William Training Versus Hold Relax Stretching of Iliopsoas Muscle

Study Overview
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Brief Summary
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Hyper lordosis is a condition in which there is an excessive spine curvature in the lower back. Hyper lordosis is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population Only a small proportion of people have a well understood pathological cause-eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain.Hyper lordosis creates a characteristic C-shaped curve in the lower back, or lumbar region, where the spine curves inward just above the buttocks. It often occurs as a result of poor posture or a lack of exercise. Hyperlordosis can cause muscle tightening and stiffness in the lower back. It can also damage the spine and soft tissues in the lumbar region. Hyperlordosis leads to excessive curvature of the spine in the lower back, causing the abdomen and buttocks to appear more prominent in profile view. People with hyperlordosis may experience mild to severe lower back pain, which may worsen with movement. Various conservative treatments are used to treat hyperlordosis and low back pain due to hyperlordosis. Most commonly used are the manual therapy techniques that employ William's protocol and hold relax stretching of iliopsoas muscle at lumbar spine. This study will be randomized control trial used to compare the effects of William protocol and hold relax stretching of iliopsoas muscle in subjects with hyperlordosis and low back pain. Subjects meeting the predetermined inclusion and exclusion criteria will be divided into two groups using lottery method. Pre assessment will be done using LUMBAR SPINE QUESTIONNAIRE as subjective measurements and NPRS as objective measurements. Subjects in one group will be treated using William's protocol and the other one will be treated with hold relax stretching of iliopsoas muscle. Each subject will receive 08 treatment sessions with 02 treatment sessions per week. Post treatment reading for NPRS and lumbar spine questionnaire will be recorded after every week.

Detailed Description
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Hyper lordosis is a condition in which there is an excessive spine curvature in the lower back. Hyper lordosis is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population Only a small proportion of people have a well understood pathological cause-eg, a vertebral fracture, malignancy, or infection. People with physically demanding jobs, physical and mental comorbidities, smokers, and obese individuals are at greatest risk of reporting low back pain.Hyper lordosis creates a characteristic C-shaped curve in the lower back, or lumbar region, where the spine curves inward just above the buttocks. It often occurs as a result of poor posture or a lack of exercise. Hyperlordosis can cause muscle tightening and stiffness in the lower back. It can also damage the spine and soft tissues in the lumbar region. Hyperlordosis leads to excessive curvature of the spine in the lower back, causing the abdomen and buttocks to appear more prominent in profile view. People with hyperlordosis may experience mild to severe lower back pain, which may worsen with movement. Various conservative treatments are used to treat hyperlordosis and low back pain due to hyperlordosis. Most commonly used are the manual therapy techniques that employ William's protocol and hold relax stretching of iliopsoas muscle at lumbar spine. This study will be randomized control trial used to compare the effects of William protocol and hold relax stretching of iliopsoas muscle in subjects with hyperlordosis and low back pain. Subjects meeting the predetermined inclusion and exclusion criteria will be divided into two groups using lottery method. Pre assessment will be done using LUMBAR SPINE QUESTIONNAIRE as subjective measurements and NPRS as objective measurements. Subjects in one group will be treated using William's protocol and the other one will be treated with hold relax stretching of iliopsoas muscle. Each subject will receive 08 treatment sessions with 02 treatment sessions per week. Post treatment reading for NPRS and lumbar spine questionnaire will be recorded after every week.Various conservative treatments are used to treat hyperlordosis and low back pain due to hyperlordosis. Most commonly used are the manual therapy techniques that employ William's protocol and hold relax stretching of iliopsoas muscle at lumbar spine. This study will be randomized control trial used to compare the effects of William protocol and hold relax stretching of iliopsoas muscle in subjects with hyperlordosis and low back pain. Subjects meeting the predetermined inclusion and exclusion criteria will be divided into two groups using lottery method. Pre assessment will be done using LUMBAR SPINE QUESTIONNAIRE as subjective measurements and NPRS as objective measurements. Subjects in one group will be treated using William's protocol and the other one will be treated with hold relax stretching of iliopsoas muscle. Each subject will receive 08 treatment sessions with 02 treatment sessions per week. Post treatment reading for NPRS and lumbar spine questionnaire will be recorded after every week.

Official Title
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Effects of William Training Versus Hold Relax Stretching of Iliopsoas Muscle in Females With Hyperlordosis

Conditions
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Hyperlordosis

Intervention / Treatment
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* Other: HOLD RELAX STRETCHING OF ILIOPSOAS
* Other: WILLIAM'S PROTOCOL


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 21-40 years Hyperlordosis Angle Females having increased lordotic curve Pain perceived anywhere in the region of lumbar spine from L1 to l5. Limitation of lumbar spine range of motion. Exclusion Criteria: Any red flags including tumors, fractures. Spinal canal stenosis Rheumatoid arthritis Osteoporosis

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 40 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: HOLD RELAX STRETCHING OF ILIOPSOAS<br>10-second isometric contraction of iliopsoas muscle (HR), 10-second rest, 20-second static stretch, 5 repetitions. The stretching exercise was performed 2 times a week for 8 weeks. | Other: HOLD RELAX STRETCHING OF ILIOPSOAS<br>* 10 second isometric contraction of iliopsoas muscle (HR), 10-second rest, 20 second static stretch, 5 repetitions. • The stretching exercise was performed 2 times a week for 8 weeks. 10 second isometric contraction of iliopsoas muscle (HR), 10-second rest, 20 second static stretch, 5 repetitions. The stretching exercise was performed 2 times a week for 8 weeks.<br>|
| Experimental: • WILLIAM'S PROTOCOL<br>Pelvic tilt Single Knee to chest Double knee to chest Partial sit-up Hamstring stretch Hip Flexor stretch Squat Each group performed special trainings for 8 weeks, 2 sessions per week; each session took about 1 hour. Duration of each exercise was 8 to 10 seconds in each set. Protocols were started with 1 set of 10 repetitions at starting baseline and by improving performance and patients' compatibility with trainings, all eventually finished with 3 sets of 20 repetitions at the end of protocols. | Other: WILLIAM'S PROTOCOL<br>* Pelvic tilt Single Knee to chest Double knee to chest Partial sit-up Hamstring stretch Hip Flexor stretch Squat Each group performed special trainings for 8 weeks, 2 sessions per week; each session took about 1 hour. Duration of each exercise was 8 to 10 seconds in each set. Protocols were started with 1 set of 10 repetitions at starting baseline and by improving performance and patients' compatibility with trainings, all eventually finished with 3 sets of 20 repetitions at the end of protocols.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain assessment | The NRS for pain is a unidimensional measure of pain intensity in adults including those with chronic pain due to rheumatic diseases. Although various iterations exist, the most commonly used is the 11-item NRS | 8 weeks | 
| lordatic angle | 2- Flexicurve ruler: The angle of lumbar lordosis will be measured with a flexible ruler. The subject remained in the normal standing posture while lordatic angle was measured | 8 weeks | 
| low back pain | 3- Lumbar spine questionnaire (LSQ): It is used for the assessment of low back pain. It contains various items and patients will be asked relevant questions and answers will be noted and written | 8 weeks |