Individuals With Lumbar Spondylosis
Conditions
Keywords
lumbar spondylosis
Brief summary
This study is conducted to determine the effect of thoracic mobility versus hip mobility exercises to core stabilization on pain severity (NPRS-Ar), functional disability (MODI-Ar), lumbar range of motion (BROM), spinal mobility (modified schober test), quality of life (SF-36-Ar) and fear of movement (Tampa-Ar) in treatment of patients with lumbar spondylitis.
Detailed description
This study is conducted to determine the effect of thoracic mobility versus hip mobility exercises to core stabilization on pain severity , functional disability , lumbar range of motion , spinal mobility , quality of life and fear of movement in treatment of patients with lumbar spondylitis.
Interventions
BEHAVIORALGroup A : Core stabilization exercises (control group)
Before starting the exercise, patients will be taught to reduce the lumbar lordosis by contracting and drawing in the abdominal muscles and to find the 24 lumbar and pelvic neutral position by moving the pelvis forwards and backwards (pelvic tilt, bridge, bird-dog and plank etc.). In each session, the neutral position will be found first and attention will be paid to maintain the neutral position throughout the exercise. In addition, core stability exercises including simultaneous contractions of the multifidus and pelvic floor muscles will be given in different positions such as supine, prone, crawling, bridge, kneeling, sitting and standing. The exercises will consist of 3 levels (from easy to difficult). In the advanced level exercises, patients will be asked to maintain the neutral curvature of the lumbar spine, resistance limb exercises will be added and the exercises will be completed gradually. Each exercise will be performed for 3 sets of 8-10 repetition.
BEHAVIORALGroup B: Thoracic Mobility Exercises (1st experimental group only)
The exercise will consist of movements in all directions of thoracic spine flexion, extension, lateral flexion, and rotation. In the thoracic spine extension exercise, both hands will be locked behind the wrists and the back will be placed on a foam roller with the feet positioned 25 flat on the floor. The knee will be maintained at 90° to perform the extension exercise on the foam roller. The hands will be locked with the elbow on a chair. After kneeling, the hip will be moved toward the heels to extend the thoracic spine. In the thoracic spine flexion exercise, the thoracic spine will be flexed by moving backward until the hip touched the heels in a quadruped position.The rotation exercise will be conducted with patients lying on their sides.The elbows will be straight and the palms will be held together. The leg facing the ceiling will be bent to the level of the stomach. Then, the arm facing the ceiling will be moved backward in a large arc to rotate the thoracic spine.
BEHAVIORALGroup C: Hip Mobility Exercises (2nd experimental group only)
The patients will perform 8 different hip mobility exercises; reverse v-ups, butterfly, frog, internal rotation with foot rise, pike, revolved crescent lunge, pigeon, lunge on the knee. Each exercise will be performed for 2 sets of 20 seconds.
Sponsors
Cairo University
physical therapy of cairo university
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Intervention model description
Single blinded randomized controlled trial (examiner)This study will be conducted on patients with lumbar spondylosis. Patients will be randomly assigned into 3 groups . The control group will receive core stabilization. The 1st experimental group will receive core stabilization in addition to thoracic mobility exercises. The 2nd experimental group will receive core stabilization in addition to hip mobility exercises.
Eligibility
Sex/Gender
ALL
Age
40 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* 1\. Patients will be referred from an orthopedic surgeon with confirmed diagnosis of lumbar spondylosis with imaging findings (MRI, CT or X-ray reports within the last 6 months) (Battié et al., 2014). 2.Duration of patient's symptoms will be more than 3 months (Oliveira et al., 2022). 3. Patients' age will range from 40-60 years (Kalichman \& Hunter, 2008). 4.Localized back pain and pain radiating to lower extremities with no distal involvement below knee with an NPRS more than 3 (Thompson et al., 2021).
Exclusion criteria
1. Spinal or hip surgery history (Williams et al., 2022). 2. Red Flags: Cauda equina syndrome, fracture, infection, malignancy (Finucane et al., 2020). 3. Neurological Disorders: Parkinsonism, multiple sclerosis, or other neurological deficits (Odzimek et al., 2023). 4. Inflammatory Conditions: Rheumatoid arthritis, ankylosing spondylitis, or infectious spinal disorders (Lee et al., 2018). 5. Cognitive Impairment: Unable to understand or follow instructions (Martinez et al., 2024). 6. Pregnancy. -
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain levels | (pre-treatment) and after 6 weeks of intervention (post-treatment) | Pain levels in participants were assessed using the Numerical Pain Rating Scale (NPRS-Ar). |
| Disability | (pre-treatment) and after 6 weeks of intervention (post-treatment) | Using the Arabic MODI (Appendix III), Patients will be instructed to choose the best answer of the possible answers which describes the level of function and disability during daily activities in each of items of the questionnaire (Alnahdi, 2025). |
| Lumbar Range of motion | (pre-treatment) and after 6 weeks of intervention (post-treatment) | The Back Range of Motion (BROM) device will be utilized to measure the lumbar range of motion (ROM), as a valid and reliable measure of spinal motion (Kumar \& Singh, 2021; Chen et al., 2022), according to established procedures (Madson et al., 1999). After palpating and marking the spinous processes of T 12 and S1 with adhesive dots, a warm-up trial for each plane of motion will be completed by patients. The BROM device will be used to measure active ROM in the order of flexion/extension, right/left lateral flexion, and right/left rotation. Once the data for each movement was taken, the BROM device was removed, and the skin markers were reapplied after a 10-15 second rest period. Each motion will have three trials, and data from the three trials will be averaged and used for analysis in order to maximize reliability. |
| Spinal mobility: | (pre-treatment) and after 6 weeks of intervention (post-treatment) | Using the Modified Schober Test, Patient will be standing. The examiner will mark both posterior superior iliac spine (PSIS) and then will draw a horizontal line at the center of both marks. A second line is marked 5 cm below the first line. A third line is marked 10 cm above the first line. Patient will be instructed to flex forward as if attempting to touch his/her toes. The examiner re measures the distance between the top and bottom line (Rezvani et al., 2012). Three trials will be conducted and the mean of the three trials will be chosen for the purpose of data analysis |
| Fear of movement | (pre-treatment) and after 6 weeks of intervention (post-treatment) | Using the Arabic Tampa (Appendix V), Patients will be asked about any excessive, irrational, and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or re-injury (Al Shudifat et al., 2020). |
Countries
Egypt
Contacts
STUDY_DIRECTORMOAAZ RAGAB RIYAD, PhD
CAIRO UNIVERCITY
CONTACTYAHYA ABDU KULAYBI, MSc
CONTACTRAMY GNADY KOMIR, MSc
Outcome results
None listed