Comparing the Effects of Muscle Energy Technique Versus Myofascial Mobilization in Managing Sub-acute Low Back Pain

Study Overview
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Brief Summary
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Institute for Clinical Systems Improvement (ICSI) defines sub-acute low back pain as low back pain lasting between 4 and 12 weeks. There is insufficient evidence regarding the comparative effect of muscle energy technique and myofascial mobilization in the management of sub-acute non-specific low back pain with the tightness of quadratus lumborum and erector spinae muscles

Detailed Description
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A randomized experimental controlled trial will be carried out to compare the effectiveness of muscle energy technique and myofascial mobilization in the management of sub-acute non-specific low back pain. A total of 60 male and female volunteers having subjects with sub-acute nonspecific low back pain will be recruited in this study. Subjects will be assessed at baseline for pain and disability using Visual Analogue Scale and Ronald Morris Disability Questionnaire (RMDQ 0-24) respectively. After baseline assessment, all subjects will be allocated to two groups through computer-generated random sampling. Group 1 will perform Muscle energy technique combined with conventional exercise; Group 2 will receive Myofascial Mobilization combined with conventional exercise. This study will be conducted at the Physiotherapy Department of Sindh Institute of Physical Medicine and Rehabilitation (SIPM&R). Data will be analyzed using SPSS 21 and ANCOVA technique will be used in this study.

Official Title
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Effectiveness of Muscle Energy Technique Versus Myofascial Mobilization in Improving Functional Outcome in Sub-acute Non-specific Low Back Pain: A Randomized Controlled Trial

Conditions
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Lordosis, Low Back Pain

Intervention / Treatment
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* Other: Physiotherapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Sub-acute low back pain with the range of 7 to 12 weeks of unresolved symptoms. Positive test of tight Erector spinae muscle and Tight Quadratus Lumboram muscle Exclusion Criteria: Spinal malignancy Spinal fracture Spine foraminal stenosis Nerve root compression Radicular symptoms Sciatica Cord compression Paralysis Muscular dystrophy Myelopathy Seizure disorder Severe trauma Unexplained weight loss

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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All

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: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Muscle Energy Techniques<br>Following physiotherapy will be given to the participants in this group for 4 weeks, 3 times a week: 1. Muscle Energy Technique | Other: Physiotherapy<br>* Conventional treatment consisted of Transcutaneous Electrical Nerve Stimulation and Progressive Back Strengthening Exercise<br>|
| Active Comparator: Myofascial Mobilization Techniques<br>Following physiotherapy will be given to the participants in this group for 4 weeks, 3 times a week: 1. Myofascial Mobilization | Other: Physiotherapy<br>* Conventional treatment consisted of Transcutaneous Electrical Nerve Stimulation and Progressive Back Strengthening Exercise<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual Analogue Scale | The visual analogue scale is used for measurement of pain intensity. It is a continuous scale. It comprises a horizontal or vertical 10 centimeters or 100 millimeters line. The participant is asked to indicate a point of pain intensity by placing a line perpendicular to the Visual analogue scale line. The scale is most commonly referred by no pain with score of 0 and worst imaginable pain with score of 100 on the scale. The higher scores shows higher pain intensity and lower scores shows lower pain intensity. | Change from baseline pain intensity at 4 weeks | 
| Rolland Morris Disability Questionnaire | It is a standard questionnaire with questions regarding pain and the disabling effect on daily activities. Its score ranges from 0 to 24 (no disability to maximum disability) | Change from baseline functional disability at 4 weeks |