Chronic Low Back Pain, Chronic Low Back Pain (CLBP)
Conditions
Keywords
Low back pain, Chronic low back pain, Bowen therapy, Disability index, Lumbar mobility, McGill stabilization, Pain reduction, Range of motion, Rehabilitation exercises
Brief summary
This randomized controlled trial aims to compare the effectiveness of Bowen Therapy combined with McGill stabilization exercises versus Bowen Therapy alone in individuals with chronic nonspecific low back pain. The study will evaluate changes in pain intensity, lumbar range of motion, and functional disability over a six-week intervention period. It is hypothesized that the combined intervention will produce greater improvements in clinical outcomes than Bowen Therapy alone.
Detailed description
This is a single-center, parallel-group, randomized controlled trial conducted at Sehat Medical Complex. A total of 100 participants aged 25-55 years with chronic nonspecific low back pain of more than three months' duration will be randomly allocated to one of two treatment groups using a computer-generated randomization sequence. Participants in the experimental group will receive Bowen Therapy combined with the McGill stabilization exercise program, while participants in the comparator group will receive Bowen Therapy alone. Both groups will receive standard physiotherapy modalities, including a 10-minute moist hot pack and transcutaneous electrical nerve stimulation (TENS) before each treatment session. The intervention period will last six weeks, with treatment sessions conducted three times per week. Outcome assessments will be performed at baseline and at Weeks 2, 4, and 6. Pain intensity will be measured using the Numeric Pain Rating Scale (NPRS), lumbar range of motion will be assessed using a bubble inclinometer, and functional disability will be evaluated using the Modified Oswestry Disability Index (MODI). All assessments will be performed by the same trained physiotherapist to ensure measurement consistency. The study has been approved by the Institutional Review Board of Sehat Medical Complex (Approval No. IREB-UOL-SMC/001-26/2024) and will be conducted in accordance with the Declaration of Helsinki. Written informed consent will be obtained from all participants before enrollment. Statistical analysis will be performed using SPSS version 25.0. Descriptive statistics will summarize baseline characteristics, the Shapiro-Wilk test will assess data normality, and repeated-measures analysis of variance (RM-ANOVA) will be used to evaluate changes between groups over time. Statistical significance will be set at p \< 0.05.
Interventions
PROCEDUREBowen Therapy + McGill Stabilization Exercise
Bowen Therapy is a manual therapy involving gentle rolling movements applied over muscles, tendons, ligaments, and fascia using the fingers or thumbs. Treatment consisted of standardized movement sequences with 2-5 minute intervals between sets to facilitate neuromuscular integration. Each session included two to three repetitions per set and four to five sets, administered three times per week for six weeks. The McGill stabilization exercise program consisted of evidence-based core stabilization exercises including the curl-up, side-bridge, and bird-dog. Exercises were performed three times per week on alternate days for six weeks, with 30 repetitions and a 10-second isometric hold during each repetition. Participants also performed conventional physiotherapy exercises, including single and double knee-to-chest stretches, prone lying, heel slides, supine bicycling, and bridging exercises.
PROCEDUREBowen Therapy
Bowen Therapy is a manual therapy involving gentle rolling movements applied over muscles, tendons, ligaments, and fascia using the fingers or thumbs. Treatment consisted of standardized movement sequences with 2-5 minute intervals between sets to facilitate neuromuscular integration. Each session included two to three repetitions per set and four to five sets, administered three times per week for six weeks. Participants in both study groups received Bowen Therapy according to the same standardized protocol.
Sponsors
Sehat Medical Complex
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
25 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* With chronic localized low back pain lasting over three months * Without any signs of pain below the gluteal fold * Fulfills the recommended diagnostic criteria of nonspecific chronic low back pain.
Exclusion criteria
* Lumbar disc herniation * Lumbar canal stenosis * Spondylolisthesis * Spondylitis * Radiculopathy * Vertebral fracture * Neurological deficits * Pregnancy or radiating pain below the gluteal fold.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain Intensity Measured by the Numeric Pain Rating Scale (NPRS) | Baseline, Week 2, Week 4, and Week 6 | Pain intensity will be assessed using the 11-point Numeric Pain Rating Scale (NPRS), where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate greater pain intensity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Functional Disability Measured by the Modified Oswestry Disability Index (MODI) | Baseline, Week 2, Week 4, and Week 6 | Functional disability will be assessed using the Modified Oswestry Disability Index (MODI). Scores range from 0% to 100%, with higher scores indicating greater disability. |
Countries
Pakistan
Outcome results
None listed