questionnaire that scores pain-related disability in patients with LBP. It is a valid measure for disability in LBP. The ODI is made up of 10 items dealing with various functional aspects. Each item is scored from 0 to 5, with higher values representing greater disability . The ODI-U has excellent test-retest reliability for total score (ICC2,1 = 0.95).

  upto 4 weeks

• Lateral Flexion

  Lateral Flexion Test: To evaluate trunk lateral flexion ROM, patients stand with their backs against a wall and feet shoulder-width apart. An initial mark is made where the middle fingertip rests on the lateral thigh. Then, they flex laterally, keeping their back and shoulders against the wall. A second mark is made where the middle fingertip moves down to on the thigh. The distance between the two marks is measured in centimeters. An average is calculated using three readings per side. lateral flexion test shows strong reliability, with intraclass correlations over 0.84.

  upto 4 weeks

Study Arms (2)

Post-Isometric Relaxation (PIR)

EXPERIMENTAL

The practitioner stands behind the side lying patient, at waist level. The patient has the uppermost arm extended over the head to firmly grasp the top end of the table and, on an inhalation, abducts the uppermost leg until the practitioner palpates strong quadratus activity (elevation of around 30° usually). The patient holds the leg isometrically in this manner, allowing gravity to provide resistance for 10-second, the patient allows the leg to hang slightly behind him over the back of the table. The practitioner straddles this and, cradling the pelvis with both hands (fingers interlocked over crest of pelvis), leans back to take out all slack and to ease the pelvis away from the lower ribs during an exhalation. The stretch should be held for between 10 and 30 seconds. Contraction followed by stretch is repeated with raised leg in front of, behind the trunk in order to activate different fibers and was given bilaterally

Other: Post-Isometric Relaxation (PIR)

Conventional Traetment

ACTIVE COMPARATOR

Core Stability Exercises TENS for 10 minutes Maitland's Mobilization

Other: Conventional Traetment

Interventions

Conventional Traetment OTHER

Maitland MobilizationPosterior-Anterior Glide will be performed on the transverse processes of the L1 to L4 vertebrae. The amplitude will initially be grade 1 and 2 for pain relief, and grade 3 and 4 will be used to improve ROM, with slow speed, smooth rhythm, and 2 to 3 oscillations per second for 30 seconds. There will be 2 to 3 sets for each vertebra

Conventional Traetment

Post-Isometric Relaxation (PIR) OTHER

The practitioner stands behind the side lying patient, at waist level. The patient has the uppermost arm extended over the head to firmly grasp the top end of the table and, on an inhalation, abducts the uppermost leg until the practitioner palpates strong quadratus activity (elevation of around 30° usually). The patient holds the leg isometrically in this manner, allowing gravity to provide resistance for 10-second, the patient allows the leg to hang slightly behind him over the back of the table. The practitioner straddles this and, cradling the pelvis with both hands (fingers interlocked over crest of pelvis), leans back to take out all slack and to ease the pelvis away from the lower ribs during an exhalation. The stretch should be held for between 10 and 30 seconds. Contraction followed by stretch is repeated with raised leg in front of, behind the trunk in order to activate different fibers and was given bilaterally

Post-Isometric Relaxation (PIR)

Eligibility Criteria

• Age: 20 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age group between 20 and 45 years (2)
• Both gender male and female
• Positive Hip hike test
• Positive Lateral flexion test (14)
• Positive McGill endurance test

You may not qualify if:

• Patients will be excluded if they are diagnosed with the following conditions;
• Radiating pain
• Paresthesia
• Numbness into buttocks or lower extremity
• Patients having low back pain of more than 12 weeks of duration (chronic)
• Spondylolisthesis
• Spondylosis
• Lumbar disc herniation

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Ittefaq Hospital

Lahore, Punjab Province, 54000, Pakistan

Location

Related Publications (1)

• Jairakdee Y, Chansirinukor W, Sitti T. Effect of releasing quadratus lumborum muscle on hip and knee muscle length in asymptomatic individuals. J Bodyw Mov Ther. 2021 Apr;26:542-547. doi: 10.1016/j.jbmt.2020.11.008. Epub 2020 Nov 7.

  PMID: 33992295 BACKGROUND

MeSH Terms

Conditions

Pain

Condition Hierarchy (Ancestors)

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

Study Officials

• Samrood Akram, PhD*

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Samrood Assistant Professor, PhD Scholar

CONTACT

+923324806143; samrood.akram@riphah.edu.pk

Sidra Khan Head of Department Ittefaq Hospital, MSPT

CONTACT

923004132720; sidra_khan5544@yahoo.com

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: SPONSOR

Study Record Dates

• First Submitted: July 3, 2025
• First Posted: June 2, 2026
• Study Start: June 6, 2026
• Primary Completion (Estimated): August 6, 2026
• Study Completion (Estimated): September 6, 2026
• Last Updated: June 2, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)