Published Paper Details:

Main goal of the treatment is to reduce the pain, lumbar hyperlordosis and enhance function by improvement in the TrA activation, lumbar stability and iliopsoas muscle length by stretching of the iliopsoas muscle in chronic mechanical low back pain patients with hyperlordosis. Method: Total 80 patients with chronic mechanical low back pain with lumbar hyperlordosis were selected from OPD setups/hospitals. Each patient was clinically assessed by the first author based on the inclusion and exclusion criteria. Following pre-test the patient were assigned to receive the intervention either Hold-relax stretching group or Static stretching group. All patients were assessed pre and post-test by the first author. The immediate effect of these interventions were measured and compared using outcome measures like Visual analogue scale, Transversus abdominis activation using pressure biofeedback unit, Modified isometric stability test for Lumbar stability, Lumbar lordosis angle using flexiruler and iliopsoas muscle length by measuring passive hip extension in modified Thomas test position. Statistical analysis was done using Mixed way ANOVA test. Result: On comparison of pre and post treatment values, both hold-relax stretching and static stretching of iliopsoas muscle showed significant effect by reducing pain , lumbar lordosis angle and improving transversus abdominis muscle capacity , lumbar stability and iliopsoas muscle length. (p<0.0001) On comparison between hold-relax stretching group and static stretching group, extremely significant difference found for VAS (p=0.001), Transversus abdominis activation (p=0.047), lumbar stability (p=0.028) and lumbar lordosis angle (p=0.025). Whereas, significant difference was found for left iliopsoas muscle length (0.008) when compared between both groups but the right iliopsoas muscle length (p=0.069) did not show any significant difference. Conclusion: The study concludes that both hold-relax and static stretching of iliopsoas muscle was effective in improving the transversus abdominis activation in chronic mechanical low back pain with hyperlordosis. Further, Iliopsoas stretching improved pain, lumbar stability, lumbar lordosis angle and unilateral iliopsoas muscle length in these patients.