SCSCRLCS: Sequential Core Stability Corrective Exercise Approach in Lower Crossed Syndrome

Sponsor

Riphah International University (Other)

Overall Status

Not yet recruiting

CT.gov ID

NCT05505851

Collaborator

(none)

Enrollment

Location

Arms

Anticipated Duration (Months)

2.5

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The objective of the study will be to determine the effects of Sequential Core Stability Corrective Exercise Approach for Alignment and Muscle Function in Lower Crossed Syndrome.

Condition or Disease	Intervention/Treatment	Phase
Low Back Pain	Other: Control Other: Sequential Core Stability Corrective Exercise Approach	N/A

Detailed Description

Lower Crossed Syndrome is one of common postural disorder which occurs due to the muscular imbalance. It refers to specific altered muscle activation and movement patterns along with some postural deviations. Alterations in muscle activation include overactivity of hip flexors and lower back muscles paired underactivity of abdominals and gluteus muscle. This pattern of imbalance creates dysfunction. Postural correction exercise with inner and outer core muscles are necessary. There are different traditional structural approach, functional approach and biomechanics and are presumed to lead to adjustments in the length and strength of local muscles while ignoring other related malalignments and core stability. The objective of the study will be to determine the effects of Sequential Core Stability Corrective Exercise Approach for Alignment and Muscle Function in Lower Crossed Syndrome.

It will be a randomized controlled trial. Sample size will be collected after running the pilot study. The participants will be recruited through convenient sampling technique and then allocated randomly to Groups. Outcome measures will be alignment and muscle function. Pre and post reading and after one month follow-up will be recorded. Data will be analyzed using statistical package for social sciences software version 25. After assessing normality of data by Shapiro-Wilk test, it will be decided either parametric or nonparametric test will be use within a group or between two groups.

Keywords: Alignment, Core Stability, Diaphragm, Muscular Imbalance, Muscle thickness Pelvic floor.

Study Design

Study Type:

Interventional

Anticipated Enrollment :

40 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Intervention Model Description:

Masking:

Double (Participant, Outcomes Assessor)

Primary Purpose:

Treatment

Official Title:

Sequential Core Stability Corrective Exercise Approach for Alignment And Muscle Function In Lower Crossed Syndrome

Anticipated Study Start Date :

Sep 1, 2022

Anticipated Primary Completion Date :

Jan 1, 2024

Anticipated Study Completion Date :

Jan 1, 2024

Arms and Interventions

Arm	Intervention/Treatment
Active Comparator: A: Control Corrective Exercises Hip Flexor Stretch 30 seconds hold 3 repetitions on each side Thoracolumbar extensors stretch 30 second holds 3 repetitions Abdominal Curl ups with hands at side 10 repetitions 2 sets Progression: • Abdominal curl up with arms crossed • Abdominal curl ups with hands behind head Pelvic bridging 10 seconds hold 10 repetitions 2 sets	Other: Control Hip Flexor Stretch 30 seconds hold 3 repetitions on each side Thoracolumbar extensors stretch 30 second holds 3 repetitions Abdominal Curl ups with hands at side 10 repetitions 2 sets Progression: • Abdominal curl up with arms crossed • Abdominal curl ups with hands behind head Pelvic bridging 10 seconds hold 10 repetitions 2 sets
Experimental: B: Sequential Core Stability Corrective Exercise Approach Corrective Exercises Diaphragm Training Program As per standardized pulmonary rehabilitation guidelines,. Participant will be advised to breathe in gently with an improved tidal volume for ten repetitions, then after a short interval of break 15 repetitions will be done again. 30 Repetitions in set of 15, 15 with the interval rest. 2 sets. Pelvic floor Muscle training Participants will be asked to do pelvic floor training with high intensity (close to maximum) contractions with holding each muscle contraction for 6-8 seconds with relaxation of 6 seconds. Total 8 to 12 contractions. Core Stability exercises Beginning Progressing Advanced	Other: Sequential Core Stability Corrective Exercise Approach Corrective Exercises Diaphragm Training Program As per standardized pulmonary rehabilitation guidelines,. Participant will be advised to breathe in gently with an improved tidal volume for ten repetitions, then after a short interval of break 15 repetitions will be done again. 30 Repetitions in set of 15, 15 with the interval rest. 2 sets. Pelvic floor Muscle training Participants will be asked to do pelvic floor training with high intensity (close to maximum) contractions with holding each muscle contraction for 6-8 seconds with relaxation of 6 seconds. Total 8 to 12 contractions. Core Stability exercises Beginning Progressing Advanced

Arm

Intervention/Treatment

Active Comparator: A: Control

Corrective Exercises Hip Flexor Stretch 30 seconds hold 3 repetitions on each side Thoracolumbar extensors stretch 30 second holds 3 repetitions Abdominal Curl ups with hands at side 10 repetitions 2 sets Progression: • Abdominal curl up with arms crossed • Abdominal curl ups with hands behind head Pelvic bridging 10 seconds hold 10 repetitions 2 sets

Other: Control

Hip Flexor Stretch 30 seconds hold 3 repetitions on each side Thoracolumbar extensors stretch 30 second holds 3 repetitions Abdominal Curl ups with hands at side 10 repetitions 2 sets Progression: • Abdominal curl up with arms crossed • Abdominal curl ups with hands behind head Pelvic bridging 10 seconds hold 10 repetitions 2 sets

Experimental: B: Sequential Core Stability Corrective Exercise Approach

Corrective Exercises Diaphragm Training Program As per standardized pulmonary rehabilitation guidelines,. Participant will be advised to breathe in gently with an improved tidal volume for ten repetitions, then after a short interval of break 15 repetitions will be done again. 30 Repetitions in set of 15, 15 with the interval rest. 2 sets. Pelvic floor Muscle training Participants will be asked to do pelvic floor training with high intensity (close to maximum) contractions with holding each muscle contraction for 6-8 seconds with relaxation of 6 seconds. Total 8 to 12 contractions. Core Stability exercises Beginning Progressing Advanced

Other: Sequential Core Stability Corrective Exercise Approach

Outcome Measures

Primary Outcome Measures

Photometry for Pelvic Tilt [6th Week]
Angle of Pelvic tilt will be measured Through a Reliable and validated camera.
Photometry for Chest Expansion [6th Week]
Angle of Chest expansion will be measured at Nipple line, Xiphoid level and at waist level, Through a Reliable and validated camera.
Photometry for Cervicothoracic level [6th Week]
Angle of C7-T1 will be measured Through a Reliable and validated camera.
Photometry for Lumber flexion [6th Week]
Angle of Lumber curve will be measured Through a Reliable and validated camera.
Diaphragmatic excursion [6th Week]
To assess the diaphragmatic motion by M-mode US a 2.5-5 megahertz (MHz) phase array will be used.
Levator ani Excursion [6th Week]
To assess the pelvic floor motion by M-mode US a 2.5-5 megahertz (MHz) array will be used.
Diaphragmatic thickness and thickening [6th Week]
diaphragmatic thicknesses and thickening will be assessed by B-mode ultrasonography during various respiratory maneuvers
Levator ani thickness and thickening [6th Week]
Levator ani thicknesses and thickening will be assessed by B-mode ultrasonography during various respiratory maneuvers
Core stability [6th Week]
It will be measured by Pressure biofeedback unit for the transverse abdomens.

Secondary Outcome Measures

Forced Vital Capacity (FVC) [6th Week]
Pulmonary function test through spirometer, It will be measured by digital spirometer.
Forced Expiratory Volume per second FEV1 [6th Week]
Pulmonary function test through spirometer, It will be measured by digital spirometer.
Ratio of FEV1/ FVC [6th Week]
Pulmonary function test through spirometer, It will be measured by digital spirometer.

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years to 28 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

Inclusion Criteria:

• Age group between 18 to 28 years
No current incidence of low back pain or past history of low back dysfunction
Kendall double leg lowering test: Abdominal muscle weakness to the extent of not being able to maintain posterior pelvic tilt during a double leg lowering test in supine position.
Diagnosed with lower cross syndrome through assessment criteria of Janda muscle testing and assessment

Exclusion Criteria:

• Having any history of low back pain, spinal trauma,
Joint dysfunction in past 3 months
Congenital deformities at hip or lumbar region,
Recent fracture to related joints in past 6 months
Any family history of cardiopulmonary disease
Any disease or urogenital tract
Participants having BMI above 30.
Recent history of hepatitis or Fatty liver or
Any athlete having high physical activity.
History of abdominal, hip or lumbar surgeries in past 3 months

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Al-khumeini Trust Hospital	Lahore	Punjab	Pakistan	54000

Sponsors and Collaborators

Riphah International University

Investigators

Principal Investigator: Wajeeha Zia, PhD*, Riphah International University
Principal Investigator: Wajeeha Zia, PhD*, Riphah International University , QIE, Campus