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NCT Number: NCT06303388

Effects of Bruegger's Exercises Versus Egoscue Exercise on Lower Cross Syndrome

This study aims to find effects of Bruegger's Exercise versus Egoscue exercise on pain and hyperlordosis on patient with lower cross syndrome. This is interventional study which recruits 34 participants ,14 in each group.

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Key information

Conditions

Lower Cross Syndrome Animal Diseases Deficiency Diseases Malnutrition Neurologic Manifestations Nutrition Disorders Nutritional and Metabolic Diseases Pain Pathological Conditions, Signs and Symptoms Sheep Diseases Signs and Symptoms Swayback

Age range

16 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Pakistan Railway General Hospital

Rawalpindi, Federal, 44000, Pakistan

About this study

A randomized control trial will be conducted on patients with lower cross syndrome. A total number of 34 participants will be randomised into two groups with 17 participants in each group. Both groups will receive Hot Packs on the lumbar area for 10 minutes. Group A will receive Conventional Therapy and will follow protocol of Bruegger's Exercise. Group B will follow protocol of the Egoscue exercise. This study aims to decrease pain and hyperlordosis.

Each group will be assessed at baseline which will include pain through NPRS, hyperlordosis through flexicurve ruler and anterior pelvic tilt through pelvic inclinometer. Data from both groups will again be assessed after 4 weeks of intervention.

Protocol of Bruegger's Exercise: Pt. position: Upright sitting on a chair.

  • Sit with your buttocks at the edge of a chair.
  • Spread your legs apart slightly.
  • Turn your toes out slightly.
  • Rest your weight on your legs/feet & relax your abdominal muscles.
  • Tilt your pelvis forward (i.e. arch your lower back) while lifting your chest up
  • Rotate your arms outward while turning your palms up.
  • Hold your head high in the air, with a slight arch in the neck.

The patient is to perform this exercise once or twice every 20-30 minutes of prolonged sitting and held in this position for 30-60 seconds. To avoid non-compliance patient will be asked to perform five repetitions of particular exercise with five second hold during their clinical session.

Protocol of Egoscue Exercise The Egoscue group received a total of 10 exercises which includes

  • Static back alone and with breathing
  • Abdominal contraction while in the static back position
  • abductor press
  • Overhead extension
  • elbow curls on a wall
  • Static wall
  • Upper spinal twist
  • pelvic tilts
  • supine groin progressive
  • Air bench exercises

Week 1: 3 times with 10 s hold time Week 2: 5 times with 10 s hold time Week 3: 15 times with 10 s hold time Week 4: 20 times with 10 s hold time

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

• Females and males aged between 16 to 65 years

  • Participants had to present with low back pain
  • Participants had to meet the criteria for lower crossed syndrome indicating tight hip flexors (Modified Thomas test) and erector spinae (visual assessment through toe touching) together with weak glutei (Prone Hip Extension Co-ordination/Strength Test) and abdominals (Trunk Flexion Co-ordination and Strength Test)and thoracic kyphosis.
  • Angle of anterior pelvic tilt > 10 degrees

Exclusion criteria

• Participants who would be undergoing other forms of treatment that may interfere with the study, for the duration of the study, including other manipulative and physical therapies specific to back pain.

  • Presence of other conditions that may mimic low back pain, e.g. nerve entrapment.
  • Participants taking any medication that may interfere with the results of this study including, pain medication, anti-inflammatory medication, and muscle relaxants.
  • Surgery on the back, pelvis, or sacrum is indicated or has previously occurred
  • LBP having localised or radiating pain.
  • Practiced any kind of exercise or sports activity during the last 6 months.

Treatment and study plan

Bruegger,s Exercise

Other

Bruegger's Exercise protocol along with conventional Physiotherapy.

Egoscue Exercise

Other

Egoscue Exercise along with conventional Physiotherapy.

Primary outcomes

  1. Flexicurve Ruler

    Time frame: 12 day

    The flexicurve ruler (flexible) is commonly used to measure the degree of spinal curvature of the lumbar lordosis in the sagittal plane. The flexible ruler was placed according to the Youdas method, over spinous processes from T12 to S2 vertebrae. The ruler was then cautiously removed from the spine and traced onto a plain piece of white paper. A vertical line was drawn to connect the T12 and S2 landmarks (L line) and together with the maximum width of the lumbar curvature (H line

  2. Pelvic Inclinometer

    Time frame: 12 day

    A pelvic inclinometer was used to measure the anterior/posterior inclination of the pelvis of the subjects. An inclinometer has a 23 Cm length base and two 15 Cm arms in each side that freely move 360 degrees in horizontal plane. The ends of the arms are placed on the bony landmarks.The subject was asked to stand with the feet shoulder width apart. Even pressure was applied to both the arms of the inclinometer at anterior superior iliac spine and posterior superior iliac spine, with a bubble in the center the reading was then measured in degrees.

  3. NPRS

    Time frame: 12 Day

    Several pain scales are used clinically to evaluate the severity of musculoskeletal pain, one of which is the Numeric Pain Rating Scale (NPRS-11), which is an eleven-point scale in which the endpoints are the extremes of no pain at all (score of 0) and the worst pain the patient has ever experienced (score of 10).

Secondary outcomes

  1. Modified Thomas Test

    Time frame: 12 day

    This test was performed with the patient supine and the thighs positioned over the edge of the examining table. The patient was told to grasp the thigh of the untested limb and pull it toward the chest to flatten the back and stabilise the pelvis, preventing an increase in lumbar lordosis. A standard stretch position for the iliopsoas muscle is demonstrated with the hip extended and the leg hanging freely with normal knee flexion. A positive test was indicated if the hip remained flexed against gravity on tested limb. Additionally, if there was also knee extension on the tested limb then further testing was needed to decide between a tight iliopsoas or rectus femoris muscle. This was done by passively extending the knee of the tested limb to neutralize the effect of the rectus femoris and find if there was still no change in hip flexion.

  2. Visual Assessment through toe touching

    Time frame: 12 day

    The patient was seated on the examining table with the pelvis in a vertical position and the legs extended. The patient was asked to actively flex foreword in order to bring the forehead to the knees. The normal functioning of the erector spinae should display an even 'C' shaped curve and a distance of 10cm from the knees to the forehead. There should be also no knee flexion and involve no pelvic tilting. Any deviation from these norms indicates shortness of the erector spinae muscles.

  3. Prone Hip Extension Co-ordination Test

    Time frame: 12 day

    The patient lay prone and raised the tested thigh into extension with the knee held in an extended position. The researcher then palpated the lumbar erector spinae and gluteus maximus muscles. A normal activation sequence was then observed and palpated which involved first the hamstring and gluteus maximus muscles, then the contralateral lumbar erector spinae muscles and lastly the ipsilateral lumbar erector spinae muscles. A positive test result occurred if the lumbar erector spinae contracted before the gluteus maximus muscles did.

  4. Trunk Flexion Co-ordination and Strength Test

    Time frame: 12 day

    The patient lay supine with the arms either behind the neck or forward across the body and knees bent. The researcher then contacted the patient's heels or positioned a hand under the patient's lumbar spine. The patient was then asked to complete a posterior pelvic tilt and raise the trunk up until the scapulae cleared the table. This position was maintained for 2 seconds. The patient then held the pelvic tilt while lowering their back to the table. The patient was then instructed to perform 10 repetitions while holding the last repetition for 30 seconds. A positive test result occurred if the patient could not perform 10 repetitions without the lumbar spine or heels rising off the table.

Sponsors and collaborators

Lead sponsor

Riphah International University

Other

Registry information

Important dates

Study start
2024
Primary completion
2024
Study completion
2024
First posted
Mar 12, 2024
Registry last updated
Jul 28, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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