Effect of Lumber Sustained Natural Apophyseal Glides on Lower Cross Syndrome: A Randomized Controlled Trial
Abstract
Background: Lower cross syndrome, also referred to as pelvic crossed syndrome, develops when insufficient muscle strength causes an imbalance in the lower extremities. It is marked by a pattern of weakness and tightness between opposing muscle groups on the front and back of the body. Lumbar sustained natural apophyseal glides (SNAGs) are a mobilization technique used to reduce pain, correct hypomobility and biomechanical faults such as anterior pelvic tilt and hyperlordosis, and improve posture and function.
Objective: To determine the effect of lumbar SNAGs on pain and hypomobility in individuals with Lower Cross Syndrome.
Methodology: A randomized controlled trial was conducted at Gulam Abbas Orthopedic Hospital, kotli, Azad Kashmir and the District Headquarter Hospital, kotli Azad Kashmir, with a sample size of 36 participants determined by G*Power (effect size 0.25, α = 0.05, power = 0.95). Participants were allocated into two group using non-probability purposive sampling technique Group A (lumbar SNAGs plus moist heat, stretching tight erector spinae, hip flexors and strengthening of weak abdominals and gluteal muscles) and Group B (moist heat with stretching tight erector spinae, hip flexors and strengthening of weak abdominals and gluteal muscles only, with 5-7 reps of 1 set of each exercise, delivered three times a week for three weeks. Pain was assessed using the Numeric Pain Rating Scale and lumbar range of motion using goniometer. (Clinical Trial Registry Number: (NCT06707805)
Results: Between-group analysis demonstrated statistically significant effects of lumbar SNAGs combined with conventional therapy, showing a reduction in pain intensity (p < 0.05) and an improvement in lumbar range of motion (p ≤ 0.05).
Conclusion: This study concludes that the addition of lumbar SNAGs to conventional therapy produces clinically meaningful improvements in pain reduction and lumbar mobility compared with conventional therapy alone, in the management of patients with lower-crossed syndrome.
Keywords: Conventional therapy, Lumbar SNAGs, Lower cross syndrome, NPRS, ROM
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