Psoas Muscle Release in Non-specific Mechanical Low Back Pain

Официальное название

Efficacy of Psoas Muscle Release in Young Adults With Non-specific Mechanical Low Back Pain: Randomized Controlled Trial

Обзор

Nonspecific low back pain affects approximately 80% of the population at some point in their lives. The psoas muscle-positioned between the lumbar and pelvic regions-together with the paravertebral muscles, constitutes the primary muscular group responsible for dynamic stabilization of the spine. Alterations in this muscle may contribute to the onset of low back pain by modifying spinal biomechanics, particularly through increased lumbar lordosis and greater mechanical overload in the lumbar region. Latent myofascial trigger points are asymptomatic but can lead to muscle shortening and weakness. They are characterized by local tenderness and may provoke a localized muscular response known as a local twitch response. The aim of this randomized experimental study was to evaluate the immediate effect of ischemic compression applied to the trigger point of the psoas muscle on pain perception and lumbar range of motion. Researchers will compare a group with a placebo technique to see if the release of the psoas muscle produces effects in this condition. The variables analyzed in this study included low back pain, assessed using the Numeric Pain Rating Scale (NPRS); lateral lumbar flexion (right and left), measured using a tape measure (distance from the third finger to the floor); and lumbar flexion range of motion, assessed using the Schober test.

Подробное описание

The present study will be a randomized, double-blind clinical trial designed to analyze the immediate effect of trigger point release of the psoas muscle on pain and lumbar spine range of motion in young adults with nonspecific mechanical low back pain.

The research will involve a sample composed of individuals aged between 18 and 30 years, who will have experienced low back pain within one month prior to participation and will present a latent trigger point in the psoas muscle.

Participants will be randomly assigned to two groups: the experimental group, which will undergo the ischemic compression technique on the psoas muscle; and the control group, which will receive a simulated technique involving listening to the mobility and motility of the small intestine. Assessments will be conducted before and after the intervention using the Visual Analog Scale (VAS), the Numeric Pain Rating Scale (NPRS), measurement of lumbar lateral flexion with a measuring tape, and the modified Schober test for trunk forward flexion.

This study will aim to address the existing gap in the literature regarding the effectiveness of specific osteopathic techniques applied to the psoas muscle in relieving low back pain and improving mobility and range of motion. The methodological rigor, randomization, and double-blind design will contribute to ensuring the reliability of the collected data and the validity of the results obtained.

Вмешательства

• Другое Trigger point release
  Ischemic compression technique is based on the application of manual pressure to treat trigger points. The patient was asked to lie in the supine position on the examination table. The osteopath identified the muscle through deep palpation and movement-based muscle differentiation, then applied 90 seconds of tolerable pressure to the trigger point on both sides.
• Другое Simulation of the intestinal listening technique.
  The patient will be asked to lie in a supine position on the treatment table to simulate the listening technique for assessing the mobility and motility of the small intestine without influencing the final results, with the sensory hand placed below the umbilicus.

Первичные конечные точки

• Low back pain [Срок оценки: Immediately after the intervention]
• Range of motion [Срок оценки: Immediately after the intervention]

Критерии участия

Критерии включения

• Age between 18 and 30 years.
• Presence of low back pain for less than 1 month.
• Presence of a latent trigger point in the psoas muscle.

Критерии исключения

• Volunteers with low back pain caused by: Disc herniation, Tumor, Infection, Fracture, Osteoporosis, Structural deformity or Inflammation.
• Individuals with a history of spinal surgery.
• Continuous use of analgesics.
• Participants who had undergone manual therapy in the previous month.
• Pregnant individuals.
• Obese individuals.
• Students of Osteopathy (from the 2nd, 3rd, or 4th year) and professionals in the manual therapy field.
• Participants presenting red flags for osteopathic intervention.
• Individuals with cognitive impairments that hindered their ability to understand the study/project.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Двойное слепое

Основная цель

Лечение

Центры проведения

Список центров уточняется — проверьте первичный протокол.

Публикации

• Furtado RN, Ribeiro LH, Abdo Bde A, Descio FJ, Martucci CE Jr, Serruya DC. [Nonspecific low back pain in young adults: associated risk factors]. Rev Bras Reumatol. 2014 Sep-Oct;54(5):371-7. doi: 10.1016/j.rbr.2014.03.018. Epub 2014 Jul 6. Portuguese. PMID 25627301
• Chiarotto A, Maxwell LJ, Ostelo RW, Boers M, Tugwell P, Terwee CB. Measurement Properties of Visual Analogue Scale, Numeric Rating Scale, and Pain Severity Subscale of the Brief Pain Inventory in Patients With Low Back Pain: A Systematic Review. J Pain. 2019 Mar;20(3):245-263. doi: 10.1016/j.jpain.2018.07.009. Epub 2018 Aug 10. PMID 30099210
• Balague F, Mannion AF, Pellise F, Cedraschi C. Non-specific low back pain. Lancet. 2012 Feb 4;379(9814):482-91. doi: 10.1016/S0140-6736(11)60610-7. Epub 2011 Oct 6. PMID 21982256
• Seyedhoseinpoor T, Sanjari MA, Taghipour M, Dadgoo M, Mousavi SJ. Spinopelvic malalignment correlates to lumbar instability and lumbar musculature in chronic low back pain-an exploratory study. Sci Rep. 2024 Dec 30;14(1):31974. doi: 10.1038/s41598-024-83570-6. PMID 39738674
• Celik D, Mutlu EK. Clinical implication of latent myofascial trigger point. Curr Pain Headache Rep. 2013 Aug;17(8):353. doi: 10.1007/s11916-013-0353-8. PMID 23801006
• Xu A, Huang Q, Rong J, Wu X, Deng M, Ji L. Effectiveness of ischemic compression on myofascial trigger points in relieving neck pain: A systematic review and meta-analysis. J Back Musculoskelet Rehabil. 2023;36(4):783-798. doi: 10.3233/BMR-220045. PMID 36872769
• Siglan U, Colak S. Effects of diaphragmatic and iliopsoas myofascial release in patients with chronic low back pain: A randomized controlled study. J Bodyw Mov Ther. 2023 Jan;33:120-127. doi: 10.1016/j.jbmt.2022.09.029. Epub 2022 Sep 29. PMID 36775506
• Desai R, Rathi M, Palekar TJ. Effects of Movement Retraining and Lumbar Stabilization Exercises in Mechanical Low Back Pain: A Pilot Study. Cureus. 2024 Feb 16;16(2):e54291. doi: 10.7759/cureus.54291. eCollection 2024 Feb. PMID 38496129

Идентификаторы

NCT: NCT06994364 · OST1- 017

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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