Effect of Diaphragm Manual Therapy With Conventional Physical Therapy in Chronic Non-Specific Low Back Pain Patients
Condition: Low Back Pain; Chronic Low-back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      A randomized single-blind clinical study will be performed. A sample size of 34 patients
      including only male gender, will be taken from various clinical settings of Faisalabad.
      Non-probability purposive sampling technique will be used. Patients will be randomly
      allocated into two groups. Treatment Group A will perform Conventional Physical Therapy and
      Diaphragm Manual Therapy and Group B will perform Conventional Physical Therapy and Sham
      Diaphragm Manual Therapy. Numerical Pain Rating Scale and lumbar range of motion scores will
      be assessed at pre-treatment, 2nd-week post-treatment and 4th-week post-treatment. Oswestry
      Disability Index scores and Short Form 12 Health Survey Questionnaire will be assessed at
      pre-treatment and 4th-week post-treatment. Statistical analysis will be performed on
      Statistical Package for the Social Sciences Version 25.
    

Detailed description: 
      Over 80% of people experience Lower back pain in their lives, of which 23% suffer from
      chronic pain. Physiotherapists use multiple treatment options for treating non-specific
      chronic low back pain such as joint mobilization, therapeutic exercises, electrotherapeutic
      modalities and soft tissue release techniques.

      The objective of the study is to determine the effect of conventional physical therapy with
      or without diaphragm manual therapy in patients with chronic non-specific low back pain.

      A randomized, single-blind clinical study will be performed. A sample size of 34 patients
      comprising of only male gender will be taken from various clinical settings of Faisalabad.
      Non-probability purposive sampling technique will be used. Patients will be randomly
      allocated into two groups. Treatment Group A will perform Conventional Physical Therapy and
      Diaphragm Manual Therapy and Group B will perform Conventional Physical Therapy and Sham
      Diaphragm Manual Therapy. Numerical Pain Rating Scale and lumbar range of motion scores will
      be assessed at pre-treatment, 2nd-week post-treatment and 4th-week post-treatment. Oswestry
      Disability Index scores and Short Form 12 Health Survey Questionnaire will be assessed at
      pre-treatment and 4th-week post-treatment.

      Statistical analysis will be performed on Statistical Package for the Social Sciences Version
      25. Mean ± Standard Deviation will be used to present Quantitative variables while
      Qualitative variables will be shown through frequency tables and percentages will be shown in
      the form of frequency tables and percentages. Summary of group measurements will be
      represented through Graphs. Normal distribution of data will be analyzed through skewness,
      kurtosis and Shapiro wilk test. If data is found normally distributed, then parametric tests
      will be applied, which will include an Independent sample t-test for measuring inter-group
      changes. Paired Sample t-test/Repeated measure ANOVA for measuring intra-group differences.
      If data is found non-normally distributed, then non-parametric tests will be applied, which
      will include Mann-Whitney U-Test for measuring inter-group changes and Wilcoxon Test/Friedman
      Test for measuring intra-group differences. P-value ≤ 0.05 will be taken as significant.
    

Intervention name(s): Manual Diaphragm Technique; Conventional Physical Therapy; Sham Diaphragm Manual Technique
Intervention type(s): Other; Other; Other
Intervention description(s): Treatment group will receive Manual Diaphragm Technique in addition to Conventional Physical Therapy. Therapist will make physical contact to the underside of the 7th to 10th rib costal cartilages. During the inspiratory phase, the therapist will use both hands to gently pull the points of contact in the direction of the head. During exhalation, the therapist will maintain resistance. The procedure will be done in two sets of ten deep breaths, separated by a one-minute pause.; Conventional Physical Therapy group comprises electrotherapeutic treatment and exercise plan. Subjects will undergo a thermal continuous ultrasound, conventional transcutaneous electrical nerve stimulation and a hot pack.
Stretching activities for the back, iliopsoas, and hamstring muscles, as well as abdominal muscle strengthening exercises, will be included in the workout.; The Control group will also receive a sham diaphragm release technique. The therapist and participant will have the same manual contacts, duration, and placement as the treatment group, but the therapist will simply use a light touch with the same anatomical landmarks and will not apply pressure.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Low Back Pain, Manual Therapy, Conventional Physical Therapy