Comparing Different Physiotherapy Interventions on APT in Non Specific Low Back Pain
Comparative Analysis of Different Physiotherapy Interventions on Anterior Pelvic Tilt in Subjects With Non-Specific Low Back Pain: A Randomized Controlled Trial
National Orthopedic and General Hospital
100 participants
Mar 20, 2025
INTERVENTIONAL
Conditions
Summary
Anterior pelvic tilt (APT) is a prevalent postural deviation characterized by excessive forward rotation of the pelvis, often resulting in increased lumbar lordosis. This condition is frequently associated with non-specific low back pain (NSLBP), which affects a significant portion of the global population and poses substantial challenges for individuals' well-being and healthcare systems worldwide. NSLBP is a multifactorial condition with various etiological factors, including poor posture, muscle imbalances, sedentary lifestyle, and biomechanical abnormalities such as APT. Understanding and effectively managing APT in the context of NSLBP is crucial for reducing pain, improving functional capacity, and enhancing quality of life for affected individuals . Despite the prevalence and clinical significance of APT in NSLBP, there is a lack of comprehensive research comparing the effectiveness of different therapeutic interventions. Various approaches have been proposed, including core stability exercises, soft tissue release with manual therapy, stretching and flexibility exercises, and postural correction exercises . However, the relative efficacy of these interventions remains uncertain, hindering evidence-based decision-making in clinical practice. A variety of therapeutic interventions have been proposed for managing APT and NSLBP, aiming to address underlying biomechanical imbalances, improve musculoskeletal function, and alleviate pain. Core stability exercises, focused on strengthening the deep stabilizing muscles of the spine and pelvis, have shown promise in improving postural alignment and reducing NSLBP symptoms. Soft tissue release techniques, such as manual therapy and myofascial release, target tight and restricted muscles associated with APT, promoting relaxation and improved range of motion. Stretching and flexibility exercises aim to elongate tight musculature, particularly in the hip flexors and lumbar extensors, thereby reducing excessive pelvic tilt and alleviating NSLBP. Additionally, postural correction exercises focus on retraining optimal alignment and body mechanics, promoting a more neutral pelvic position and reducing strain on the lumbar spine.
Eligibility
Inclusion Criteria9
- Age: Participants must be between 20 and 40 years old.
- Gender: Both genders, Male and Female have equal chance of selection as participant in the study.
- Diagnosis: Participants must have a confirmed diagnosis of non-specific low back pain (NSLBP), altered lumbar posture, restricted range of motion of lumbar spine due to muscular spasm etc., altered anterior pelvic tilt angle by a qualified healthcare professional, based on standardized diagnostic criteria (e.g., clinical examination, imaging studies).
- Confirmation of Anterior Pelvic Tilt (APT): Participants exhibiting APT confirmed through physical assessment by a trained examiner. This confirmation will involve the use of standardized measures such as digital inclinometers or goniometers.
- Severity: Participants should have mild to moderate symptoms of non-specific low back pain (NSLBP) specially pain, as determined by the assessing healthcare provider.
- Physical Capability: Participants who are physically capable of performing the prescribed exercises and interventions without significant limitations.
- Consent: Participants who provide informed consent to participate in the study after receiving detailed information about the study objectives, procedures, potential risks, and benefits.
- Compliance: Participants who are willing and able to comply with the study procedures, including attending scheduled sessions, adhering to the intervention protocols, and completing required assessments.
- No Concurrent Treatment: Participants who have not undergone any concurrent treatments specifically targeting APT or low back pain during the study period to avoid confounding effects.
Exclusion Criteria12
- Trauma or Fracture: Individuals with a history of trauma or fracture around the pelvic and lumbar region, as this may significantly affect the participant's ability to perform the prescribed exercises and interventions and confound study outcomes.
- Orthopedic or Neurological Surgery: Participants with a history of orthopedic or neurological surgery related to the pelvic or lumbar region, as this may impact the participant's musculoskeletal function and response to the interventions.
- Malignancy: Individuals with a diagnosis of malignancy, as this may introduce confounding variables and complicate the interpretation of study outcomes.
- Autoimmune Disorders: Participants with autoimmune disorders affecting musculoskeletal function, as these conditions may influence the participant's response to interventions and introduce variability in study outcomes.
- Referred or Radiating Visceral Pains: Individuals experiencing referred or radiating visceral pains, as these symptoms may indicate underlying pathologies requiring specific treatment and may confound the assessment of APT and NSLBP.
- Gait Abnormalities and Neurological Disorders: Participants with gait abnormalities or neurological disorders affecting musculoskeletal function, as these conditions may influence the participant's ability to perform exercises and interventions and confound study outcomes.
- Congenital and Developmental Disorders: Individuals with congenital or developmental disorders affecting musculoskeletal function, as these conditions may introduce variability in study outcomes and complicate the interpretation of results.
- Pregnancy: Pregnant individuals will be excluded from the study due to the potential risks associated with certain physiotherapy modalities and the need for specialized considerations in this population.
- Contraindications: Participants with contraindications to specific physiotherapy modalities included in the study protocol (e.g., contraindications to electrotherapy) will be excluded to ensure participant safety.
- Inability to Attend Sessions: Participants who are unable to attend scheduled physiotherapy sessions due to logistical constraints (e.g., transportation issues, scheduling conflicts) will be excluded.
- Cognitive Impairment: Participants with significant cognitive impairment or communication difficulties that may impede their ability to understand and follow study instructions will be excluded.
- Participation in Other Research: Participants who are currently participating in other research studies involving treatment interventions for MPS and/or radiculopathy will be excluded to avoid potential confounding effects on outcomes and treatment adherence.
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Interventions
electrotherapy modalities for pain control will be used and exercises strengthening abdominal core muscles will be applied in two phases.
Manual soft tissue release will be performed and then stretching of back muscles and thigh muscles will be added to treatemnet.
Hot and cold packs will be used one after other for 10-15mins and specific exercises which are designed to improve posture will be taught and performed
some pain reducing electrotherapy modality like TENS will be used and general stretching and flexibility exercises will be performed
Locations(1)
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NCT07098741