Effect of Global Postural Reeducation (GPR) Program With Hamstring Stretch for Patients With Low Back Pain

Study Overview
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Brief Summary
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The purpose of this study is to find out the additional effect of global re-education program with hamstring stretching in patients with low back pain.

Detailed Description
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Low back pain (LBP) is a very common health problem worldwide and a major cause of disability which affecting performance at work and general well-being. LBP is a complicated condition which affects the physiological and psychosocial aspects of the patient. The muscles of the low back provide the strength and mobility for all activities of daily living. The purpose of this study is to find out the additional effect of global re-education program with hamstring stretching in patients with low back pain.

Official Title
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Effect of Global Postural Reeducation Program With Hamstring Stretch for Patients With Low Back Pain

Conditions
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Back Pain

Intervention / Treatment
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* Other: Global Postural Reeducation Program
* Other: Hamstring Stretch Program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Females 18-35 years Low back pain > 3 month no exercise for last 6 months Exclusion Criteria: Any diagnosed pathology (disc herniation, lumbar stenosis, spinal deformity, fracture, spondylolisthesis) Any lower limb abnormality Congenital deformities Central or peripheral neurologic signs Systemic illness (tumor and rheumatologic diseases), Psychiatric and mental deficits Diabetic neuropathy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Global Postural Reeducation Program<br>Global Postural Reeducation Program with hamstring stretch | Other: Global Postural Reeducation Program<br>* Global Postural Reeducation Program with hamstring stretch The lying posture with flexion of the legs aimed to stretch the posterior chain (upper trapezius, levator scapulae, sub occipital, erector spinae, gluteus maximus, ischio-tibial, triceps surae, and foot intrinsic muscles). The initial position will lying with the hip flexed and progression consisted of increasing hip flexion, knee extension, and dorsiflexion of the ankle All above exercises will be given and to be held for 15 minutes each. 40 min/session, 3 times/week for 6 weeks<br>|
| Active Comparator: Hamstring Stretch Program<br>Hamstring Stretch Program and Knee -flexor eccentric training | Other: Hamstring Stretch Program<br>* Hamstring Stretch Program 3 times for 30 seconds hold, subjects rested for 15 seconds between stretches. Knee -flexor eccentric training to prevent hamstring muscle strain 10-15 rep 40 min/session, 3 times/week for 6 weeks<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Oswestry Disability Index (ODI) | The Oswestry Disability Index (also known as the Oswestry Low Back Pain Disability Questionnaire) is an extremely important tool that researchers and disability evaluators use to measure a patient's permanent functional disability. The test is considered the 'gold standard' of low back functional outcome tools. For each section the total possible score is 5: if the first statement is marked the section score = 0; if the last statement is marked, it = 5. 0% to 20%: minimal disability 81%-100% exaggerating symptoms. | 6th week | 
| Numeric Pain Rating Scale | A numerical rating scale (NRS) requires the patient to rate their pain on a defined scale. For example, 0-10 where 0 is no pain and 10 is the worst pai | 6th week | 
| Goniometry | A goniometer is an instrument which measures the available range of motion at a joint. A large Universal Goniometer having 12-inch arms and full-circle plastic body will be used for measuring Assisted Range of Motion (AROM) for hamstring length, it is a useful measurement tool that can be used to do the Active knee extension test. An active knee-extension test has been shown to be a reliable method of assessing hamstring tightness and has good intra-tester reliability [intraclass correlation coefficient (ICC): 0.97-0.98] | 6th week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Low Back Pain, Oswestry Disability Index, Numeric Pain Rating Scale, Stretch