Myofascial Release and Mobilization With Impulse Technique Torsion in Low Back Pain

Study Overview
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Brief Summary
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The purpose of the current randomized clinical trial was to compare the effectiveness of myofascial soft tissue release versus mobilization with impulse technique torsion (anterior) on pain, disability, and kinesiophobia in individuals with chronic non-specific low back pain.

Detailed Description
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Design: Randomized Clinical Trial. Objective: to determine the effects of myofascial soft tissue release versus mobilization with impulse technique torsion (anterior) on pain, disability and kinesiophobia in individuals with chronic non-specific low back pain. Methods and Measures: sixty-four individuals will be randomly assigned to one of two groups. Intervention: For 12-week, the group 1 will undergo treatment comprising a myofascial soft tissue release protocol (1/week) and the group 2 will receive a mobilization with impulse technique torsion (anterior) (1/week). Main Outcome Measures: Intensity of pain, disability, fear of movement, isometric endurance of trunk flexor muscles and lumbar mobility in flexion data will be collected at baseline, and 24hr after the last manual therapy application. Mixed-model analyses of variance will be used to examine the effects of the treatment on each outcome measure.

Official Title
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Effects of Myofascial Soft Tissue Release and Mobilization With Impulse Technique Torsion in Subjects With Chronic Non-specific Low Back Pain: A Randomized Clinical Trial

Conditions
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Low Back Pain, Chronic Disease

Intervention / Treatment
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* Other: Myofascial Soft Tissue Release
* Other: Mobilization with impulse technique.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Score ≥4 on the Roland Morris Disability Questionnaire Inability to achieve lumbar muscle flexion-relaxation in trunk flexion Low back pain for ≥3 months Not undergoing another physical therapy treatment Exclusion Criteria: Disease of the central or peripheral nervous system Having previously undergone spinal manipulative therapy Contraindication to low back thrust manipulation A history of spinal surgery Treatment with corticosteroid in the past two weeks Clinical signs of radiculopathy Presence of lumbar stenosis Diagnosis of spondylolisthesis

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 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: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Myofascial Soft Tissue Release<br>Protocol: Transverse Plane-Level Clavicular Release. Diaphragmatic Transverse Plane Release. Square the Lumbar Fascia Release. Gluteal Fascia Release. Hint Of Pubic Region Release. Fascia Psoas Release. Lumbo-sacral Decompression. Pelvic Floor Release. | Other: Myofascial Soft Tissue Release<br>* Protocol: Transverse Plane-Level Clavicular Release. Diaphragmatic Transverse Plane Release. Square the Lumbar Fascia Release. Gluteal Fascia Release. Hint Of Pubic Region Release. Fascia Psoas Release. Lumbo-sacral Decompression. Pelvic Floor Release.<br>|
| Active Comparator: Mobilization with impulse technique<br>Subject in lateral decubitus with extension and lower limb traction contact the couch with contralateral lower limb was performed triple flexion and left trunk rotation. This technique reduces the slack (tension joints) of the ventral pelvis, head and into the contralateral side of the sacrum support (base) with the forearm. | Other: Mobilization with impulse technique.<br>* Subject in lateral decubitus with extension and lower limb traction contact the couch with contralateral lower limb was performed triple flexion and left trunk rotation. This technique reduces the slack (tension joints) of the ventral pelvis, head and into the contralateral side of the sacrum support (base) with the forearm.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in Roland Morris Disability Questionnaire (RMDQ) | This is a self-reported questionnaire consisting of 24 items reflecting limitations in different activities of daily living attributed to low back pain including walking, bending over, sitting, lying down, dressing, sleeping, self-care and daily activities. | At baseline, 12 weeks and 16 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in Oswestry Low Back Pain Disability Index (ODI) | The ODI has 10 items referring to activities of daily living that might be disrupted by low back pain. Each item is answered on a 6-point Likert scale ranging from no problem at all [0] to not possible [5]. The total score ranges from 0 to 50. | At baseline, 12 weeks and 16 weeks | 
| Change from baseline in Numerical Pain Rating Scale | A 10-point Numerical Pain Rating Scale (NPRS; 0: no pain, 10: maximum pain) assesses the patients' current level of pain, and the worst and lowest level of pain experienced in the preceding 24 hours. | At baseline, 12 weeks and 16 weeks | 
| Change from baseline in Tampa Scale of Kinesiophobia | The Tampa Scale of Kinesiophobia (TSK) is a 17-item questionnaire developed to measure the fear of movement and (re)injury. Each item is scored on a four-point Likert scale ranging from strongly disagree [1] to strongly agree [4]. | At baseline, 12 weeks and 16 weeks | 
| Change from baseline in Isometric endurance of trunk flexor muscles | The McQuade test measures the isometric resistance of abdominal muscles in seconds. | At baseline, 12 weeks and 16 weeks | 
| Change from baseline in Lumbar mobility in flexion | Lumbar mobility in flexion is determined by measuring the finger-to-floor distance with a tape. | At baseline, 12 weeks and 16 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Low Back Pain, Chronic Pain, Manipulation, Manual Therapy, Randomized Controlled Trial