Low Back PainNCT07026045
Post Isometric Relaxation Versus Post Facilitation Stretch Techniques in Chronic Low Back Pain
A study testing Post isometric relaxation (Lewit,s) and Post-Facilitation Stretch Technique (Janda's technique) in people with Low Back Pain, run by Riphah International University at 1 site in Pakistan.
Trial summary
This randomized controlled trial will be conducted at Riphah Rehabilitation Clinic and Spinacure clinic in Lahore over a 9-month period. A sample size of 42 participants, aged 18 to 45, will be selected using convenient sampling. Informed consent will be obtained from all participants. Read more about this study
- Who is it for?
- Ages 18 to 45 years
- Conditions the study is for
- Low Back Pain
- What is being tested?
- Post isometric relaxation (Lewit,s) and Post-Facilitation Stretch Technique (Janda's technique)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 42 participants
- Where
- 1 sitePakistan
- Study dates
- 1 May 2025to 28 Sep 2025
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 18 to 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age of patient between 18 to 45 year
- Both gender
- (LBP) for more than 3 months
- Diagnosis of Chronic Low Back Pain (CLBP)
- Negative SLR, negative faber test, negative lumber quadrant
- Lumber extension test positive, positive scobber test
Show all 9Show fewer
- Having low back pain below the costal margin and above inferior gluteal folds and suffering from low back pain
- Disability level of more than 14% and less than 50% according to Oswestry questionnaire
- NPRS score of >3 to ≤7
Who cannot join
- Chronic systemic soft tissue and bony disease
- Any neurological symptoms involving Prolapsed Intervertebral Disc, Radiculopathy Back pain with trauma
- History of recent abdominal, back surgeries and pregnancy
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site, 1 recruiting
- Recruiting
Riphah Rehabilitation Clinic
Lahore, Punjab Province, 54000
Syed Shakil ur Rehman, PhD, +92 320 7866611, shakil.urrehman@riphah.edu.pk
Rao Irfan Ali, MS*
About this study
Official title: Effects of Post Isometric Relaxation Versus Post Facilitation Stretch Techniques on Pain, Mobility and Disability in Patients With Chronic Low Back Pain
This randomized controlled trial will be conducted at Riphah Rehabilitation Clinic and Spinacure clinic in Lahore over a 9-month period. A sample size of 42 participants, aged 18 to 45, will be selected using convenient sampling. Informed consent will be obtained from all participants. Participants will be divided into two groups: Group A will receive Post-Isometric Relaxation in addition to standard physical therapy, while Group B will receive Post-Facilitation Stretch in addition to standard physical therapy. Outcome measures, including the Numeric Pain Rating Scale (NPRS) for pain, inclinometer for mobility assessment, and Oswestry Disability Index (ODI) Urdu version for disability, will be assessed at baseline and after 4 weeks. Inclusion criteria include patients with CLBP aged 18-45 years, with pain levels between >3 and <7 on the NPRS, and an ODI score between 14% and 50%. Exclusion criteria include any neurological symptoms, systemic soft tissue and bony disease, and previous spinal surgeries. Data will be analyzed using IBM SPSS 25.0.
Read the detailed description
Low back pain (LBP) is one of the primary causes of physical impairment globally, affecting a significant portion of the population. It is associated with a high rate of absenteeism from work and substantial healthcare costs due to its pervasive nature. Chronic low back pain (CLBP), specifically, is a condition where pain is localized in the lumbar region and persists for more than 12 weeks. In contrast to acute low back pain, which typically resolves within six weeks, CLBP is characterized by a complex interplay of physical, psychological, and social factors that contribute to its persistence and chronicity .
Compared to other diseases, it is the primary cause of medical consultations, affects quality of life and performance at work, and occurs in a proportion that is similar in all cultures and ethnicities. Over 20% of people globally suffer from chronic LBP, and 24-80% of individuals experience a relapse during the first year. The prevalence of chronic low back pain (CLBP) in Pakistan is a significant health concern. A national survey conducted in 2021 found that 18% of individuals experiencing chronic pain reported low back pain as their primary complaint. This survey, involving 4,801 participants, highlighted the substantial impact of CLBP on daily life and the need for better pain management and awareness among patients (Journal of the Medical Association).
Management of CLBP typically involves a combination of pharmacological and non-pharmacological treatments. Pharmacological interventions include nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and analgesics to manage pain and inflammation. In some cases, antidepressants and anticonvulsants are prescribed for their pain-modulating effects. Non-pharmacological approaches are crucial for improving mobility and function. Physical therapy, including exercise programs designed to strengthen core muscles and improve flexibility, plays a vital role in rehabilitation. Manual therapy techniques, such as spinal manipulation and massage, and cognitive-behavioral therapy (CBT) to address the psychological aspects of chronic pain are also important. Lifestyle modifications, such as weight management, ergonomic adjustments, and activity modifications, are essential components of a comprehensive treatment plan.
Chronic low back pain (CLBP) is a prevalent and serious problem that affects millions of people, disrupting their daily activities and quality of life. To manage this condition effectively, strategies that reduce pain, improve movement, and lessen disability are needed. Post Isometric Relaxation (PIR) and Post Facilitation Stretch (PFS) are two techniques that can help with these goals. This study aims to compare the effects of PIR and PFS on pain, mobility, and disability in patients with CLBP. By finding out which method is more effective, clinicians can choose better treatments, improve patient outcomes, create better treatment guidelines, and enhance the quality of life for those suffering from chronic low back pain. This approach can also help lower healthcare costs by reducing the need for more invasive treatments and long-term medication use.
- Conditions
- Low Back Pain
- Being tested
- Post isometric relaxation (Lewit,s), Post-Facilitation Stretch Technique (Janda's technique)
- Keywords
- Low back pain, Post isometric relaxation, Post facilitation stretch
- Medical subject headings
- Low Back Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Post isometric relaxation (Lewit,s)Other
Post-isometric relaxation technique for the erector spinae, Iliopsoas, Quadratus Lumborum
Post-Facilitation Stretch Technique (Janda's technique)Other
Post-Facilitation Stretch Technique for the erector spinae, Iliopsoas, Quadratus Lumborum
| Study group | Role | What they receive |
|---|---|---|
| Group A | Experimental | Post isometric relaxation (Lewit,s) Receives: Other: Post isometric relaxation (Lewit,s) |
| Group B | Active comparator | Post facilitation stretch (Janda's technique) Receives: Other: Post-Facilitation Stretch Technique (Janda's technique) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numerical Pain Rating Scale
Measured: Baseline, 4th Week
Lumbar Flexion
Measured: Baseline, 4th Week
Lumbar Extension
Measured: Baseline, 4th week
Lumbar Side Flexion
Measured: Baseline, 4th Week
Oswestry Disability Index
Measured: Baseline, 4th Week
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Jun 2025
- Study start1 May 2025
- Primary completion30 Aug 2025 (estimated)
- Study completion28 Sep 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Low Back PainStudies of the same condition, open and under way.
- 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
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 42 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Syed Shakil ur Rehman, PhD, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07026045
- Sponsor's protocol ID
- Rao Irfan- REC/RCR&AHS 24/0136
- Status last verified
- Jun 2025
- First submitted
- 11 Jun 2025
- Last updated
- 18 Jun 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
van Tulder MW, Koes BW, Bouter LM. Conservative treatment of acute and chronic nonspecific low back pain. A systematic review of randomized controlled trials of the most common interventions. Spine (Phila Pa 1976). 1997 Sep 15;22(18):2128-56. doi: 10.1097/00007632-199709150-00012.
PubMed 9322325Amjad MA, Siddiqui AM, Bashir K, Ghafoor AU, Durrani RS. Prevalence of chronic pain in Pakistan - a national survey. J Pak Med Assoc. 2023 Jun;73(6):1217-1220. doi: 10.47391/JPMA.6671.
PubMed 37427618Koes 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
Study at a glance
From the registry record, last updated by the sponsor on 18 Jun 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Post Isometric Relaxation Versus Post Facilitation Stretch Techniques on Pain, Mobility and Disability in Patients With Chronic Low Back Pain
- ClinicalTrials.gov ID
- NCT07026045
- Acronym / sponsor ID
- Rao Irfan- REC/RCR&AHS 24/0136
- Conditions
- Low Back Pain
- Keywords
- Low back pain, Post isometric relaxation, Post facilitation stretch
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 42 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 1 May 2025 (actual)
- Primary completion
- 30 Aug 2025 (estimated)
- Study completion
- 28 Sep 2025 (estimated)
- First posted
- 18 Jun 2025 (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.
This randomized controlled trial will be conducted at Riphah Rehabilitation Clinic and Spinacure clinic in Lahore over a 9-month period. A sample size of 42 participants, aged 18 to 45, will be selected using convenient sampling. Informed consent will be obtained from all participants. Participants will be divided into two groups: Group A will receive Post-Isometric Relaxation in addition to standard physical therapy, while Group B will receive Post-Facilitation Stretch in addition to standard physical therapy. Outcome measures, including the Numeric Pain Rating Scale (NPRS) for pain, inclinometer for mobility assessment, and Oswestry Disability Index (ODI) Urdu version for disability, will be assessed at baseline and after 4 weeks. Inclusion criteria include patients with CLBP aged 18-45 years, with pain levels between >3 and <7 on the NPRS, and an ODI score between 14% and 50%. Exclusion criteria include any neurological symptoms, systemic soft tissue and bony disease, and previous spinal surgeries. Data will be analyzed using IBM SPSS 25.0.
Detailed description
Low back pain (LBP) is one of the primary causes of physical impairment globally, affecting a significant portion of the population. It is associated with a high rate of absenteeism from work and substantial healthcare costs due to its pervasive nature. Chronic low back pain (CLBP), specifically, is a condition where pain is localized in the lumbar region and persists for more than 12 weeks. In contrast to acute low back pain, which typically resolves within six weeks, CLBP is characterized by a complex interplay of physical, psychological, and social factors that contribute to its persistence and chronicity .
Compared to other diseases, it is the primary cause of medical consultations, affects quality of life and performance at work, and occurs in a proportion that is similar in all cultures and ethnicities. Over 20% of people globally suffer from chronic LBP, and 24-80% of individuals experience a relapse during the first year. The prevalence of chronic low back pain (CLBP) in Pakistan is a significant health concern. A national survey conducted in 2021 found that 18% of individuals experiencing chronic pain reported low back pain as their primary complaint. This survey, involving 4,801 participants, highlighted the substantial impact of CLBP on daily life and the need for better pain management and awareness among patients (Journal of the Medical Association).
Management of CLBP typically involves a combination of pharmacological and non-pharmacological treatments. Pharmacological interventions include nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and analgesics to manage pain and inflammation. In some cases, antidepressants and anticonvulsants are prescribed for their pain-modulating effects. Non-pharmacological approaches are crucial for improving mobility and function. Physical therapy, including exercise programs designed to strengthen core muscles and improve flexibility, plays a vital role in rehabilitation. Manual therapy techniques, such as spinal manipulation and massage, and cognitive-behavioral therapy (CBT) to address the psychological aspects of chronic pain are also important. Lifestyle modifications, such as weight management, ergonomic adjustments, and activity modifications, are essential components of a comprehensive treatment plan.
Chronic low back pain (CLBP) is a prevalent and serious problem that affects millions of people, disrupting their daily activities and quality of life. To manage this condition effectively, strategies that reduce pain, improve movement, and lessen disability are needed. Post Isometric Relaxation (PIR) and Post Facilitation Stretch (PFS) are two techniques that can help with these goals. This study aims to compare the effects of PIR and PFS on pain, mobility, and disability in patients with CLBP. By finding out which method is more effective, clinicians can choose better treatments, improve patient outcomes, create better treatment guidelines, and enhance the quality of life for those suffering from chronic low back pain. This approach can also help lower healthcare costs by reducing the need for more invasive treatments and long-term medication use.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group A | Experimental | Other: Post isometric relaxation (Lewit,s)Post isometric relaxation (Lewit,s) |
| Group B | Active comparator | Other: Post-Facilitation Stretch Technique (Janda's technique)Post facilitation stretch (Janda's technique) |
Who may qualify
- Ages
- 18 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (9 listed)
- Age of patient between 18 to 45 year
- Both gender
- (LBP) for more than 3 months
- Diagnosis of Chronic Low Back Pain (CLBP)
- Negative SLR, negative faber test, negative lumber quadrant
Key exclusion criteria (3 listed)
- Chronic systemic soft tissue and bony disease
- Any neurological symptoms involving Prolapsed Intervertebral Disc, Radiculopathy Back pain with trauma
- History of recent abdominal, back surgeries and pregnancy
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 |
|---|---|---|
| Post isometric relaxation (Lewit,s)Post-isometric relaxation technique for the erector spinae, Iliopsoas, Quadratus Lumborum | Other | Group A |
| Post-Facilitation Stretch Technique (Janda's technique)Post-Facilitation Stretch Technique for the erector spinae, Iliopsoas, Quadratus Lumborum | Other | Group B |
Primary outcome
Numerical Pain Rating Scale
Time frame: Baseline, 4th Week
Lumbar Flexion
Time frame: Baseline, 4th Week
Lumbar Extension
Time frame: Baseline, 4th week
Lumbar Side Flexion
Time frame: Baseline, 4th Week
Oswestry Disability Index
Time frame: Baseline, 4th Week
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Jun 2025.
- Background: PubMed 9322325van Tulder MW, Koes BW, Bouter LM. Conservative treatment of acute and chronic nonspecific low back pain. A systematic review of randomized controlled trials of the most common interventions. Spine (Phila Pa 1976). 1997 Sep 15;22(18):2128-56. doi: 10.1097/00007632-199709150-00012.
- Background: PubMed 37427618Amjad MA, Siddiqui AM, Bashir K, Ghafoor AU, Durrani RS. Prevalence of chronic pain in Pakistan - a national survey. J Pak Med Assoc. 2023 Jun;73(6):1217-1220. doi: 10.47391/JPMA.6671.
- Background: PubMed 16777886Koes 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.
- 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.
Syed Shakil ur Rehman, PhD 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 Post isometric relaxation (Lewit,s) and Post-Facilitation Stretch Technique (Janda's technique) in people with Low Back Pain, 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 9 inclusion and 3 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: looking for participants now, as of the sponsor's last update on 18 Jun 2025. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Syed Shakil ur Rehman, PhD (+92 320 786661, shakil.urrehman@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numerical Pain Rating Scale (time frame: Baseline, 4th Week). The study lists 5 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 NCT07026045, which also lists 3 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 18 Jun 2025.