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IRCT20230719058844N2 IRCT 2026-01-06 Bagheiat-allah University of Medical Sciences Effects of dry needling plus static stretching of hamstring muscle in chronic nonspecific low back pain Effects of dry needling plus static stretching on pain, hamstring flexibility, disability, and balance in patients with chronic non-specific low back pain 2026-02-04 anticipated 48 Complete https://irct.ir/trial/88424 interventional Randomization: Randomized, Blinding: Double blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: In this study, the participants were divided into two groups by a simple randomization by Cards or Envelopes Shuffling which were prepared according to their number and one of the names of the intervention or control was written on it. All patients have the same chance of being placed in any of the two groups. This study is a double-blind study. In this study, due to the use of sham dry needling, patients in the control group will be blinded of their placement in the intervention and control groups. Also, the assessor is blinded of the control and intervention groups and only knows them as groups A and B. Only the interventionist is aware of the research events completely, Blinding description: The assessor is the researcher and during the assessments, he is not aware of the grouping of the patients and only knows them into two groups A and B. The use of sham dry needling in the control group causes the patient to be blinded to being in the control or intervention group. N/A Non-specific low back pain. Intervention 1: Intervention group: In the intervention group, patients received static stretching of the hamstring muscle in each treatment session after dry needling. Dry needling is preferred before static stretching with the aim of reducing muscle tension and allowing for more effective application of stretching in a greater range. A) Dry needling: A sterile disposable needle (0.25mm×0.60mm, SMC, Seoul, Korea) is used for dry needling. The patient is asked to lie prone on the bed and the Fast in Fast out technique is used deeply on three points of the hamstring muscle (long and short heads of the biceps femoris, semitendinosus and semimembranosus) for 3 minutes (1 minute at each point). The exact needle location is determined by connecting a line from the ischial tuberosity to the fibular head, and the needle enters the long and short heads of the biceps femoris muscle at 60% and 30% of this line, respectively. Another line from the ischial tuberosity is also connected to the medial femoral condyle, and at 60% of this line, the needle enters the semitendinosus and semimembranosus (29). The number of treatment sessions for dry needling is performed once a day, every other day, for 3 sessions (53). b) Static stretching: To apply static stretching, patients are asked to lie supine on the bed and, while maintaining the knee in extension, move the hip towards flexion using an exercise band, placing the hamstring muscle under maximum tension. This static stretching is applied in 3 sets of 2 minutes with 2 minutes of rest between sets. The number of treatment sessions for static stretching is performed once a day, every other day, for 3 sessions (18). Intervention 2: Control group: In the control group, in each treatment session, Sham dry needling will be performed by applying 10 grams of monofilament, and then static stretching will be applied according to the intervention group. The number of treatment sessions and the duration of the sessions will be the same as the intervention group. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is no more information
public Mahdi Esmaeeli
3rd Floor, No 10, Rashidi Alley, Meghdad St, Pirouzi Ave, Tehran
Tehran Iran (Islamic Republic of) 1766717194 +98 21 3317 0630 mahdiesmaeeli@yahoo.com Bagheiat-allah University of Medical Sciences scientific Mahdi Esmaeeli
3rd Floor, No 10, Rashidi Alley, Meghdad St, Pirouzi Ave, Tehran
Tehran Iran (Islamic Republic of) 1766717194 +98 21 3317 0630 mahdiesmaeeli@yahoo.com Bagheiat-allah University of Medical Sciences Iran (Islamic Republic of) Men and women with non-specific low back pain Decreased passive knee extension of more than 25 degrees 12 weeks after the onset of low back pain Visual analog scale between 3 and 7 No contraindication for dry needling No history of other neuromuscular system disorders Ability to understand and follow the instructions no limit no limit Both Non-cooperation in carrying out treatment protocols Absence of the person in two consecutive treatment sessions Inability to complete the pre and post assessments M54.5 Low back pain Rehabilitation Rehabilitation Intervention group: In the intervention group, patients received static stretching of the hamstring muscle in each treatment session after dry needling. Dry needling is preferred before static stretching with the aim of reducing muscle tension and allowing for more effective application of stretching in a greater range. A) Dry needling: A sterile disposable needle (0.25mm×0.60mm, SMC, Seoul, Korea) is used for dry needling. The patient is asked to lie prone on the bed and the Fast in Fast out technique is used deeply on three points of the hamstring muscle (long and short heads of the biceps femoris, semitendinosus and semimembranosus) for 3 minutes (1 minute at each point). The exact needle location is determined by connecting a line from the ischial tuberosity to the fibular head, and the needle enters the long and short heads of the biceps femoris muscle at 60% and 30% of this line, respectively. Another line from the ischial tuberosity is also connected to the medial femoral condyle, and at 60% of this line, the needle enters the semitendinosus and semimembranosus (29). The number of treatment sessions for dry needling is performed once a day, every other day, for 3 sessions (53). b) Static stretching: To apply static stretching, patients are asked to lie supine on the bed and, while maintaining the knee in extension, move the hip towards flexion using an exercise band, placing the hamstring muscle under maximum tension. This static stretching is applied in 3 sets of 2 minutes with 2 minutes of rest between sets. The number of treatment sessions for static stretching is performed once a day, every other day, for 3 sessions (18). Control group: In the control group, in each treatment session, Sham dry needling will be performed by applying 10 grams of monofilament, and then static stretching will be applied according to the intervention group. The number of treatment sessions and the duration of the sessions will be the same as the intervention group. Visual Analogue Scale. Timepoint: Before the intervention, after the intervention, one week after the intervention. Method of measurement: with a ruler from 1-10. Passive knee extension test. Timepoint: Before the intervention, after the intervention, one week after the intervention. Method of measurement: By goniometer in degrees. Functional rating index. Timepoint: Before the intervention, after the intervention, one week after the intervention. Method of measurement: Questionnaire with 10 items and scores between 0 and 40 as a percentage. Timed up and go test. Timepoint: Before the intervention, after the intervention, one week after the intervention. Method of measurement: Time measured by a chronometer. Quality of life. Timepoint: Before the intervention, after the intervention, one week after the intervention. Method of measurement: European quality of life questionnaire. Bagheiat-allah University of Medical Sciences Approved 2025-12-13 Research Ethics committee of Baqiyarallah University of Medical Sciences 3rd Floor, No 10, Rashidi Alley, Meghdad St, Pirouzi Ave Tehran Tehran Iran (Islamic Republic of)