Thoracic Mobility Versus Hip Mobility Exercises to Core Stabilization in Lumbar Spondylitis

Overview

This study is conducted to determine the effect of thoracic mobility versus hip mobility exercises to core stabilization on pain severity (NPRS-Ar), functional disability (MODI-Ar), lumbar range of motion (BROM), spinal mobility (modified schober test), quality of life (SF-36-Ar) and fear of movement (Tampa-Ar) in treatment of patients with lumbar spondylitis.

Detailed description

This study is conducted to determine the effect of thoracic mobility versus hip mobility exercises to core stabilization on pain severity

, functional disability , lumbar range of motion , spinal mobility , quality of life and fear of movement in treatment of patients with lumbar spondylitis.

Interventions

• Behavioral Group A : Core stabilization exercises (control group)
  Before starting the exercise, patients will be taught to reduce the lumbar lordosis by contracting and drawing in the abdominal muscles and to find the 24 lumbar and pelvic neutral position by moving the pelvis forwards and backwards (pelvic tilt, bridge, bird-dog and plank etc.). In each session, the neutral position will be found first and attention will be paid to maintain the neutral position throughout the exercise. In addition, core stability exercises including simultaneous contractions o
• Behavioral Group B: Thoracic Mobility Exercises (1st experimental group only)
  The exercise will consist of movements in all directions of thoracic spine flexion, extension, lateral flexion, and rotation. In the thoracic spine extension exercise, both hands will be locked behind the wrists and the back will be placed on a foam roller with the feet positioned 25 flat on the floor. The knee will be maintained at 90° to perform the extension exercise on the foam roller. The hands will be locked with the elbow on a chair. After kneeling, the hip will be moved toward the heels
• Behavioral Group C: Hip Mobility Exercises (2nd experimental group only)
  The patients will perform 8 different hip mobility exercises; reverse v-ups, butterfly, frog, internal rotation with foot rise, pike, revolved crescent lunge, pigeon, lunge on the knee. Each exercise will be performed for 2 sets of 20 seconds.

Primary outcome measures

• Pain levels [Time frame: (pre-treatment) and after 6 weeks of intervention (post-treatment)]
• Disability [Time frame: (pre-treatment) and after 6 weeks of intervention (post-treatment)]
• Lumbar Range of motion [Time frame: (pre-treatment) and after 6 weeks of intervention (post-treatment)]
• Spinal mobility: [Time frame: (pre-treatment) and after 6 weeks of intervention (post-treatment)]
• Fear of movement [Time frame: (pre-treatment) and after 6 weeks of intervention (post-treatment)]

Eligibility criteria

Inclusion criteria

• 1\. Patients will be referred from an orthopedic surgeon with confirmed diagnosis of lumbar spondylosis with imaging findings (MRI, CT or X-ray reports within the last 6 months) (Battié et al., 2014). 2.Duration of patient's symptoms will be more than 3 months (Oliveira et al., 2022). 3. Patients' age will range from 40-60 years (Kalichman \& Hunter, 2008). 4.Localized back pain and pain radiating to lower extremities with no distal involvement below knee with an NPRS more than 3 (Thompson et al., 2021).

Exclusion criteria

• Spinal or hip surgery history (Williams et al., 2022).
• Red Flags: Cauda equina syndrome, fracture, infection, malignancy (Finucane et al., 2020).
• Neurological Disorders: Parkinsonism, multiple sclerosis, or other neurological deficits (Odzimek et al., 2023).
• Inflammatory Conditions: Rheumatoid arthritis, ankylosing spondylitis, or infectious spinal disorders (Lee et al., 2018).
• Cognitive Impairment: Unable to understand or follow instructions (Martinez et al., 2024).
• Pregnancy. -

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Egypt · 1 center

• Faculity Og Physical Therapy in Cairo Univercity — Cairo

Publications

• World Health Organization, (WHO). (2023). Global health estimates 2019: Deaths by cause, age, sex, by country and by region, 2000-2019.
• Wilson, A. & Clarke, S. (2023). Hip mobility interventions in chronic low back pain: A biomechanical analysis using 3D motion capture. Clin Biomech, 98: 105-112.
• Wilson, A., Thompson, M. & Kumar, S. (2023). Multi-regional approach to chronic low back pain: Combining thoracic and hip interventions. J Rehabil Med, 55(4): 245-253.
• Thompson, M., Reiman, M. P., Sylvain, J., Tenforde, A. S. & Davis, I. S. (2021). The role of hip abductor strength in people with patellofemoral pain: A systematic review and meta-analysis. Sports Health, 12(6): 552 558.
• Skundric, G., Vukicevic, V., & Lukic, N. (2021). Effects of Core Stability Exercises, Lumbar Lordosis and Low-Back Pain: A Systematic Review. Journal of Anthropology of Sport and Physical Education, 5(1), 17-23. https://doi.org/10.26773/jaspe.210104
• Sivakumar, R. & Hossain, S. (2025). Effects of thoracic mobility exercises combined with breathing techniques on pain, muscle strength, and self efficacy in undergraduate students with upper back pain. Int J Therap Rehabil, 32(1): 1-9. DOI:10.13140/RG.2.2.34909.01767
• Scholtes, S. A., Gombatto, S. P. & Van Dillen, L. R. (2009). The influence of hip motion on the lumbar spine and pelvis during gait in people with and without low back pain. Phys. Ther., 89(11): 1151-1160.
• Salah Eldeen, A. A., Rehab, N. I., Fahmy, E., Shendy, W. S. & Alsaid, H. M. (2024). Effect of thoracic spine mobilization as an adjunct to conventional physical therapy on chronic lumbosacral radiculopathy: A randomized controlled trial. Benha Int J Phys Ther, 2(2): 35 - 42. DOI: 10.21608/bijpt.2024.303076.1034

Identifiers

NCT: NCT07482527 · P.T.REC/012/006229

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗