Comparative Effects of Autogenic Inhibition vs Reciprocal Inhibition in Patients With Lower Cross Syndrome

NCT07838558 | Recruiting

• 1 other identifier: FUI/FUCP/CTR/MSMSK/MomnaKhadim
• Study Type: interventional
• Target: 46
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial aims to compare the effectiveness of Autogenic Inhibition Muscle Energy Technique (MET) and Reciprocal Inhibition MET in individuals with Lower Crossed Syndrome. Participants will be randomly assigned to two intervention groups. One group will receive Autogenic Inhibition MET, while the other will receive Reciprocal Inhibition MET for the iliopsoas, rectus femoris, and erector spinae muscles. Both groups will also perform the same standardized strengthening exercises targeting the transversus abdominis, gluteus maximus, and gluteus medius muscles to improve muscle balance and functional outcomes.

Conditions

Lower Cross Syndrome

Outcome Measures

Primary Outcomes (5)

• Lumbar Extensor Muscle Length

  The Modified Schober's Test will be used to assess lumbar extensor muscle length and lumbar spine mobility. The increase in distance between standardized spinal landmarks during maximal forward flexion will be measured and recorded in centimeters (cm). A greater increase in distance indicates greater lumbar extensor flexibility or length.

  Baseline & after 6 weeks of intervention.

• Functional Movement dysfunction

  Functional Movement Screen will be used to assess functional movement dysfunction. It consists of seven tests, scored on a 0-3 scale, with a total score ranging from 0 to 21. Lower scores indicate greater movement dysfunction.

  Baseline and after 6 Weeks of intervention.

• Back Pain

  Pain intensity will be assessed using the Numerical Pain Rating Scale, ranging from 0 (no pain) to 10 (worst possible pain). Participants reporting pain intensity scores of 0-6 on the NPRS will be eligible for inclusion in the study.

  Baseline and after 6 Weeks of intervention.

• Functional Disability

  Functional disability will be assessed using the Oswestry Disability Index (ODI), a 10-item questionnaire, with each item consisting of six response options.

  Baseline and after 6 Weeks of intervention

• Lumbar Range Of Motion

  Lumbar spine range of motion (ROM) will be assessed using inclinometer, including lumbar flexion, extension, and lateral flexion. Lumbar ROM will be determined by measuring the difference between the readings obtained at the T12 and S2 spinal landmarks.

  Baseline and after 6 Weeks of invention

Study Arms (2)

Autogenic Inhibtion (Group A)

ACTIVE COMPARATOR

Group A will receive Autogenic inhibition using PFS, preceded by 10 minutes heating pad application. 30% Isometric contraction(7-10 sec), followed by relaxation \& 30 sec stretch, will be repeated 3-5 time. From Weeks 3-6, strenghtening exercises for hip extensors \& Transverse Abdominis will be performed.

Procedure: Autogenic Inhibition (Group A)

Reciprocal Inhibition (Group B)

EXPERIMENTAL

Group B will receive Reciprocal Inhibition using using MET,preceding by a 10 minute heating pad application. A 30% isometric contraction(7-10 sec) of antagonist muscle, followed by relaxation \& 30-60sec passive stretch, will be repeated 3-5 times. From 3-6 weeks strenghening exercises for hip extensor \& transverse abdominis will be performed.

Procedure: Reciprocal Inhibition

Interventions

Autogenic Inhibition (Group A) PROCEDURE

Experimental Group 1 will receive MET based on autogenic inhibition using Modified Post-Facilitation Stretch (PFS) for the iliopsoas, rectus femoris, and erector spinae. For the iliopsoas, subjects will assume modified Thomas position and perform a 30% isometric contraction for 7-10 seconds, followed by relaxation and hip extension stretching for 30 seconds. For rectus femoris, the procedure will be performed in modified Thomas position with knee flexion, followed by hip extension and knee flexion stretching for 30 seconds. For erector spinae, subjects will sit with legs hanging and arms crossed, perform a 30% isometric contraction for 7-10 seconds, followed by trunk flexion for 30 seconds. Each technique will include 30-second rest and 3-5 repetitions. From the 3rd to 6th week, strengthening will include TA activation, gluteus maximus bridging, and gluteus medius abduction.

Autogenic Inhibtion (Group A)

Reciprocal Inhibition PROCEDURE

Experimental Group 2 will receive MET based on reciprocal inhibition for the iliopsoas, rectus femoris, and erector spinae. For the iliopsoas, subjects will assume modified Thomas position and perform a 30% isometric contraction of the gluteus maximus for 7-10 seconds, followed by relaxation and passive hip extension stretching for 30-60 seconds. For rectus femoris, subjects will assume modified Thomas position followed by a 30% isometric hamstring contraction for 7-10 seconds and passive stretching into hip extension with knee flexion for 30-60 seconds. For Erector Spinae, subjects will sit with legs hanging and perform a 30% isometric transverse abdominis contraction for 7-10 seconds, followed by trunk flexion for 30-60 seconds. From the 3rd to 6th week, strengthening will include TA activation, gluteus maximus bridging, and gluteus medius abduction.

Reciprocal Inhibition (Group B)

Eligibility Criteria

• Age: 19 Years - 35 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age 19-35 years.
• Both genders will include in this study.
• According to Janda's Approach, Clinical diagnosis of LCS based on ≥3 positive clinical tests.
• Patient with positive modified Thomas test, Patients with a positive testing of prone hip extension test, Patients with a positive test of trunk flexion test, Patients with tight erector spinae muscles.
• Participants with no lumbar pain to moderate lumbar pain (NPRS0-6) will be included.
• Painless movement and activity.
• Pain only produced by sustained loading in relevant position, which is then relieved after maintaining a corrected posture for 5 minutes, indicating posture-related pain.

You may not qualify if:

• Leg symptoms when walking, eased in flexion (Signs of stenosis)
• Pain due to repetitive movement
• Lumbar Radiculopathy
• Neurological Symptoms (Paresthesia/numbness)
• Structural deformity (Kyphosis, lordosis, scoliosis, spondylosis, spondylolysis, spondylolisthesis)

Sponsors & Collaborators

• Foundation University Islamabad: lead

Study Sites (1)

Foundation University College of Physical Therapy

Islamabad, Punjab Province, 44000, Pakistan

RECRUITING

Central Study Contacts

Momna Khadim, DPT

CONTACT

03321569497; momnakhadim117@gmail.com

Hafiz Ali Bin Asim, MS-SPT

CONTACT

03135088144; pt.ali.asim@gmail.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: September 18, 2026
• First Posted: September 24, 2026
• Study Start: February 12, 2026
• Primary Completion (Estimated): December 18, 2026
• Study Completion (Estimated): January 18, 2027
• Last Updated: September 24, 2026

Record last verified: 2026-09

Locations

PA (1)