Effects of Bruegger's Exercises Versus Egoscue Exercise on Lower Cross Syndrome

This study aims to find effects of Bruegger's Exercise versus Egoscue exercise on pain and hyperlordosis on patient with lower cross syndrome. This is interventional study which recruits 34 participants ,14 in each group.

A randomized control trial will be conducted on patients with lower cross syndrome. A total number of 34 participants will be randomised into two groups with 17 participants in each group. Both groups will receive Hot Packs on the lumbar area for 10 minutes. Group A will receive Conventional Therapy and will follow protocol of Bruegger's Exercise. Group B will follow protocol of the Egoscue exercise. This study aims to decrease pain and hyperlordosis.

Each group will be assessed at baseline which will include pain through NPRS, hyperlordosis through flexicurve ruler and anterior pelvic tilt through pelvic inclinometer. Data from both groups will again be assessed after 4 weeks of intervention.

Protocol of Bruegger's Exercise: Pt. position: Upright sitting on a chair.

1. Sit with your buttocks at the edge of a chair.
2. Spread your legs apart slightly.
3. Turn your toes out slightly.
4. Rest your weight on your legs/feet \& relax your abdominal muscles.
5. Tilt your pelvis forward (i.e. arch your lower back) while lifting your chest up
6. Rotate your arms outward while turning your palms up.
7. Hold your head high in the air, with a slight arch in the neck.

The patient is to perform this exercise once or twice every 20-30 minutes of prolonged sitting and held in this position for 30-60 seconds. To avoid non-compliance patient will be asked to perform five repetitions of particular exercise with five second hold during their clinical session.

Protocol of Egoscue Exercise The Egoscue group received a total of 10 exercises which includes

1. Static back alone and with breathing
2. Abdominal contraction while in the static back position
3. abductor press
4. Overhead extension
5. elbow curls on a wall
6. Static wall
7. Upper spinal twist
8. pelvic tilts
9. supine groin progressive
10. Air bench exercises

Week 1: 3 times with 10 s hold time Week 2: 5 times with 10 s hold time Week 3: 15 times with 10 s hold time Week 4: 20 times with 10 s hold time

Eligibility Criteria:
Inclusion Criteria: • Females and males aged between 16 to 65 years

* Participants had to present with low back pain
* Participants had to meet the criteria for lower crossed syndrome indicating tight hip flexors (Modified Thomas test) and erector spinae (visual assessment through toe touching) together with weak glutei (Prone Hip Extension Co-ordination/Strength Test) and abdominals (Trunk Flexion Co-ordination and Strength Test)and thoracic kyphosis.
* Angle of anterior pelvic tilt \> 10 degrees

Exclusion Criteria: • Participants who would be undergoing other forms of treatment that may interfere with the study, for the duration of the study, including other manipulative and physical therapies specific to back pain.

* Presence of other conditions that may mimic low back pain, e.g. nerve entrapment.
* Participants taking any medication that may interfere with the results of this study including, pain medication, anti-inflammatory medication, and muscle relaxants.
* Surgery on the back, pelvis, or sacrum is indicated or has previously occurred
* LBP having localised or radiating pain.
* Practiced any kind of exercise or sports activity during the last 6 months.