Clinical Research Directory

The conventional approach includes ultrasound (US) application combined with muscle energy technique (MET) for the lumbopelvic region. The subjects will receive therapeutic ultrasound (for 5 mins, intensity of 1W/cm2). In addition, MET will be applied in prone for anterior and posterior innominate rotation around the pelvis. The subject will then be asked to apply 20% force against that applied by the therapist and hold that contraction for 10 seconds over 5 to 10 repetitions.

In addition to the conventional protocol including US and MET stretching, subjects in this group will perform core stabilization exercises (CSE) to improve the activation and coordination of deep core stabilizers: transversus abdominis, multifidus, and pelvic floor muscles, which are essential for maintaining lumbopelvic stability and neuromuscular control. The core stabilization exercises consist of 5 exercises: pelvic tilt, double knee to chest, bridging, bird-dog, and cat-camel, to be performed in the same order. Also, before each exercise, the physical therapist will give detailed verbal explanation and visual instructions (pictures) regarding the start and end positions. Each exercise will be done for two sets of 10 repetitions, 3 sessions per week (day after day), for 8 weeks.

In addition to the traditional protocol including US and MET stretching, subjects in this group will undergo lumbopelvic cognitive movement control training (CMCT) that requires the lumbopelvic region to be positioned in a neutral alignment and the subject will be asked to consciously maintain the desired alignment and keep a pre-determined value of PBU whilst the lower limbs are actively moved to achieve a pre-determined benchmark. This training will be in multi-directions to address the lumbopelvic uncontrolled movements into flexion, extension and rotation as follows: * Into flexion, we will use double bent leg lift exercise * Into extension, we will use double leg lower exercise and also, double knee bend exercise * Into rotation, we will use single hip extension exercise and also, bent knee fallout exercise Each exercise will be done for 20-30 slow repetitions or up to two consecutive mins. of slow repetitions, with hold time (no pressure change) for at least 5 seconds inbetween.