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Lower Cross SyndromeNCT06303388

Effects of Bruegger's Exercises Versus Egoscue Exercise on Lower Cross Syndrome

A study testing Bruegger,s Exercise and Egoscue Exercise in people with Lower Cross Syndrome, run by Riphah International University at 1 site in Pakistan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study aims to find effects of Bruegger's Exercise versus Egoscue exercise on pain and hyperlordosis on patient with lower cross syndrome. This is interventional study which recruits 34 participants ,14 in each group. Read more about this study

Who is it for?
Ages 16 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Lower Cross Syndrome
What is being tested?
Bruegger,s Exercise and Egoscue Exercise
Could I receive a placebo?
No, everyone receives an active treatment
How many people
34 participants
Where
1 sitePakistan
Study dates
26 Feb 2024to 15 Jun 2024
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 16 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Inclusion Criteria: • Females and males aged between 16 to 65 years

  • Participants had to present with low back pain
  • Participants had to meet the criteria for lower crossed syndrome indicating tight hip flexors (Modified Thomas test) and erector spinae (visual assessment through toe touching) together with weak glutei (Prone Hip Extension Co-ordination/Strength Test) and abdominals (Trunk Flexion Co-ordination and Strength Test)and thoracic kyphosis.
  • Angle of anterior pelvic tilt > 10 degrees

Exclusion Criteria: • Participants who would be undergoing other forms of treatment that may interfere with the study, for the duration of the study, including other manipulative and physical therapies specific to back pain.

  • Presence of other conditions that may mimic low back pain, e.g. nerve entrapment.
  • Participants taking any medication that may interfere with the results of this study including, pain medication, anti-inflammatory medication, and muscle relaxants.
  • Surgery on the back, pelvis, or sacrum is indicated or has previously occurred
  • LBP having localised or radiating pain.
  • Practiced any kind of exercise or sports activity during the last 6 months.

Trial locations and contacts

1 site in 1 country.

Pakistan1 site
  • Pakistan Railway General Hospital

    Rawalpindi, Federal, 44000

Other trials in Pakistan

About this study

This study aims to find effects of Bruegger's Exercise versus Egoscue exercise on pain and hyperlordosis on patient with lower cross syndrome. This is interventional study which recruits 34 participants ,14 in each group.

Read the detailed description

A randomized control trial will be conducted on patients with lower cross syndrome. A total number of 34 participants will be randomised into two groups with 17 participants in each group. Both groups will receive Hot Packs on the lumbar area for 10 minutes. Group A will receive Conventional Therapy and will follow protocol of Bruegger's Exercise. Group B will follow protocol of the Egoscue exercise. This study aims to decrease pain and hyperlordosis.

Each group will be assessed at baseline which will include pain through NPRS, hyperlordosis through flexicurve ruler and anterior pelvic tilt through pelvic inclinometer. Data from both groups will again be assessed after 4 weeks of intervention.

Protocol of Bruegger's Exercise: Pt. position: Upright sitting on a chair.

  1. Sit with your buttocks at the edge of a chair.
  2. Spread your legs apart slightly.
  3. Turn your toes out slightly.
  4. Rest your weight on your legs/feet \& relax your abdominal muscles.
  5. Tilt your pelvis forward (i.e. arch your lower back) while lifting your chest up
  6. Rotate your arms outward while turning your palms up.
  7. Hold your head high in the air, with a slight arch in the neck.

The patient is to perform this exercise once or twice every 20-30 minutes of prolonged sitting and held in this position for 30-60 seconds. To avoid non-compliance patient will be asked to perform five repetitions of particular exercise with five second hold during their clinical session.

Protocol of Egoscue Exercise The Egoscue group received a total of 10 exercises which includes

  1. Static back alone and with breathing
  2. Abdominal contraction while in the static back position
  3. abductor press
  4. Overhead extension
  5. elbow curls on a wall
  6. Static wall
  7. Upper spinal twist
  8. pelvic tilts
  9. supine groin progressive
  10. Air bench exercises

Week 1: 3 times with 10 s hold time Week 2: 5 times with 10 s hold time Week 3: 15 times with 10 s hold time Week 4: 20 times with 10 s hold time

Being tested
Bruegger,s Exercise, Egoscue Exercise
Keywords
Pain, Hyperlordosis, Anterior pelvic tilt
Medical subject headings
Pain, Swayback

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Bruegger,s ExerciseOther

    Bruegger's Exercise protocol along with conventional Physiotherapy.

  • Egoscue ExerciseOther

    Egoscue Exercise along with conventional Physiotherapy.

Study groups in NCT06303388
Study groupRoleWhat they receive
Egoscue ExerciseExperimental• The Egoscue exercise comprise of 10 exercises which Included 1. Static back alone and with breathing. 2. Abdominal contraction while in the static back position. 3. abductor press 4. overhead extension 5. elbow curls on a wall 6. static wall 7. upper spinal twist 8 pelvic tilts 9.supine groin progressive 10.air bench exercises.
Receives: Other: Egoscue Exercise
Bruegger's ExerciseActive comparatorsteps include in Breugger's Exercise 1. Sit with your buttocks at the edge of a chair. 2. Spread your legs apart slightly. 3. Turn your toes out slightly. 4. Rest your weight on your legs/feet \& relax your abdominal muscles. 5. Tilt your pelvis forward (i.e. arch your lower back) while lifting your chest up 6. Rotate your arms outward while turning your palms up. 7. Hold your head high in the air, with a slight arch in the neck. The patient is to slowly exhale by breathing out through their lips while actively externally rotating their arms and spreading their fingers. The patient is to perform this exercise once or twice every 20-30 minutes of prolonged sitting and held in this position for 30-60 seconds
Receives: Other: Bruegger,s Exercise

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Flexicurve Ruler

    The flexicurve ruler (flexible) is commonly used to measure the degree of spinal curvature of the lumbar lordosis in the sagittal plane. The flexible ruler was placed according to the Youdas method, over spinous processes from T12 to S2 vertebrae. The ruler was then cautiously removed from the spine and traced onto a plain piece of white paper. A vertical line was drawn to connect the T12 and S2 landmarks (L line) and together with the maximum width of the lumbar curvature (H line

    Measured: 12 day

  2. Pelvic Inclinometer

    A pelvic inclinometer was used to measure the anterior/posterior inclination of the pelvis of the subjects. An inclinometer has a 23 Cm length base and two 15 Cm arms in each side that freely move 360 degrees in horizontal plane. The ends of the arms are placed on the bony landmarks.The subject was asked to stand with the feet shoulder width apart. Even pressure was applied to both the arms of the inclinometer at anterior superior iliac spine and posterior superior iliac spine, with a bubble in the center the reading was then measured in degrees.

    Measured: 12 day

  3. NPRS

    Several pain scales are used clinically to evaluate the severity of musculoskeletal pain, one of which is the Numeric Pain Rating Scale (NPRS-11), which is an eleven-point scale in which the endpoints are the extremes of no pain at all (score of 0) and the worst pain the patient has ever experienced (score of 10).

    Measured: 12 Day

Secondary outcomes (4)
  1. Modified Thomas Test

    This test was performed with the patient supine and the thighs positioned over the edge of the examining table. The patient was told to grasp the thigh of the untested limb and pull it toward the chest to flatten the back and stabilise the pelvis, preventing an increase in lumbar lordosis. A standard stretch position for the iliopsoas muscle is demonstrated with the hip extended and the leg hanging freely with normal knee flexion. A positive test was indicated if the hip remained flexed against gravity on tested limb. Additionally, if there was also knee extension on the tested limb then further testing was needed to decide between a tight iliopsoas or rectus femoris muscle. This was done by passively extending the knee of the tested limb to neutralize the effect of the rectus femoris and find if there was still no change in hip flexion.

    Measured: 12 day

  2. Visual Assessment through toe touching

    The patient was seated on the examining table with the pelvis in a vertical position and the legs extended. The patient was asked to actively flex foreword in order to bring the forehead to the knees. The normal functioning of the erector spinae should display an even 'C' shaped curve and a distance of 10cm from the knees to the forehead. There should be also no knee flexion and involve no pelvic tilting. Any deviation from these norms indicates shortness of the erector spinae muscles.

    Measured: 12 day

  3. Prone Hip Extension Co-ordination Test

    The patient lay prone and raised the tested thigh into extension with the knee held in an extended position. The researcher then palpated the lumbar erector spinae and gluteus maximus muscles. A normal activation sequence was then observed and palpated which involved first the hamstring and gluteus maximus muscles, then the contralateral lumbar erector spinae muscles and lastly the ipsilateral lumbar erector spinae muscles. A positive test result occurred if the lumbar erector spinae contracted before the gluteus maximus muscles did.

    Measured: 12 day

  4. Trunk Flexion Co-ordination and Strength Test

    The patient lay supine with the arms either behind the neck or forward across the body and knees bent. The researcher then contacted the patient's heels or positioned a hand under the patient's lumbar spine. The patient was then asked to complete a posterior pelvic tilt and raise the trunk up until the scapulae cleared the table. This position was maintained for 2 seconds. The patient then held the pelvic tilt while lowering their back to the table. The patient was then instructed to perform 10 repetitions while holding the last repetition for 30 seconds. A positive test result occurred if the patient could not perform 10 repetitions without the lumbar spine or heels rising off the table.

    Measured: 12 day

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Mar 2024
  2. Study start26 Feb 2024
  3. Primary completion5 Jun 2024
  4. Study completion15 Jun 2024

Resources

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
Single blind
Who is masked
Participant
Enrolment
34 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06303388
Sponsor's protocol ID
REC/MS-PT/01721
Status last verified
Jul 2026
First submitted
4 Mar 2024
Last updated
28 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Waters T. The effect of Bruegger's exercise on chronic low back pain in association with lower crossed syndrome: University of Johannesburg (South Africa); 2014.

  • Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. BMJ. 2006 Jun 17;332(7555):1430-4. doi: 10.1136/bmj.332.7555.1430. No abstract available.

    PubMed 16777886
  • May S, Johnson R. Stabilisation exercises for low back pain: a systematic review. Physiotherapy. 2008;94(3):179-89

  • Nourbakhsh MR, Arabloo AM, Salavati M. The relationship between pelvic cross syndrome and chronic low back pain. Journal of back and musculoskeletal rehabilitation. 2006;19(4):119-28.

  • Kudchadkar GS, Gurudut P, Welling A. Comparative effect of mat pilates and egoscue exercises in asymptomatic individuals with lumbar hyperlordosis: A randomized controlled trial. Indian Journal of Physical Therapy and Research. 2019;1(2):79-88.

  • Sequeira S, Gurudut P, Kage V. Exploring effects of Egoscue versus lumbar stabilisation exercises for lower crossed syndrome on postural stability and hyperlordotic posture correction. Comparative Exercise Physiology. 2023:1-12.

  • Vehrs Z. The Effect of Egoscue Corrective Exercises on Chronic Knee and Hip Pain: Brigham Young University; 2014.

  • Laxmi V R, G N, V S, G M, Gopinath Y, G T. Efficacy of Janda's approach versus bruegger's exercise in pelvic cross syndrome and its impact on quality of life. International Journal of Research in Pharmaceutical Sciences. 2020;11:1701-6.

  • Childs JD, Piva SR, Fritz JM. Responsiveness of the numeric pain rating scale in patients with low back pain. Spine (Phila Pa 1976). 2005 Jun 1;30(11):1331-4. doi: 10.1097/01.brs.0000164099.92112.29.

    PubMed 15928561
  • Kahl C, Cleland JA. Visual analogue scale, numeric pain rating scale and the McGill pain Questionnaire: an overview of psychometric properties. Physical therapy reviews. 2005;10(2):123-8.

  • Macintyre NJ, Bennett L, Bonnyman AM, Stratford PW. Optimizing reliability of digital inclinometer and flexicurve ruler measures of spine curvatures in postmenopausal women with osteoporosis of the spine: an illustration of the use of generalizability theory. ISRN Rheumatol. 2011;2011:571698. doi: 10.5402/2011/571698. Epub 2011 Feb 7.

    PubMed 22482067
  • Khan N, Nouman M, Iqbal MA, Anwar K, Sajjad AG, Hussain SA. Comparing the Effect of Stretching and Muscle Energy Technique in the Management of Lower Cross Syndrome. Pakistan Journal of Medical & Health Sciences. 2022;16(07):31-

Questions about this trial

What is this clinical trial studying?

A study testing Bruegger,s Exercise and Egoscue Exercise in people with Lower Cross Syndrome, 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?

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 Jul 2026. 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?

Flexicurve Ruler (time frame: 12 day). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06303388, which also lists 12 linked publications.

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 Jul 2026.

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