Muscle Energy Technique Versus Back Stretching Among Non-specific Low Back Pain-subacute

Study Overview
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Brief Summary
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This study will highlight LBP management using MET and stretching application among subacute type of back pain

Detailed Description
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This study will explore effects of two approaches , out of two MET has not been used in clinical practice more often, therefore this study will explore its physiological impact among back pain

Official Title
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Effects of Muscle Energy Technique and General Stretching in the Management of Sub-acute Non-specific Low Back Pain :A Randomized Control Trial

Conditions
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Low Back Pain

Intervention / Treatment
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* Other: Muscle energy technique of erector spinae muscle
* Other: Muscle energy technique of quadratus lumborum muscle
* Other: Stretching of erector spinae muscle
* Other: Stretching of quadratus lumborum muscle
* Other: Back strengthening exercises
* Other: Thermotherapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - low back pain (subacute) VAS score( more than 3 cm) Quadratus lumborum and erector spinae tightness present Exclusion Criteria: back pain (specific)

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 45 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
Interventional Model Description: Single blinding will be used in which only the researcher doing the study knows which treatment or intervention the participant is receiving until the trial is over.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Muscle energy technique+ Thermotherapy +Back Strengthening exercise<br> | Other: Muscle energy technique of erector spinae muscle<br>* Therapist will develop cross hand position left hand on lower thoracic and right hand on sacrum. Patient will asked to lift shoulder out of couch to contract the lumber erector spinae and apply force twenty percent against therapist force and keep this position of muscle contraction 7 to 10 seconds then 5 second relax . Then therapist will take new position of muscle restriction by slacking and will hold 30 second that position at the end of restriction then will finally end stretch with three repetition. Muscle energy technique of erector spinae muscle.<br>Other: Muscle energy technique of quadratus lumborum muscle<br>* Therapist will take step over the patient off leg and squeezes gently with their thigh. Patient will abduct leg with 20 percent force against the resistance of therapists thigh for 7 to 10 second. the therapist gently and passively will move patient leg towards adduction by squatting down slowly. Therapist at same time with both hands cradling the iliac crest of pelvic for 30 second stretch and 3 repetition.<br>Other: Back strengthening exercises<br>* Supine Abdominal Draw In Supine Butt Lift with Arms at Side Abdominal Draw In with Heel Slide Abdominal Draw In with Knee to Chest Abdominal Draw In with feet on the ball Abdominal Draw In with feet on the ball- add movement<br>Other: Thermotherapy<br>* Ten minute duration of hot pack given on low back for local superficial heat.<br>|
| Active Comparator: General stretching+ Thermotherapy +Back Strengthening exercise<br> | Other: Stretching of erector spinae muscle<br>* The therapist standing on the side in a way to place his elbow placed on erector spine and apply stretching on the muscle belly in the direction of longitudinal or transverse plane( figure 1).Duration of stretch will be 15 seconds and four repetition.<br>Other: Stretching of quadratus lumborum muscle<br>* Placing patient's legs to one side of the table and upper body also move to the same side in lateral flexion. This position generate a basic gentle stretch of the muscle. The therapist use elbow on tight/ flat part of muscle belly to stretch out the muscle(figure 2). Duration of stretch will be 15 seconds and four repetition<br>Other: Back strengthening exercises<br>* Supine Abdominal Draw In Supine Butt Lift with Arms at Side Abdominal Draw In with Heel Slide Abdominal Draw In with Knee to Chest Abdominal Draw In with feet on the ball Abdominal Draw In with feet on the ball- add movement<br>Other: Thermotherapy<br>* Ten minute duration of hot pack given on low back for local superficial heat.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from Visual Analogue scale scores at 3 weeks | It is subjective outcome measure for pain intensity on 1 to10 cm scores. The '0 cm' score refers no pain and '10 cm' refers more excruciating pain. Increase in scores suggest worst pain intensity. | at baseline and 3 weeks | 
| Change from Rolland Morris Disability Questionnaire scores at 3 weeks | It is explore area of function leading to understand the level of disability. It consists of total 24 scores. The '0' score refers no disability and '24' refers maximum disability. Increase in scores suggest worst disability. | at baseline and 3 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Low back pain