Hamstring InjuryNCT05655585
Comparison of Mulligan Bent Leg Raise vs Active Release Technique in Patients With Hamstring Tightness
A study testing Active Release Technique and Mulligan Bent Leg Raise in people with Hamstring Injury, run by Riphah International University at 1 site in Pakistan.
Trial summary
The sedentary lifestyle of today's world, prolonged time period of sitting during office hours and educational setups do have an effect on the flexibility of bi-articular muscles. Read more about this study
- Who is it for?
- Ages 30 to 50 years
- Conditions the study is for
- Hamstring Injury
- What is being tested?
- Active Release Technique and Mulligan Bent Leg Raise
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 44 participants
- Where
- 1 sitePakistan
- Study dates
- 3 Dec 2022to 1 Mar 2023
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 30 to 50 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Patients having Low Back Pain due to hamstring tightness.
- Patients having Sacro Iliac Joint pain due to hamstring tightness.
- 20-40-degree active knee extension loss with hip in 90-degree flexion
Who cannot join
- Fractures of hip and knee.
- Patients with hamstring injury in past 2 years.
- Hypermobility of lower limb joint.
- Neurological abnormalities.
- Tumors
- Infection
- Medical history of injury to back
- Inflammatory conditions (rheumatoid arthritis, ankylosing spondylitis)
Trial locations and contacts
1 site in 1 country.
About this study
The sedentary lifestyle of today's world, prolonged time period of sitting during office hours and educational setups do have an effect on the flexibility of bi-articular muscles. Hamstring flexibility is a significant variable as decreased extensibility has been suggested as a prejudicing feature for injuries, poor posture and non-specific low back pain.Active Release Technique (ART) is a soft tissue method that focuses on relieving tissue tension via the removal of fibrosis/adhesions which can develop in tissues as a result of overload due to repetitive use. These disorders may lead to muscular weakness, numbness, aching, tingling and burning sensations. ART has been reported to be both a diagnostic and a treatment technique.Mulligan's bent leg raise (BLR) is a stretching technique which is a modern progression in the treatment of hamstring tightness. It is indicated in hamstring tightness patients with backache having restricted or painful straight leg raise (SLR), leg pain above knee and it is very beneficial in the patients having gross bilateral limitations of straight leg raise. It stretches the lower extremity muscles in combination of hamstring, adductors and rotators
Read the detailed description
The hamstring muscle is two joint muscles and is certainly exposed to large length changes. The hamstring constitutes three large muscles that are semi-tendinosis, semi-membranous and biceps femoris. They are positioned in the posterior compartment of the thigh and act on the hip and knee joint as hip extensors and knee flexors. Flexibility dysfunction is a common problem encountered by general as well as athletic population specifically in hamstring.
The tightness of hamstring muscle not only causes decrease range of motion but it can also be a reason for many musculoskeletal dysfunctions. Tightness results in adaptive shortening of the contractile and non-contractile elements of the muscle. The two-joint muscles are more prone to shortening. The tightness of hamstring affects the lumbo-pelvic rhythm. Moreover the tight hamstring restricts the anterior tilting of pelvic in the position of spinal flexion which causes increase tension of muscles and ligaments in the lumbar area resulting in aggravated compressive load on lumbar spine. It also has an indirect effect on sacroiliac joint stability causing Sacro Iliac Joint pain.
The most common method of treatment is to initially feel for areas of soft tissue injury. Then, the tissue is taken from a shortened position to fully lengthened position with a specific hand contact on the soft tissue. This allows the contact to pass longitudinally along the soft tissue fibers and the lesion. The goal is to break up adhesions that may have formed from scarring within the soft tissue. In addition, ART also aims to restore soft tissue structures that feel strained or inflexible to their original healthy condition. The use of ART is becoming a commonality in the restoration of soft tissue injuries, especially in the world of competitive sports.
Active release technique therapy for the hamstrings is intended to relieve pain and lessen tightness and support the hamstring to reappear in its normal condition.
Mulligan's bent leg raise (BLR) is a stretching technique which is a modern progression in the treatment of hamstring tightness. It is indicated in hamstring tightness patients with backache having restricted or painful straight leg raise (SLR), leg pain above knee and it is very beneficial in the patients having gross bilateral limitations of straight leg raise. It stretches the lower extremity muscles in combination of hamstring, adductors and rotators. The BLR technique consists of three repetitions of pain-free isometric contraction of the hamstrings, performed in five progressively greater positions of hip flexion.
- Conditions
- Hamstring Injury
- Being tested
- Active Release Technique, Mulligan Bent Leg Raise
- Keywords
- pain, active release technique, mulligan bent leg raise, hamstring tightness
- Medical subject headings
- Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Active Release TechniqueOther
Participant will be in prone position on a couch with the therapist standing next to the patient. The patient is asked to flex the knee to 90 degree of the involved side. The therapist then applies gentle tension longitudinally to the hamstring muscle along the entire length while the patient actively moves his knee from flexion to extension
Mulligan Bent Leg RaiseOther
Participant was in supine lying on a high couch with the therapist in standing position lateral to the leg, which is to be stretched. Hip and Knee of the side to be stretched was bent at 90- 90 degree. Investigator places participant's flexed knee over his shoulder such that the popliteal fossa of the knee rest on his shoulder. A distraction (longitudinal traction force along the long axis of femur) was applied at the lower end of femur
| Study group | Role | What they receive |
|---|---|---|
| Active Release Technique | Experimental | Participant will be in prone position on a couch with the therapist standing next to the patient. The patient is asked to flex the knee to 90 degree of the involved side. The therapist then applies gentle tension longitudinally to the hamstring muscle along the entire length while the patient actively moves his knee from flexion to extension Receives: Other: Active Release Technique; Other: Mulligan Bent Leg Raise |
| Mulligan Bent Leg Raise | Experimental | Participant was in supine lying on a high couch with the therapist in standing position lateral to the leg, which is to be stretched. Hip and Knee of the side to be stretched was bent at 90- 90 degree. Investigator places participant's flexed knee over his shoulder such that the popliteal fossa of the knee rest on his shoulder. A distraction (longitudinal traction force along the long axis of femur) was applied at the lower end of femur Receives: Other: Active Release Technique; Other: Mulligan Bent Leg Raise |
What is being measured
The primary outcome is the main question the study is designed to answer.
Active Knee Extension Test
The Active Knee Extension test is used to measure the length of hamstring, with normal values of knee motion to within 20֯degree of full extension being quoted. The patient lies in supine position on a plinth and flexes his knee and hip to 90֯. The therapist monitors the position of the femur with his hand. The patient was asked to extend his involved leg as far as possible; keeping his foot relaxed, and holds the position for 5sec. The angle of knee extension was measured using a standard goniometer
Measured: four weeks
Lower extremity functional scale
The Lower extremity functional scale is a questionnaire consisting of 20 questions, used to assess a person's ability to perform everyday tasks. The maximum possible score is 80 points, indicating very high function. The minimum possible score is 0 points, indicating very low function.
Measured: four weeks
Visual Analogue Scale (VAS).
This tool is used to measure the intensity of pain. The patient marks the intensity of pain on scale ranging 0 to 10. Where 0 is no pain and 10 describes worst ever type of pain
Measured: four weeks
Modified sit and reach test
This test is used to assess the flexibility of hamstring and lower back. For the Modified Sit and Reach, the participants will be seated on the floor with head, back and hip against a wall (90◦ angle at hip joint), with both legs fully extended and the feet placed against the box. In this position, the participant will be required to place hand over hand and reach out level with the measurement scale, keeping the head, back, and hips in contact with the wall, with only scapular abduction performed. Then the finger to-box distance will be measured as the distance between the fingertips and the point at which the feet rested against the box (point 35 of the scale).
Measured: four weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Dec 2022
- Study start3 Dec 2022
- Primary completion1 Mar 2023
- Study completion1 Mar 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Hamstring InjuryStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 44 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- maria Khalid, MSOMPT, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05655585
- Sponsor's protocol ID
- REC -01393 Roheena Mustansar
- Status last verified
- Jun 2023
- First submitted
- 9 Dec 2022
- Last updated
- 28 Jun 2023
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 28 Jun 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of Mulligan Bent Leg Raise vs Active Release Technique in Patients With Hamstring Tightness
- ClinicalTrials.gov ID
- NCT05655585
- Acronym / sponsor ID
- REC -01393 Roheena Mustansar
- Conditions
- Hamstring Injury
- Keywords
- pain, active release technique, mulligan bent leg raise, hamstring tightness
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 44 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 3 Dec 2022 (actual)
- Primary completion
- 1 Mar 2023 (actual)
- Study completion
- 1 Mar 2023 (actual)
- First posted
- 19 Dec 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The sedentary lifestyle of today's world, prolonged time period of sitting during office hours and educational setups do have an effect on the flexibility of bi-articular muscles. Hamstring flexibility is a significant variable as decreased extensibility has been suggested as a prejudicing feature for injuries, poor posture and non-specific low back pain.Active Release Technique (ART) is a soft tissue method that focuses on relieving tissue tension via the removal of fibrosis/adhesions which can develop in tissues as a result of overload due to repetitive use. These disorders may lead to muscular weakness, numbness, aching, tingling and burning sensations. ART has been reported to be both a diagnostic and a treatment technique.Mulligan's bent leg raise (BLR) is a stretching technique which is a modern progression in the treatment of hamstring tightness. It is indicated in hamstring tightness patients with backache having restricted or painful straight leg raise (SLR), leg pain above knee and it is very beneficial in the patients having gross bilateral limitations of straight leg raise. It stretches the lower extremity muscles in combination of hamstring, adductors and rotators
Detailed description
The hamstring muscle is two joint muscles and is certainly exposed to large length changes. The hamstring constitutes three large muscles that are semi-tendinosis, semi-membranous and biceps femoris. They are positioned in the posterior compartment of the thigh and act on the hip and knee joint as hip extensors and knee flexors. Flexibility dysfunction is a common problem encountered by general as well as athletic population specifically in hamstring.
The tightness of hamstring muscle not only causes decrease range of motion but it can also be a reason for many musculoskeletal dysfunctions. Tightness results in adaptive shortening of the contractile and non-contractile elements of the muscle. The two-joint muscles are more prone to shortening. The tightness of hamstring affects the lumbo-pelvic rhythm. Moreover the tight hamstring restricts the anterior tilting of pelvic in the position of spinal flexion which causes increase tension of muscles and ligaments in the lumbar area resulting in aggravated compressive load on lumbar spine. It also has an indirect effect on sacroiliac joint stability causing Sacro Iliac Joint pain.
The most common method of treatment is to initially feel for areas of soft tissue injury. Then, the tissue is taken from a shortened position to fully lengthened position with a specific hand contact on the soft tissue. This allows the contact to pass longitudinally along the soft tissue fibers and the lesion. The goal is to break up adhesions that may have formed from scarring within the soft tissue. In addition, ART also aims to restore soft tissue structures that feel strained or inflexible to their original healthy condition. The use of ART is becoming a commonality in the restoration of soft tissue injuries, especially in the world of competitive sports.
Active release technique therapy for the hamstrings is intended to relieve pain and lessen tightness and support the hamstring to reappear in its normal condition.
Mulligan's bent leg raise (BLR) is a stretching technique which is a modern progression in the treatment of hamstring tightness. It is indicated in hamstring tightness patients with backache having restricted or painful straight leg raise (SLR), leg pain above knee and it is very beneficial in the patients having gross bilateral limitations of straight leg raise. It stretches the lower extremity muscles in combination of hamstring, adductors and rotators. The BLR technique consists of three repetitions of pain-free isometric contraction of the hamstrings, performed in five progressively greater positions of hip flexion.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Active Release Technique | Experimental | Other: Active Release Technique, Other: Mulligan Bent Leg RaiseParticipant will be in prone position on a couch with the therapist standing next to the patient. The patient is asked to flex the knee to 90 degree of the involved side. The therapist then applies gentle tension longitudinally to the hamstring muscle along the entire length while the patient actively moves his knee from flexion to extension |
| Mulligan Bent Leg Raise | Experimental | Other: Active Release Technique, Other: Mulligan Bent Leg RaiseParticipant was in supine lying on a high couch with the therapist in standing position lateral to the leg, which is to be stretched. Hip and Knee of the side to be stretched was bent at 90- 90 degree. Investigator places participant's flexed knee over his shoulder such that the popliteal fossa of the knee rest on his shoulder. A distraction (longitudinal traction force along the long axis of femur) was applied at the lower end of femur |
Who may qualify
- Ages
- 30 to 50 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Patients having Low Back Pain due to hamstring tightness.
- Patients having Sacro Iliac Joint pain due to hamstring tightness.
- 20-40-degree active knee extension loss with hip in 90-degree flexion
Key exclusion criteria (8 listed)
- Fractures of hip and knee.
- Patients with hamstring injury in past 2 years.
- Hypermobility of lower limb joint.
- Neurological abnormalities.
- Tumors
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Active Release TechniqueParticipant will be in prone position on a couch with the therapist standing next to the patient. The patient is asked to flex the knee to 90 degree of the involved side. The therapist then applies gentle tension longitudinally to the hamstring muscle along the entire length while the patient actively moves his knee from flexion to extension | Other | Active Release Technique, Mulligan Bent Leg Raise |
| Mulligan Bent Leg RaiseParticipant was in supine lying on a high couch with the therapist in standing position lateral to the leg, which is to be stretched. Hip and Knee of the side to be stretched was bent at 90- 90 degree. Investigator places participant's flexed knee over his shoulder such that the popliteal fossa of the knee rest on his shoulder. A distraction (longitudinal traction force along the long axis of femur) was applied at the lower end of femur | Other | Active Release Technique, Mulligan Bent Leg Raise |
Primary outcome
Active Knee Extension Test
Time frame: four weeks
The Active Knee Extension test is used to measure the length of hamstring, with normal values of knee motion to within 20֯degree of full extension being quoted. The patient lies in supine position on a plinth and flexes his knee and hip to 90֯. The therapist monitors the position of the femur with his hand. The patient was asked to extend his involved leg as far as possible; keeping his foot relaxed, and holds the position for 5sec. The angle of knee extension was measured using a standard goniometer
Lower extremity functional scale
Time frame: four weeks
The Lower extremity functional scale is a questionnaire consisting of 20 questions, used to assess a person's ability to perform everyday tasks. The maximum possible score is 80 points, indicating very high function. The minimum possible score is 0 points, indicating very low function.
Visual Analogue Scale (VAS).
Time frame: four weeks
This tool is used to measure the intensity of pain. The patient marks the intensity of pain on scale ranging 0 to 10. Where 0 is no pain and 10 describes worst ever type of pain
Modified sit and reach test
Time frame: four weeks
This test is used to assess the flexibility of hamstring and lower back. For the Modified Sit and Reach, the participants will be seated on the floor with head, back and hip against a wall (90◦ angle at hip joint), with both legs fully extended and the feet placed against the box. In this position, the participant will be required to place hand over hand and reach out level with the measurement scale, keeping the head, back, and hips in contact with the wall, with only scapular abduction performed. Then the finger to-box distance will be measured as the distance between the fingertips and the point at which the feet rested against the box (point 35 of the scale).
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Jun 2023.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
maria Khalid, MSOMPT principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Active Release Technique and Mulligan Bent Leg Raise in people with Hamstring Injury, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 28 Jun 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Active Knee Extension Test (time frame: four weeks). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jun 2023.