Clinical Research Directory

H-Reflex-Guided Direction-Sensitive Exercise (H-RGDSE) is an individualized physiotherapy intervention in which the participant's lumbar posture and movement direction are selected according to changes in the soleus H-reflex. The H-reflex is recorded using surface electromyography while the participant is tested in lying, sitting, standing, and different lumbar movement positions. Increased H-reflex amplitude is interpreted as a favorable response suggesting reduced neural compression, whereas a reduced response indicates a position or direction that should be avoided. Intervention Procedure Baseline assessment: Record pain intensity, neurological findings, range of motion, functional limitations, and baseline soleus H-reflex amplitude on the symptomatic and asymptomatic sides. H-reflex testing: Measure the soleus H-reflex during unloading and loading positions, including supine or prone lying, sitting, standing, lumbar flexion, extension, side bending, rotation, and relevant combine

Standard Lumbar Extension Exercise is a standardized physiotherapy program intended to improve lumbar extension mobility, promote upright spinal posture, and strengthen the lumbar extensor muscles. The same exercise sequence is provided to all control-group participants, without using H-reflex findings to select the treatment direction. Exercise Components Prone lying: Lie face down with the legs relaxed and the pelvis supported comfortably. Prone-on-elbows extension: Slowly raise the upper trunk onto the elbows while keeping the pelvis and hips in contact with the mat. Prone press-ups: Place the hands beside the shoulders and gently press the upper body upward while keeping the pelvis relaxed. Standing lumbar extension: Stand with the feet apart and hands supporting the lower back, then gently lean backward while keeping the knees straight. Progressive strengthening: Add controlled trunk-extension, hip-extension, and functional upright-posture exercises as tolerated.