AzTrials
AzTrials

Lower Cross SyndromeNCT07642271

Effects of Sahrmann's Versus Janda Approach in Lower Crossed Syndrome Patients

A study testing Sahrmann's approach and Jandas approach in people with Lower Cross Syndrome, run by Riphah International University at 1 site in Pakistan.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Muscular imbalance due to prolonged sitting or standing posture leads to a condition lower cross syndrome(LCS) or lumbopelvic syndrome. Several stretching and strengthening regimens are used to treat cross pattern of muscular tightness and weakness in LCS. Read more about this study

Who is it for?
Ages 18 to 40 years
Conditions the study is for
Lower Cross Syndrome
What is being tested?
Sahrmann's approach and Jandas approach
Could I receive a placebo?
No, everyone receives an active treatment
How many people
54 participants
Where
1 sitePakistan
Study dates
30 May 2026to 30 Aug 2026
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 40 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • • Gender (both)
  • Age (18 to 40)
  • Participants who fulfilled the criteria of lower cross syndrome

Who cannot join

  • • Any serious pathology i.e. Neoplasm
  • Any history of trauma
  • Spinal malalignment i.e. Scoliosis
  • Receiving any other form of Physical therapy treatment

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Samrood Akram, PhD* contact

03324806143

samrood.akram@riphah.edu.pk

Pakistan1 site

  • Rasheed Hospital

    Lahore, Punjab Province, 54000

    Dr Abdul Rauf, MSPT, 923134649810, Dr.abdulraufpt@gmail.com

Other trials in Pakistan

About this study

Official title: Effects of Sahrmann's Versus Janda Approach on Pain, Pelvic Tilt and Lumbar Lordosis in Lower Crossed Syndrome Patients

Muscular imbalance due to prolonged sitting or standing posture leads to a condition lower cross syndrome(LCS) or lumbopelvic syndrome. Several stretching and strengthening regimens are used to treat cross pattern of muscular tightness and weakness in LCS. This study aims to compare the effects of Sahrmann's versus Janda's approach on pain, pelvic tilt and lumbar lordosis in lower crossed syndrome patients.

Read the detailed description

This study will be a randomized clinical trial and will be conducted in physiotherapy department of Rasheed Hospital, DHA. Non probability convenience sampling will be used to collect data. Sample size of 54 with age group between 18 to 40 years will be taken. Data will be collected from the patient who fulfilled the criteria of LCS. Outcome measures will be taken by using Numeric Pain Rating Scale (NPRS) for pain, I Handy Level for Pelvic tilt, flexible ruler for lumbar angle. An informed consent will be taken. Subjects will be selected on the basis of inclusion and exclusion criteria and will be equally divided into two groups by random number generator table. Group A will receive Sahrmann's exercise protocol while group B will receive Janda's Approach. Both groups will receive 10 mins heating pad and 10 mins Tens for muscle relaxation. Outcome measures will be measured at baseline and then at 4th week. Data Analysis will be done by IBM SPSS version 21.

Being tested
Sahrmann's approach, Jandas approach
Keywords
pain, pelvic tilt
Medical subject headings
Pain

What participants receive

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

  • Sahrmann's approachOther

    1. single knee to chest and double knee to chest
    2. Rectus femoris stretching
    3. kneeling psoas stretch
    4. piriformis stretch in pigeon pose
    5. lying piriformis stretch
    6. Sit and reach stretch

    1.Clamshell (side lying) strengthening of gluteus medius 2.Hip abduction gluteus medius strengthening 3.Extension of femur 4.isometric abdominal contraction(top to floor) 5. abdominal contraction(cat exercise)

  • Jandas approachOther

    1.50 to 70 degrees of trunk flexion 2.Pelvis tilting 3.One leg standing 4.Quadreped position (forward and backward movement) 5. Quadruped position (raising opposite arm and leg) 6. pelvic bridging 7.One leg bridge 8.Side Plank 9.Abdominal bracing 10. Knee active bending 90 degrees 11. Half Crunch

Study groups in NCT07642271
Study groupRoleWhat they receive
Sahrmann's approachExperimentalDr. Shirley Sahrmann's approach-rooted in her concept of Movement System Impairment (MSI) Syndromes-takes a functional, movement-based approach to postural dysfunctions like lower crossed syndrome (LCS). Rather than treating LCS strictly as a static structural cross-syndrome, her model emphasizes analyzing how the body moves in daily life
Receives: Other: Sahrmann's approach
Janda ApproachActive comparatorThe Janda approach to Lower Crossed Syndrome (LCS) corrects muscle imbalances caused by prolonged sitting or poor posture. It targets an alternating "cross" of tight and weak muscles-specifically tight hip flexors/lower back muscles and weak glutes/abdominals-to relieve low back pain and restore proper pelvic alignment.
Receives: Other: Jandas approach

What is being measured

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

  1. Numeric pain rate scale (NPRS) for pain

    The Numeric Pain Rating Scale (NRS) is an 11-point, standardized assessment tool used to measure subjective pain intensity. Ranging from 0 ("no pain") to 10 ("the worst pain imaginable"), it provides healthcare providers with a quick and reliable method to evaluate pain severity, track symptom changes, and measure treatment effectiveness

    Measured: upto 4 weeks

  2. Flexible Ruler for lumbar Lordosis (degree)

    To measure lumbar lordosis using a flexible ruler (flexicurve), mold it to the curvature of your spine from T12 to S2. Trace the curve onto paper to find the curve's length (\(L\)) and the maximum perpendicular height (\(H\)). Calculate the angle in degrees using the equation: \(\theta = 4 \times \arctan(2H/L)\).

    Measured: upto 4 weeks

  3. I Handy Level for Pelvic tilt(degree)

    The examiner performed the process three times, and during those three trials, the best view was acquired, the normal average anterior pelvic tilt angle is 9.6±3.5 and 11.7±3.8° in males and females, respectively

    Measured: upto 4 weeks

Timeline

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

  1. First posted11 Jun 2026
  2. Study start30 May 2026 (estimated)
  3. Primary completion30 Jul 2026 (estimated)
  4. Study completion30 Aug 2026 (estimated)

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
Outcomes assessor
Enrolment
54 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07642271
Sponsor's protocol ID
REC/RCR&AHS/25/0113 Rahila
Status last verified
Jun 2026
First submitted
8 Jun 2026
Last updated
11 Jun 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Kandil EA, Yamany AAER, Alsaka SSD, Abd El-Azeim AS. Effect of global postural reeducation on chronic low pain patients with lower cross syndrome. Bulletin of Faculty of Physical Therapy. 2024;29(1):8.

  • Sugavanam T, Sannasi R, Anand PA, Ashwin Javia P. Postural asymmetry in low back pain - a systematic review and meta-analysis of observational studies. Disabil Rehabil. 2025 Apr;47(7):1659-1676. doi: 10.1080/09638288.2024.2385070. Epub 2024 Aug 21.

    PubMed 39166267

  • 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.

  • Pradeep S, Heggannavar A, Metgud S. Effect of Sciatic Nerve Neurodynamic Sustained Natural Apophyseal Glides on Individuals with Pelvic Crossed Syndrome: A Randomized Controlled Trial. Indian Journal of Physical Therapy and Research. 2020;2(1):35-40.

  • Puagprakong P, Earde P, Kooncumchoo P, editors. Lumbo-Pelvic-Hip Angle Changes During Upright and Free Style Sitting in Office Workers with Lower Crossed Syndrome. Human Interaction, Emerging Technologies and Future Applications IV; 2021 2021//; Cham: Springer International Publishing.

  • 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

  • Seidi F, Rajabi R, Ts E, Sj M. Iranian Flexible ruler Reliability and Validity in Lumbar Lordosis Measurement. World Journal of Sport Sciences. 2009;2:95-9.

  • Lewandrowski KU, Elfar JC, Li ZM, Burkhardt BW, Lorio MP, Winkler PA, Oertel JM, Telfeian AE, Dowling A, Vargas RAA, Ramina R, Abraham I, Assefi M, Yang H, Zhang X, Ramirez Leon JF, Fiorelli RKA, Pereira MG, de Carvalho PST, Defino H, Moyano J, Lim KT, Kim HS, Montemurro N, Yeung A, Novellino P. The Changing Environment in Postgraduate Education in Orthopedic Surgery and Neurosurgery and Its Impact on Technology-Driven Targeted Interventional and Surgical Pain Management: Perspectives from Europe, Latin America, Asia, and The United States. J Pers Med. 2023 May 18;13(5):852. doi: 10.3390/jpm13050852.

    PubMed 37241022

  • Luna, A., Casertano, L., Timmerberg, J., O'Neil, M., Machowsky, J., Leu, C.-S., . . . Agrawal, S. (2021). Artificial intelligence application versus physical therapist for squat evaluation: a randomized controlled trial. Scientific Reports, 11(1), 18109. doi:10.1038/s41598-021-97343-y Mahmoud, H., Aljaldi, F., El-Fiky, A., Battecha, K., Thabet, A., Alayat, M., . . . Ibrahim, A. (2023). Artificial Intelligence machine learning and conventional physical therapy for upper limb outcome in patients with stroke: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci, 27(11), 4812-4827. doi:10.26355/eurrev_202306_32598

Questions about this trial

What is this clinical trial studying?

A study testing Sahrmann's approach and Jandas approach 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?

The sponsor lists 3 inclusion and 4 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: opening soon, as of the sponsor's last update on 11 Jun 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?

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 Samrood Akram, PhD* (03324806143, samrood.akram@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Numeric pain rate scale (NPRS) for pain (time frame: upto 4 weeks). 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 NCT07642271, which also lists 9 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 11 Jun 2026.

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