Effects of Feldenkrais and Otago Exercise Protocols for Mechanical Low Back Pain

Riphah International University

Status: Enrolling

Conditions: Low Back Pain

Treatments: Other: Otago exercise protocol.; Other: Feldenkrais method

Study type: Interventional

Funder types: Other

Identifiers

NCT06985849

REC/RCR & AHS/24/0181

Details and patient eligibility

About

Low back pain (LBP) is a common health issue-affecting individual across diverse ages and socio- economic backgrounds, with approximately 80% of the population experiencing this musculoskeletal concern at some point in their lives. Despite its prevalence, the prognosis for LBP is generally favorable, emphasizing the importance of effective management strategies aimed at reducing pain and improving functional ability. The Feldenkrais Method and the Otago Exercise Programme (OEP) are two interdisciplinary approaches that have demonstrated promise in addressing mechanical non-specific low back pain. This study aims to evaluate the effectiveness of these two intervention protocols in alleviating chronic low back pain while concurrently enhancing functional abilities and reducing the risk of falls among older adults.

The study will be a randomized controlled trial conducted on participants. Data will be collected from Farooq hospital and Boston physiotherapy and wellness clinic. This study will be completed in time duration of 10 months after the approval of synopsis. Non-probability convenience sampling technique will be used and participant's age between 45-65, having mechanical low back pain for more than 3 months will be recruited in study after computer generated randomization. However, participants who have any chronic illness like recurrent spinal surgery, Malignancy, Spine Infection, Spinal fracture and congenital disturbance shall be excluded from this study. The subjects will be divided into two groups. Group A will receive awareness through movement sessions of trunk mobility, which will be guided verbally(such as rolling head left and right, bringing knees to chest, tilting to the sides, rolling pelvis.) and Group B will receive lower limb strength and balance exercises like knee extensions and hip abduction.

All these sessions will be of 30 minutes to for 2 sessions per week for 6 weeks. Pre and post assessments will be conducted and the tools that will be used are NPRS for pain, Universal goniometer for ROM, Functional disability (Oswestry Disability Index), Falls-related self-efficacy will be assessed by the Activities-Specific Balance Confidence (ABC) Scale. and Balance (Berg Balance Scale). Data will be analyzed by using SPSS version 26.0.

Enrollment: 36 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• • Age group 18 to 65 year (3)

  • Both gender male and female
  • LBP (duration ≥ 3 months) (3)
  • NPRS score ≥ 4/10 (indicating moderate pain)
  • ODI: Score ≥ 20/100 (indicating moderate disability)
  • BBS: Score ≤ 45/56 (indicating balance impairment)
  • BC Scale score: ≤ 60/100 (indicating moderate to low balance confidence)
  • Ability to walk independently
  • No severe cognitive impairment
  • Patient willing to perform in the study

Exclusion criteria

• • Recurrent spinal surgery(3)

  • Malignancy
  • Spine Infection
  • Spinal fracture
  • Congenital disturbance
  • Severe LBP (NPRS ≥ 9/10)
  • Significant balance impairment (BBS ≤ 20/56)
  • Severe disability (ODI ≥ 60/100)
  • ABC Scale score: ≥ 80/100 (indicating high balance confidence)
  • Older individuals with specific health conditions, such as cardiovascular disease and diabetes

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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36 participants in 2 patient groups

Feldenkrais method.

Experimental group

Description:

Group A will receive awareness through movement lessons, which are verbally, guided explorations of movement, conducted by a physiotherapist. The Feldenkrais method intervention consisted of 10 structured lessons, each 30 minutes in duration, delivered twice weekly. The program aimed to enhance trunk mobility and overall function without pain. Lessons progressed sequentially, building upon previous sessions. Segment 1 (Lesson 1-2) focused on breathing awareness and trunk perception in supine position, gaining control of the pelvis, and freeing hip joints. Segment 2 (Lesson 3-4) addressed flexion-extension and self-care in supine and prone positions. Segment 3 (Lesson 5-6) targeted flexion-extension, rotation, and shoulder control. Segment 4 (Lesson 7-8) emphasized balance and walking. The final lessons (9-10) integrated previous themes, reinforcing functional improvement

Treatment:

Other: Feldenkrais method

Otago exercise protocol.

Active Comparator group

Description:

The study began by completing all 3-outcome measures by first asking about their pain intensity then by checking their balance through Berg Balance Scale and then checking the level of function through ODI questionere. The OEP included the following exercises: knee extension and knee flexion, hip abduction, calf raises, toe raises, sit to stand, semi squats from a standing position, tandem stand, tandem walk, sideways walking, backwards walking, heel walking, toe walking, one leg stand, and walking and turning around. All exercises will be performed with 10-20 repetitions, which will be progressed after 2 week

Treatment:

Other: Otago exercise protocol.