EFFECTIVENESS OF PNF STRETCHING WITH OR WITHOUT VOODOO FLOSS BAND ON HAMSTRING FLEXIBILITY IN PATIENTS WITH NON-SPECIFIC MECHANICAL CHRONIC LOW BACK PAIN
The study aims to find out the effects of Voodoo floss band with Proprioception neuromuscular facilitation(Hold-Relax) stretching in improving Hamstring Flexibility and pain reduction in low back and lumbar flexion ROM in patients with Non-specific Mechanical Chronic low back pain
Design
Quasi Experimental study, phase 2, sample size 36, Non-Randomized, Not blinded
Settings and conduct
Clinics and Hospitals will be the settings and the research will be conducted as follows : a screening performas will be distributed to those who are willing to participate those who fulfill the screening and inclusion exclusion criteria will be selected and then will be evaluated using ODI questionnaire, by checking SLR ,By measuring MMST and then pain on NPRS.
Participants/Inclusion and exclusion criteria
Inclusion Criteria: age 18-45 years, Both Genders, Persons who sit for more than 3 hours, During SLR having pain at >70 degree, Patients with Past three months of Non-specific Mechanical Chronic Low back pain
Exclusion Criteria: Malignancy, Pregnancy, Disc Herniation, Fracture, Surgery in past 6 months
Intervention groups
After the evaluation and recruitment of participants , the participants will be equally distributed to two groups. Two Groups , Group 1 :PNF (Hold-Relax) stretching with Voodoo Floss band, Group 2:PNF (Hold-Relax) stretching. Both groups will have equal participants with base line treatment using TENS and Ultrasound on low back and the voodoo floss band will then be wrapped around thigh and the PNF technique will be performed in Three sessions per week for four weeks and the recordings will be taken at baseline week(2) and then at week(4) in clinic and hospital settings
EFFECTIVENESS OF PNF STRETCHING WITH OR WITHOUT VOODOO FLOSS BAND ON HAMSTRING FLEXIBILITY IN PATIENTS WITH NON-SPECIFIC MECHANICAL CHRONIC LOW BACK PAIN
Public title
EFFECTIVENESS OF PNF STRETCHING WITH OR WITHOUT VOODOO FLOSS BAND ON HAMSTRING FLEXIBILITY IN PATIENTS WITH NON-SPECIFIC MECHANICAL CHRONIC LOW BACK PAIN
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Age 18-45 Years
Both Genders
Persons who sit for more than 3 hours
patients with past three months of Non-specific Mechanical Chronic low back pain
Pain above 3 on NPRS
During SLR having pain at >70 degree
persons with minimum of 11 or more ODI score
Exclusion criteria:
Persons with disc herniations
Patients with sciatic nerve pain are excluded
patients with fracture
Persons who had a surgery in past six months
Major surgeries like total Hip arthroplasty are also excluded
spinal trauma caused by accidents are excluded
pregnancy
Psychologically un-cooperative
Malignancy
Age
From 18 years old to 45 years old
Gender
Both
Phase
2
Groups that have been masked
Participant
Sample size
Target sample size:
36
More than 1 sample in each individual
Number of samples in each individual:
18
Patients will be randomly assigned into two groups. Each group will comprise of 18 patients
Randomization (investigator's opinion)
Randomized
Randomization description
Non-Probability Purposive sampling technique will be utilized for collecting sample and sample will be allocated to treatment group Group A and Group B by using online Randomization generator . Both Groups will receive 18 unique numbers per set into two groups Group A: PNF(Hold-Relax) stretching with Voodoo Floss Band , Group B :PNF(Hold-Relax) Stretching
Blinding (investigator's opinion)
Single blinded
Blinding description
Patients will be kept blinded through Allocation Concealment to treatment groups. Patients will be unaware of their respective treatment groups
Placebo
Not used
Assignment
Parallel
Other design features
Secondary Ids
empty
Ethics committees
1
Ethics committee
Name of ethics committee
Ethics committee of Faisal Institute of Health Sciences
Street address
673-A Lower canal Road E , Block A Peoples Colony no 1, Faisal Hospital, Faisalabad
City
Faisalabad
Postal code
03822
Approval date
2022-03-20, 1400/12/29
Ethics committee reference number
2017-2022 (5)
Health conditions studied
1
Description of health condition studied
Non-Specific Mechanical chronic low back pain can be defined as pain in lower lumber region caused by strain or poor posture in the lumber area associated with or caused by Hamstring tightness.
ICD-10 code
M54.5
ICD-10 code description
Low back pain
Primary outcomes
1
Description
Straight leg raise test was used to measure the hamstring flexibilty in patients with Non-Specific Mechanical Chronic Low Back Pain
Timepoint
3time points including Baseline, 2nd Week Post Treatment, 4th Week Post Treatment
Method of measurement
SLR will be measured by Universal Goniometer
2
Description
NPRS(Numeric Pain Rating Scale was be utilized to measure the intensity of pain. Pain intensity was rated 0-10 at a horizontal bar. NPRS consists of 11 points, which range from 0=no pain, 1-4=mild pain, 4-7=moderate pain, 7-10=severe pain
Timepoint
3 time points including Baseline, 2nd Week Post Treatment, 4th Week Post Treatment
Method of measurement
NPRS will be utilized to assess pain
Secondary outcomes
1
Description
Lumbar Flexion Range of motion is assessed by the use of Modified-Modified Schober's Test. This test uses Tape measure to measure the lumber flexion range. To measure the range of motion, the therapist puts his thumbs on the inferior margin of the subject’s PSIS. An ink mark is drawn along the midline of the lumbar spine horizontal to the PSIS (lower landmark). While the therapist holds the tape firmly against the subject’s skin, he marks a second line 15 cm above the original one (higher landmark). Then the subject is asked to do an active anterior flexion of the trunk without increasing the pain. The new distance between the lower and higher landmarks is then measured. The subject returns to the neutral position. The difference in the initial distance between the skin markings in the neutral position and the new measurements made in the flexion position is used to indicate the amount of lumbar flexion
Timepoint
3 time points, Baseline, 2nd Week post treatment,4th week post treatment
Method of measurement
MMST(Modified-Modified Schober's Test) will be utilized to measure Lumbar Flexion range
2
Description
ODI (Oswestry Disability Index) is a questionnair which measure low back pain function disability. It is a gold standard of low back functional outcome. There are 10 sections in this questionnair.Each section has six questions that score 0 to 5. Total score of all the sections is 50.Patients will fill the Questionnair and the scored will be (total possible score ) will be divided by 50 and then will be multiplied to 100 to get the percentage.0-20%=indicates minimal disability, 21-40%=Moderate Disability, 41-60%=Severe Disability, 61-80%=Crippled, 81-100%=These patients are either bed bound or exaggerating there symptoms.
Timepoint
3 Time Points Baseline, 2nd Week post treatment, 4th week post treatment
Method of measurement
ODI (Oswestry Disability Index) questionnaire will be utilized to measure Low back function
Intervention groups
1
Description
Intervention group 1:",Base line Treatment includes TENS (Transcutaneous Electrical Nerve Stimulation) will be used on lower back before actual treatment protocol,10 minutes in continuous mode (100 Hz with pulse duration of 50-100 micro second) and Therapeutic Ultrasound with 3 MHz for 10 minutes at 50% intensity (1.0 w/cm square, pulsed 50%). PNF(Hold-Relax) Stretching with Voodoo floss band, Voodoo floss band is a latex band black color has 2 inch width and 7 feet length is used to wrap around thighs with 50% stretch to compress blood flow around hamstring muscles and then PNF hold relax stretching technique is performed. Voodoo floss band will be wrapped around hamstrings , PNF includes Passive hamstring stretch by therapist held for 7 seconds, then 3 seconds isometric contract, 5 second relaxation, The physiotherapist then passively stretch the muscle until a mild stretch sensation is reported , 5 repetitions, , Each repetition is separated by 20 seconds , 3 sessions per week on alternative days for 4 weeks
Category
Rehabilitation
2
Description
Intervention group 2:",Base line Treatment includes TENS (Transcutaneous Electrical Nerve Stimulation) will be used on lower back before actual treatment protocol,10 minutes in continuous mode (100 Hz with pulse duration of 50-100 micro second) and Therapeutic Ultrasound with 3 MHz for 10 minutes at 50% intensity (1.0 w/cm square, pulsed 50%).PNF( Hold-Relax) Stretching includes Passive hamstring stretch by therapist held for 7 seconds, then 3 seconds isometric contract, 5 second relaxation, The physiotherapist then passively stretch the muscle until a mild stretch sensation is reported , 5 repetitions, , Each repetition is separated by 20 seconds , 3 sessions per week on alternative days for 4 weeks