Effect Of Mckenzie Exercises On Postural Stability In Mechanical Back Pain Patients With Prolonged Sitting Posture

Maintaining postural stability is a sensorimotor process that involves the functional integration of sensory afferent information from the visual, vestibular, and somatosensory systems, central processing of this sensory input, and the selection of appropriate motor responses. Impaired postural stability is a major risk factor for falls and can negatively influence social interaction and mental health, particularly in older adults.

Impairment in lumbar repositioning sense, referred to as lumbar repositioning error (LRPE), may lead to poor postural habits, loss of neutral spine alignment, and reduced mechanical efficiency of the trunk muscles. Proprioception is considered the most critical sensory system for maintaining postural stability, especially under normal fixed-surface conditions. Low levels of physical activity have also been associated with an increased risk of falls, even in younger adults.

Because physical activity influences all levels of the sensorimotor system, postural stability represents an important health variable for understanding the effects of prolonged sitting. While even low-intensity physical activity may cause a short-term reduction in postural stability, regular physical activity has a positive long-term effect. Exercise impacts sensory input, central processing, and motor output, although fatigue from endurance activities can acutely reduce postural stability.

Prolonged sitting is common in modern desk-based occupations, and lack of time is a major barrier to interrupting sedentary behavior. Active workstations, such as standing desks and treadmill desks, offer a practical way to integrate physical activity into the workday and have demonstrated benefits for body composition, metabolic health, quality of life, work performance, and cognition.

Breaking up prolonged sitting with light-intensity treadmill desk walking has been shown to improve postural stability by reducing mediolateral and anteroposterior center of pressure sway. These findings suggest that treadmill desks or regular walking breaks may provide additional neuromuscular benefits beyond general health improvements. In contrast, interrupting prolonged sitting with short bouts of bodyweight resistance exercises may produce some physiological benefits but can negatively affect postural stability.

Therefore, this study aims to evaluate the effects of McKenzie back extension exercises on postural stability, pain, and quality of life in individuals with mechanical low back pain who engage in prolonged sitting, such as office workers, computer engineers, and college students, with potential implications for both physical well-being and functional performance.

Inclusion criteria

• • patients with mechanical Low back pain aged 18 - 35 years.

• patients who spend at least 6 hours daily sitting (in office, at home, or screen time).
• patients who feel some sort of discomfort and pain after prolonged sitting.
• Patients with flat lumbar curves.
• patients have not received any physical therapy or medications in the last six months.
• Subjects with normal body mass index (BMI) from 18.5-24.9 kg/m2

Exclusion criteria

• • patients with known neurological disorders or balance disorders.

• patients who engage in regular physical activity exceeding 150 minutes per week (as this could influence balance).
• patients who do not sit for prolonged periods of time habitually.
• Major structural spinal deformities (scoliosis or stenosis) inflammatory diseases
• Sequestered hernias.
• History of spinal surgery.
• Lower limb and pelvis deformities e.g. Leg length discrepancy
• patients have Severe medical or psychiatric disorders