Effect of Muscle Energy Technique on Latissimus Dorsi on Pain , Functional Disability and Range of Motion in Patients With Mechanical Low Back Pain

Foundation University Islamabad

Status: Enrolling

Conditions: Mechanical Low Back Pain

Treatments: Procedure: Conservative physical therapy; Procedure: Post-facilitation stretch of latissimus dorsi with conservative physical therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT07328126

FUI/CTR/2025/07

Details and patient eligibility

About

Mechanical low back pain (LBP) stems from spinal structures or surrounding tissues, often caused by overuse or trauma, and is prevalent globally with high recurrence rates. Key contributing factors include biomechanical, psychological, and social elements. The latissimus dorsi (LD), along with other back muscles, plays a crucial role in lumbar stability via the thoracolumbar fascia. Stretching the LD has shown positive effects in reducing pain and improving function in chronic LBP patients. Physical therapy treatments include manual therapy, core stabilization, and flexibility exercises. Muscle Energy Techniques (MET), particularly targeting the LD, can enhance flexibility and spinal mobility when applied correctly.

Full description

Mechanical low back pain (MLBP) originates from structural components of the spine, such as intervertebral discs, muscles, ligaments, or joints, and is commonly caused by repetitive trauma, poor posture, or overuse. It is a leading cause of functional disability worldwide, with high recurrence rates. Physiotherapy plays a central role in managing MLBP by addressing contributing biological, psychological, and social factors. The latissimus dorsi (LD) muscle, due to its anatomical connection with the pelvis via the thoracolumbar fascia (TLF), significantly influences lumbar stability. Impaired extensibility or overactivity of the LD can contribute to mechanical dysfunction. Incorporating LD stretching into rehabilitation protocols has shown enhanced outcomes in pain reduction and functional improvement. Muscle Energy Techniques (MET), particularly Post Facilitation Stretching, utilize controlled muscle contractions to improve flexibility and relieve tension in shortened muscles. Proper application of MET targeting the LD has demonstrated effectiveness in increasing range of motion and supporting spinal stability in patients with chronic low back pain.

Enrollment: 32 estimated patients

Sex: All

Ages: 30 to 55 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients had low back pain for more than 3 months Moderate disability (20 to 40 %) determined through Oswestry Disability Index Subjects with pain ranging 3 to 8 on NPRS Able to perform ROM of lumbar spine (flexion and extension) within range of pain Patient were not under any medical treatment (analgesics etc) both male and female

Exclusion criteria

• presence of any red flags (i.e tumor , metabolic disease, rheumatoid arthritis , osteoporosis , history of use of steroids ) SLR test positive Muscle weakness or paralysis of lower extremity Prior surgery of lumbar spine and pregnancy Any psychological problem

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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32 participants in 2 patient groups

Conservative physical therapy

Active Comparator group

Description:

Hot pack + TENS (10 min), followed by a structured program of warm-up, 20-minute core/back strengthening, stretching (hip flexors, hamstrings, lumbar extensors), and cool-down exercises.

Treatment:

Procedure: Conservative physical therapy

Post facilitation stretch of latissimus dorsi with conservative physical therapy

Experimental group

Description:

Receives the same conservative physical therapy as the control group plus Latissimus Dorsi Muscle Energy Technique (isometric contraction for 10seconds, relaxation 2-3seconds, followed by 10seconds stretch, applied bilaterally each session).

Treatment:

Procedure: Post-facilitation stretch of latissimus dorsi with conservative physical therapy