Effects of Slump Stretching vs Lumbar Mobilization With Exercises in Relieving Non-radiculating Low Back Pain

Study Overview
=================
Brief Summary
-----------------
This study will be conducted to determine the effects of slump stretching vs lumbar mobilization with exercises in relieving non-radiculating low back pain. There will be two groups; Group I will receive Slump stretching along with standardized exercises and Group II will receive Lumbar mobilizations along with standardized exercises.

Detailed Description
-----------------
Physical therapist commonly examines and treats patients with low back pain. For this purpose, they utilize a wide range of interventions for the management of Low back pain. The rhythmical movement is thought to modulate pain and muscle spasm by stimulating receptors within the mobilized structures while, In recent years, neurodynamic test procedures, have also been used as interventions to potentially resolve abnormal physiology within the nervous system. So for this purpose not only the present study can provide an additional evidence to the literature but also can can also demonstrates a structured Physiotherapy plan for treating the Non-Radiculating Low back pain

Official Title
-----------------
Effects of Slump Stretching vs Lumbar Mobilization With Exercises in Relieving Non-radiculating Low Back Pain

Conditions
-----------------
Low Back Pain

Intervention / Treatment
-----------------
* Other: Slump stretching
* Other: Lumbar mobilization


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Individuals with Non-Radiculating Low back pain Test: i. Slump test=positive ii. Straight leg raise=negative Exclusion Criteria: Individuals with Radiculating Low Back pain,History of spinal surgery, Disc herniation,Pregnant women, Major diseases (e.g. stroke)

Ages Eligible for Study
-----------------
Minimum Age: 15 Years
Maximum Age: 50 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The two groups will be Slump stretching group and Lumbar mobilization group. All physical therapy techniques in both groups will be applied 3 times in a week up to 2 weeks with each session consisting of 25-40 minutes. Group 1 will receive slump stretching along with standardized exercises while group 2 will recieve lumbar mobilization along with standardized exercises. Demographic details of the patients will be collected at baseline (1st Visit) while Modified Oswestry Low Back Pain Disability Questionnaire,Numeric pain rating scale,Fear-Avoidance Beliefs Questionnaire,Active range of motion (AROM) of lumbar spine and Short-Form Health Survey (SF-36) will be measured at baseline, 1st week, and final week.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Slump stretching group<br>Slump stretching will be performed with the patient in the long sitting position. The position will be held for 30 seconds. A total of 5 repetitions will be completed. Patients will also complete a standardized exercise program consisting of pelvic tilts, bridging, wall squats, and quadruped alternate arms/legs activities as described by Cleland et al. Patients will perform 10 repetitions of each exercise. | Other: Slump stretching<br>* Slump stretching will be provided to this group along with standardized exercises.<br>|
| Active Comparator: Lumbar mobilization group<br>Maitland Grade 1 - 2 Posterior to anterior lumbar spine mobilization will be applied for 30 - 45 seconds for all segments through L1 to L5 at rate of 1 oscillation per 2 seconds. Patients will also complete a standardized exercise program consisting of pelvic tilts, bridging, wall squats, quadruped alternate arms/legs activities as described by Cleland et al. Patients will perform 10 repetitions of each exercise. | Other: Lumbar mobilization<br>* Lumbar mobilizations will be provided to this group along with standardized exercises.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numeric pain rating scale | On a scale of 0 to 10, with 0 being no pain at all and 10 being the worst pain imaginable. | 2 weeks | 
| Modified Oswestry Low Back Pain Disability Questionnaire | The questionnaire has been designed to give the therapist information as to how the back pain has affected the ability to manage in everyday life. | 2 weeks | 
| Short-Form Health Survey (SF-36) | SF-36 is a set of generic, coherent, and easily administered quality-of-life measures. These measures rely upon patient self-reporting. | 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fear-Avoidance Beliefs Questionnaire | It consist of two scales; Scale 1: fear-avoidance beliefs about work Scale 2: fear-avoidance beliefs about physical activity | 2 weeks | 
| Active range of motion of lumbar spine. | It includes; lumbar flexion lumbar extension left lateral flexion right lateral flexion | 2 weeks | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
effects, slump stretching, lumbar mobilization, non radiculating, Low back pain, exercises, quality of life, modified oswestry low back pain disability, numeric pain rating scale, fear avoidance beliefs