Lower Cross SyndromeNCT07838558
Comparative Effects of Autogenic Inhibition vs Reciprocal Inhibition in Patients With Lower Cross Syndrome
A study testing Autogenic Inhibition (Group A) and Reciprocal Inhibition in people with Lower Cross Syndrome, run by Foundation University Islamabad at 1 site in Pakistan.
Trial summary
This randomized controlled trial aims to compare the effectiveness of Autogenic Inhibition Muscle Energy Technique (MET) and Reciprocal Inhibition MET in individuals with Lower Crossed Syndrome. Participants will be randomly assigned to two intervention groups. Read more about this study
- Who is it for?
- Ages 19 to 35 years
- Conditions the study is for
- Lower Cross Syndrome
- What is being tested?
- Autogenic Inhibition (Group A) and Reciprocal Inhibition
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 46 participants
- Where
- 1 sitePakistan
- Study dates
- 12 Feb 2026to 18 Jan 2027
- 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 19 to 35 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age 19-35 years.
- Both genders will include in this study.
- According to Janda's Approach, Clinical diagnosis of LCS based on ≥3 positive clinical tests.
- Patient with positive modified Thomas test, Patients with a positive testing of prone hip extension test, Patients with a positive test of trunk flexion test, Patients with tight erector spinae muscles.
- Participants with no lumbar pain to moderate lumbar pain (NPRS0-6) will be included.
- Painless movement and activity.
- Pain only produced by sustained loading in relevant position, which is then relieved after maintaining a corrected posture for 5 minutes, indicating posture-related pain.
Who cannot join
- Leg symptoms when walking, eased in flexion (Signs of stenosis)
- Pain due to repetitive movement
- Lumbar Radiculopathy
- Neurological Symptoms (Paresthesia/numbness)
- Structural deformity (Kyphosis, lordosis, scoliosis, spondylosis, spondylolysis, spondylolisthesis)
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
Foundation University College of Physical Therapy
Islamabad, Punjab Province, 44000
Hafiz Ali Bin Asim, MS-SPT, 03135088144, pt.ali.asim@gmail.com
About this study
This randomized controlled trial aims to compare the effectiveness of Autogenic Inhibition Muscle Energy Technique (MET) and Reciprocal Inhibition MET in individuals with Lower Crossed Syndrome. Participants will be randomly assigned to two intervention groups. One group will receive Autogenic Inhibition MET, while the other will receive Reciprocal Inhibition MET for the iliopsoas, rectus femoris, and erector spinae muscles. Both groups will also perform the same standardized strengthening exercises targeting the transversus abdominis, gluteus maximus, and gluteus medius muscles to improve muscle balance and functional outcomes.
Read the detailed description
Participants who meet the eligibility criteria and provide informed consent will be randomly allocated into two experimental groups using a randomization method. The intervention will be carried out over a period of six weeks, with three treatment sessions per week, making a total of 18 sessions for each participant. Before the commencement of each treatment session, all participants will receive a 10-minute hot pack application over the lumbar region to promote muscle relaxation, reduce soft tissue stiffness, and prepare the muscles for manual therapy. Following the hot pack, participants will receive the assigned Muscle Energy Technique (MET) according to their respective group.
Participants in Experimental Group 1 will receive Autogenic Inhibition Muscle Energy Technique (Modified Post-Facilitation Stretch Protocol) targeting the iliopsoas, rectus femoris, and erector spinae muscles. The therapist will position the involved muscle at its initial barrier, after which the participant will perform an isometric contraction of approximately 20-30% of maximal effort for 7-10 seconds against the therapist's resistance. After relaxation, the muscle will be gently stretched to the new barrier and the stretch will be maintained for 30 seconds. This procedure will be repeated 3-5 times for each muscle during every treatment session.
Participants in Experimental Group 2 will receive Reciprocal Inhibition Muscle Energy Technique for the same muscle groups. The therapist will position the muscle at the initial barrier, and the participant will perform an isometric contraction of the antagonist muscle using approximately 20-30% of maximal effort for 7-10 seconds. Following relaxation, the therapist will move the muscle to the new barrier and maintain the stretch for 30 seconds. The technique will also be repeated 3-5 times for each targeted muscle during every treatment session.
Both groups will follow an identical strengthening exercise program to address the weak muscles commonly associated with Lower Crossed Syndrome. The strengthening program will target the transversus abdominis, gluteus maximus, and gluteus medius muscles using progressive therapeutic exercises prescribed according to the participant's tolerance. During the first two weeks, the intervention will primarily emphasize improving flexibility and reducing muscle tightness through the assigned MET. From Week 3 to Week 6, participants will continue receiving their allocated MET while simultaneously performing the strengthening exercises to restore muscle balance, improve lumbopelvic stability, and enhance functional performance. Exercise intensity and repetitions will be progressed gradually throughout the intervention while maintaining proper technique and patient comfort.
The treatment duration, session frequency, hot pack application, strengthening protocol, therapist supervision, and progression of exercises will remain identical for both groups. The only difference between the two groups will be the type of Muscle Energy Technique employed-Autogenic Inhibition MET in Experimental Group 1 and Reciprocal Inhibition MET in Experimental Group 2. Outcome measures will be recorded before and after completion of the intervention period to evaluate the comparative effectiveness of both treatment approaches in improving pain, muscle flexibility, lumbar range of motion, posture, and functional disability among individuals with Lower Crossed Syndrome.
- Conditions
- Lower Cross Syndrome
- Being tested
- Autogenic Inhibition (Group A), Reciprocal Inhibition
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Autogenic Inhibition (Group A)Procedure or surgery
Experimental Group 1 will receive MET based on autogenic inhibition using Modified Post-Facilitation Stretch (PFS) for the iliopsoas, rectus femoris, and erector spinae. For the iliopsoas, subjects will assume modified Thomas position and perform a 30% isometric contraction for 7-10 seconds, followed by relaxation and hip extension stretching for 30 seconds. For rectus femoris, the procedure will be performed in modified Thomas position with knee flexion, followed by hip extension and knee flexion stretching for 30 seconds. For erector spinae, subjects will sit with legs hanging and arms crossed, perform a 30% isometric contraction for 7-10 seconds, followed by trunk flexion for 30 seconds. Each technique will include 30-second rest and 3-5 repetitions. From the 3rd to 6th week, strengthening will include TA activation, gluteus maximus bridging, and gluteus medius abduction.
Reciprocal InhibitionProcedure or surgery
Experimental Group 2 will receive MET based on reciprocal inhibition for the iliopsoas, rectus femoris, and erector spinae. For the iliopsoas, subjects will assume modified Thomas position and perform a 30% isometric contraction of the gluteus maximus for 7-10 seconds, followed by relaxation and passive hip extension stretching for 30-60 seconds. For rectus femoris, subjects will assume modified Thomas position followed by a 30% isometric hamstring contraction for 7-10 seconds and passive stretching into hip extension with knee flexion for 30-60 seconds. For Erector Spinae, subjects will sit with legs hanging and perform a 30% isometric transverse abdominis contraction for 7-10 seconds, followed by trunk flexion for 30-60 seconds. From the 3rd to 6th week, strengthening will include TA activation, gluteus maximus bridging, and gluteus medius abduction.
| Study group | Role | What they receive |
|---|---|---|
| Autogenic Inhibtion (Group A) | Active comparator | Group A will receive Autogenic inhibition using PFS, preceded by 10 minutes heating pad application. 30% Isometric contraction(7-10 sec), followed by relaxation \& 30 sec stretch, will be repeated 3-5 time. From Weeks 3-6, strenghtening exercises for hip extensors \& Transverse Abdominis will be performed. Receives: Procedure: Autogenic Inhibition (Group A) |
| Reciprocal Inhibition (Group B) | Experimental | Group B will receive Reciprocal Inhibition using using MET,preceding by a 10 minute heating pad application. A 30% isometric contraction(7-10 sec) of antagonist muscle, followed by relaxation \& 30-60sec passive stretch, will be repeated 3-5 times. From 3-6 weeks strenghening exercises for hip extensor \& transverse abdominis will be performed. Receives: Procedure: Reciprocal Inhibition |
What is being measured
The primary outcome is the main question the study is designed to answer.
Lumbar Extensor Muscle Length
The Modified Schober's Test will be used to assess lumbar extensor muscle length and lumbar spine mobility. The increase in distance between standardized spinal landmarks during maximal forward flexion will be measured and recorded in centimeters (cm). A greater increase in distance indicates greater lumbar extensor flexibility or length.
Measured: Baseline & after 6 weeks of intervention.
Functional Movement dysfunction
Functional Movement Screen will be used to assess functional movement dysfunction. It consists of seven tests, scored on a 0-3 scale, with a total score ranging from 0 to 21. Lower scores indicate greater movement dysfunction.
Measured: Baseline and after 6 Weeks of intervention.
Back Pain
Pain intensity will be assessed using the Numerical Pain Rating Scale, ranging from 0 (no pain) to 10 (worst possible pain). Participants reporting pain intensity scores of 0-6 on the NPRS will be eligible for inclusion in the study.
Measured: Baseline and after 6 Weeks of intervention.
Functional Disability
Functional disability will be assessed using the Oswestry Disability Index (ODI), a 10-item questionnaire, with each item consisting of six response options.
Measured: Baseline and after 6 Weeks of intervention
Lumbar Range Of Motion
Lumbar spine range of motion (ROM) will be assessed using inclinometer, including lumbar flexion, extension, and lateral flexion. Lumbar ROM will be determined by measuring the difference between the readings obtained at the T12 and S2 spinal landmarks.
Measured: Baseline and after 6 Weeks of invention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted24 Sep 2026
- Study start12 Feb 2026
- Primary completion18 Dec 2026 (estimated)
- Study completion18 Jan 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Lower Cross SyndromeStudies of the same condition, open and under way.
- More trials run by Foundation University IslamabadThe 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
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 46 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Foundation University Islamabad
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07838558
- Sponsor's protocol ID
- FUI/FUCP/CTR/MSMSK/MomnaKhadim
- Status last verified
- Sep 2026
- First submitted
- 18 Sep 2026
- Last updated
- 24 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 24 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparative Effects of Autogenic Inhibition vs Reciprocal Inhibition in Patients With Lower Cross Syndrome
- ClinicalTrials.gov ID
- NCT07838558
- Acronym / sponsor ID
- FUI/FUCP/CTR/MSMSK/MomnaKhadim
- Conditions
- Lower Cross Syndrome
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 46 participants (estimated)
- Lead sponsor
- Foundation University IslamabadUniversity, hospital or other
- Study start
- 12 Feb 2026 (actual)
- Primary completion
- 18 Dec 2026 (estimated)
- Study completion
- 18 Jan 2027 (estimated)
- First posted
- 24 Sep 2026 (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 aims to compare the effectiveness of Autogenic Inhibition Muscle Energy Technique (MET) and Reciprocal Inhibition MET in individuals with Lower Crossed Syndrome. Participants will be randomly assigned to two intervention groups. One group will receive Autogenic Inhibition MET, while the other will receive Reciprocal Inhibition MET for the iliopsoas, rectus femoris, and erector spinae muscles. Both groups will also perform the same standardized strengthening exercises targeting the transversus abdominis, gluteus maximus, and gluteus medius muscles to improve muscle balance and functional outcomes.
Detailed description
Participants who meet the eligibility criteria and provide informed consent will be randomly allocated into two experimental groups using a randomization method. The intervention will be carried out over a period of six weeks, with three treatment sessions per week, making a total of 18 sessions for each participant. Before the commencement of each treatment session, all participants will receive a 10-minute hot pack application over the lumbar region to promote muscle relaxation, reduce soft tissue stiffness, and prepare the muscles for manual therapy. Following the hot pack, participants will receive the assigned Muscle Energy Technique (MET) according to their respective group.
Participants in Experimental Group 1 will receive Autogenic Inhibition Muscle Energy Technique (Modified Post-Facilitation Stretch Protocol) targeting the iliopsoas, rectus femoris, and erector spinae muscles. The therapist will position the involved muscle at its initial barrier, after which the participant will perform an isometric contraction of approximately 20-30% of maximal effort for 7-10 seconds against the therapist's resistance. After relaxation, the muscle will be gently stretched to the new barrier and the stretch will be maintained for 30 seconds. This procedure will be repeated 3-5 times for each muscle during every treatment session.
Participants in Experimental Group 2 will receive Reciprocal Inhibition Muscle Energy Technique for the same muscle groups. The therapist will position the muscle at the initial barrier, and the participant will perform an isometric contraction of the antagonist muscle using approximately 20-30% of maximal effort for 7-10 seconds. Following relaxation, the therapist will move the muscle to the new barrier and maintain the stretch for 30 seconds. The technique will also be repeated 3-5 times for each targeted muscle during every treatment session.
Both groups will follow an identical strengthening exercise program to address the weak muscles commonly associated with Lower Crossed Syndrome. The strengthening program will target the transversus abdominis, gluteus maximus, and gluteus medius muscles using progressive therapeutic exercises prescribed according to the participant's tolerance. During the first two weeks, the intervention will primarily emphasize improving flexibility and reducing muscle tightness through the assigned MET. From Week 3 to Week 6, participants will continue receiving their allocated MET while simultaneously performing the strengthening exercises to restore muscle balance, improve lumbopelvic stability, and enhance functional performance. Exercise intensity and repetitions will be progressed gradually throughout the intervention while maintaining proper technique and patient comfort.
The treatment duration, session frequency, hot pack application, strengthening protocol, therapist supervision, and progression of exercises will remain identical for both groups. The only difference between the two groups will be the type of Muscle Energy Technique employed-Autogenic Inhibition MET in Experimental Group 1 and Reciprocal Inhibition MET in Experimental Group 2. Outcome measures will be recorded before and after completion of the intervention period to evaluate the comparative effectiveness of both treatment approaches in improving pain, muscle flexibility, lumbar range of motion, posture, and functional disability among individuals with Lower Crossed Syndrome.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Autogenic Inhibtion (Group A) | Active comparator | Procedure: Autogenic Inhibition (Group A)Group A will receive Autogenic inhibition using PFS, preceded by 10 minutes heating pad application. 30% Isometric contraction(7-10 sec), followed by relaxation \& 30 sec stretch, will be repeated 3-5 time. From Weeks 3-6, strenghtening exercises for hip extensors \& Transverse Abdominis will be performed. |
| Reciprocal Inhibition (Group B) | Experimental | Procedure: Reciprocal InhibitionGroup B will receive Reciprocal Inhibition using using MET,preceding by a 10 minute heating pad application. A 30% isometric contraction(7-10 sec) of antagonist muscle, followed by relaxation \& 30-60sec passive stretch, will be repeated 3-5 times. From 3-6 weeks strenghening exercises for hip extensor \& transverse abdominis will be performed. |
Who may qualify
- Ages
- 19 to 35 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (7 listed)
- Age 19-35 years.
- Both genders will include in this study.
- According to Janda's Approach, Clinical diagnosis of LCS based on ≥3 positive clinical tests.
- Patient with positive modified Thomas test, Patients with a positive testing of prone hip extension test, Patients with a positive test of trunk flexion test, Patients with tight erector spinae muscles.
- Participants with no lumbar pain to moderate lumbar pain (NPRS0-6) will be included.
Key exclusion criteria (5 listed)
- Leg symptoms when walking, eased in flexion (Signs of stenosis)
- Pain due to repetitive movement
- Lumbar Radiculopathy
- Neurological Symptoms (Paresthesia/numbness)
- Structural deformity (Kyphosis, lordosis, scoliosis, spondylosis, spondylolysis, spondylolisthesis)
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 |
|---|---|---|
| Autogenic Inhibition (Group A)Experimental Group 1 will receive MET based on autogenic inhibition using Modified Post-Facilitation Stretch (PFS) for the iliopsoas, rectus femoris, and erector spinae. For the iliopsoas, subjects will assume modified Thomas position and perform a 30% isometric contraction for 7-10 seconds, followed by relaxation and hip extension stretching for 30 seconds. For rectus femoris, the procedure will be performed in modified Thomas position with knee flexion, followed by hip extension and knee flexion stretching for 30 seconds. For erector spinae, subjects will sit with legs hanging and arms crossed, perform a 30% isometric contraction for 7-10 seconds, followed by trunk flexion for 30 seconds. Each technique will include 30-second rest and 3-5 repetitions. From the 3rd to 6th week, strengthening will include TA activation, gluteus maximus bridging, and gluteus medius abduction. | Procedure or surgery | Autogenic Inhibtion (Group A) |
| Reciprocal InhibitionExperimental Group 2 will receive MET based on reciprocal inhibition for the iliopsoas, rectus femoris, and erector spinae. For the iliopsoas, subjects will assume modified Thomas position and perform a 30% isometric contraction of the gluteus maximus for 7-10 seconds, followed by relaxation and passive hip extension stretching for 30-60 seconds. For rectus femoris, subjects will assume modified Thomas position followed by a 30% isometric hamstring contraction for 7-10 seconds and passive stretching into hip extension with knee flexion for 30-60 seconds. For Erector Spinae, subjects will sit with legs hanging and perform a 30% isometric transverse abdominis contraction for 7-10 seconds, followed by trunk flexion for 30-60 seconds. From the 3rd to 6th week, strengthening will include TA activation, gluteus maximus bridging, and gluteus medius abduction. | Procedure or surgery | Reciprocal Inhibition (Group B) |
Primary outcome
Lumbar Extensor Muscle Length
Time frame: Baseline & after 6 weeks of intervention.
The Modified Schober's Test will be used to assess lumbar extensor muscle length and lumbar spine mobility. The increase in distance between standardized spinal landmarks during maximal forward flexion will be measured and recorded in centimeters (cm). A greater increase in distance indicates greater lumbar extensor flexibility or length.
Functional Movement dysfunction
Time frame: Baseline and after 6 Weeks of intervention.
Functional Movement Screen will be used to assess functional movement dysfunction. It consists of seven tests, scored on a 0-3 scale, with a total score ranging from 0 to 21. Lower scores indicate greater movement dysfunction.
Back Pain
Time frame: Baseline and after 6 Weeks of intervention.
Pain intensity will be assessed using the Numerical Pain Rating Scale, ranging from 0 (no pain) to 10 (worst possible pain). Participants reporting pain intensity scores of 0-6 on the NPRS will be eligible for inclusion in the study.
Functional Disability
Time frame: Baseline and after 6 Weeks of intervention
Functional disability will be assessed using the Oswestry Disability Index (ODI), a 10-item questionnaire, with each item consisting of six response options.
Lumbar Range Of Motion
Time frame: Baseline and after 6 Weeks of invention
Lumbar spine range of motion (ROM) will be assessed using inclinometer, including lumbar flexion, extension, and lateral flexion. Lumbar ROM will be determined by measuring the difference between the readings obtained at the T12 and S2 spinal landmarks.
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 24 Sep 2026.
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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.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Autogenic Inhibition (Group A) and Reciprocal Inhibition in people with Lower Cross Syndrome, run by Foundation University Islamabad 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 7 inclusion and 5 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 24 Sep 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 Momna Khadim, DPT (03321569497, momnakhadim117@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Lumbar Extensor Muscle Length (time frame: Baseline & after 6 weeks of intervention.). 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?
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 24 Sep 2026.