Psoas Major Muscle Intervention on Chronic Lumbar Pain in Cleaning Professionals.

Official title

Influence of the Stretching Technique on the Psoas Major Muscle on Chronic Lumbar Pain in Cleaning Professionals: Randomized Controlled Trial.

Overview

The goal of this randomized controlled trial is to determine the effect of a psoas major muscle intervention on non-specific and chronic lumbar pain in cleaning professionals. It is expected that this intervention will reduce the severity and frequency of symptoms. This study aims to evaluate the effect of psoas major stretching techniques. To collect data, participants will rate their pain intensity on a numeric pain scale at rest and during maximal lumbar flexion. Secondary variables include lumbar flexion range of motion (ROM), assessed by the Schöber test, and hip ROM, which will be measured before and after the intervention using a digital goniometer.

Detailed description

Cleaning professionals are particularly vulnerable to musculoskeletal pain, predominantly low back pain due to intense occupational hazards like repetitive movements, heavy lifting in awkward postures, and prolonged standing. The psoas major muscle plays a critical role in this clinical context; morphological changes, such as muscle atrophy and fat infiltration, are commonly observed in low back pain patients. Furthermore, a shortened or asymmetrical psoas alters spinal biomechanics-often increasing lumbar lordosis and overloading facet joints-which strongly predisposes individuals to chronic pain and instability. Furthermore, a shortened or asymmetrical psoas alters spinal biomechanics-often increasing lumbar lordosis and overloading facet joints-which strongly predisposes individuals to chronic pain and instability.

This study aims to highlight the biomechanical importance of the iliopsoas muscle and evaluate the therapeutic impact of the stretching technique in reducing symptoms, improving mobility, and preventing functional limitations associated with iliopsoas dysfunction.

Interventions

• Other Psoas stretching technique
  The patient is positioned supine at the edge of the table. The investigator places their hands on both of the participant's knees, applying gentle downward pressure on the ipsilateral knee to stretch the psoas major muscle. This stretch is held for 30 seconds and performed bilaterally (once on each side) to the experimental group.
• Other Placebo
  Patient is positioned supine at the edge of the table. The investigator places one hand on the participant's ipsilateral knee without applying any pressure or force, and the other hand on the contralateral knee for stabilization. This position is maintained for 30 seconds to match the duration of the experimental intervention. The technique was performed bilaterally (once on each side) to the control group.

Primary outcome measures

• Low Back Pain Intensity at Rest Assessed Using the Numeric Pain Rating Scale (NPRS, 0-10) [Time frame: Baseline and immediately after completion of the intervention.]

Secondary outcome measures (2)

• Lumbar Range of Motion Assessed Using the Schober Test [Time frame: Baseline and immediately after completion of the intervention.]
• Hip Flexion Range of Motion Assessed Using a Digital Goniometer [Time frame: Baseline and immediately after completion of the intervention.]

Eligibility criteria

Inclusion criteria

• Being a cleaning professional for at least 4 years
• Report at least 1 episode of lumbar pain in the last 3 months

Exclusion criteria

• Any severe spinal condition (such as spondylolisthesis, spine fracture, etc.)
• Any severe neurological or rheumatological condition
• Pregnancy
• Daily use of pain medication

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

Double blind

Primary purpose

Treatment

Study locations

Portugal · 1 center

• Escola Superior de Saúde do Porto — Porto

Publications

• Pourahmadi M, Asadi M, Dommerholt J, Yeganeh A. Changes in the macroscopic morphology of hip muscles in low back pain. J Anat. 2020 Jan;236(1):3-20. doi: 10.1111/joa.13086. Epub 2019 Sep 1. PMID 31475359
• Abdol Rahman, M. N., Muhamad Jaffar, M. S., Hassan, M. F., Ngali, M. Z., & Pauline, O. Exposure level of ergonomic risk factors in hotel industries. IOP Conference Series: Materials Science and Engineering. 2017. 226, 012018.
• 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. PMID 16777886
• Badarin K, Hemmingsson T, Hillert L, Kjellberg K. Physical workload and increased frequency of musculoskeletal pain: a cohort study of employed men and women with baseline occasional pain. Occup Environ Med. 2021 Jan 17;78(8):558-66. doi: 10.1136/oemed-2020-107094. Online ahead of print. PMID 33455921
• Mallio CA, Russo F, Vadala G, Papalia R, Pileri M, Mancuso V, Bernetti C, Volpecina M, Di Gennaro G, Beomonte Zobel B, Denaro V. The importance of psoas muscle on low back pain: a single-center study on lumbar spine MRI. N Am Spine Soc J. 2024 May 1;18:100326. doi: 10.1016/j.xnsj.2024.100326. eCollection 2024 Jun. PMID 38947493
• Scherzer T, Rugulies R, Krause N. Work-related pain and injury and barriers to workers' compensation among Las Vegas hotel room cleaners. Am J Public Health. 2005 Mar;95(3):483-8. doi: 10.2105/AJPH.2003.033266. PMID 15727981

Identifiers

NCT: NCT07672197 · OST1-022

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗