Quadratus LumborumNCT07619742
Effects of Post Isometric Relaxation in Patients With Quadratus Lumborum Syndrome
A study testing Conventional Traetment and Post-Isometric Relaxation (PIR) in people with Quadratus Lumborum, run by Riphah International University at 1 site in Pakistan.
Trial summary
The most common musculoskeletal problem in both developed and developing countries is low back pain. Quadratus lumborum syndrome is a common source of low back pain, defined as a myofascial pain syndrome characterized by pain due to spasm and stiffness of the quadratus lumborum muscle. Read more about this study
- Who is it for?
- Ages 20 to 45 years
- Conditions the study is for
- Quadratus Lumborum
- What is being tested?
- Conventional Traetment and Post-Isometric Relaxation (PIR)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 32 participants
- Where
- 1 sitePakistan
- Study dates
- 6 Jun 2026to 6 Sep 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 to 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- • Age group between 20 and 45 years (2)
- Both gender male and female
- Positive Hip hike test
- Positive Lateral flexion test (14)
- Positive McGill endurance test
Who cannot join
- • Patients will be excluded if they are diagnosed with the following conditions;
- Radiating pain
- Paresthesia
- Numbness into buttocks or lower extremity
- Patients having low back pain of more than 12 weeks of duration (chronic)
- Spondylolisthesis
- Spondylosis
- Lumbar disc herniation
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site
Ittefaq Hospital
Lahore, Punjab Province, 54000
Sidra khan HOD, MSPT, 923004132720, sidra_khan5544@yahoo.com
About this study
Official title: Effects of Post Isometric Relaxation on Pain, Muscle Endurance and Disability in Patients With Quadratus Lumborum Syndrome
The most common musculoskeletal problem in both developed and developing countries is low back pain. Quadratus lumborum syndrome is a common source of low back pain, defined as a myofascial pain syndrome characterized by pain due to spasm and stiffness of the quadratus lumborum muscle. This condition often occurs when weak back muscles are compensated by the quadratus lumborum, leading to painful muscle spasms. This study aims to determine the effects of PIR on pain, muscle endurance, and disability in patients with Quadratus Lumborum Syndrome.
Read the detailed description
This randomized controlled trial will be conducted at Ittefaq Hospital Lahore over a 4-month period. A sample size of 32 participants, aged 20 to 45 will be selected using non-probability convenient sampling. Informed consent will be obtained from all participants. Participants will be divided into two groups: Group A will receive Post-Isometric Relaxation in addition to standard physical therapy, while Group B will receive only standard physical therapy which includes a hot pack, TENS, core stability exercises and Maitland's mobilization. Outcome measures including the Numeric pain rating scale (NPRS), McGill's torso muscular endurance test, Oswestry disability index (ODI) urdu version and Lateral flexion test for mobility will be assessed at baseline and after 4 weeks. Inclusion criteria include positive hip hike and lateral flexion tests, lumbar pain with an NPRS score of >3 to ≤7, and an ODI score of ≥5 to ≤24. Exclusion criteria include chronic pain, spondylolisthesis and previous spinal surgeries. Data will be analyzed using IBM SPSS 25.0.
- Conditions
- Quadratus Lumborum
- Being tested
- Conventional Traetment, Post-Isometric Relaxation (PIR)
- Keywords
- Pain, disability, muscle endurance
- Medical subject headings
- Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Conventional TraetmentOther
Maitland MobilizationPosterior-Anterior Glide will be performed on the transverse processes of the L1 to L4 vertebrae. The amplitude will initially be grade 1 and 2 for pain relief, and grade 3 and 4 will be used to improve ROM, with slow speed, smooth rhythm, and 2 to 3 oscillations per second for 30 seconds. There will be 2 to 3 sets for each vertebra
Post-Isometric Relaxation (PIR)Other
The practitioner stands behind the side lying patient, at waist level. The patient has the uppermost arm extended over the head to firmly grasp the top end of the table and, on an inhalation, abducts the uppermost leg until the practitioner palpates strong quadratus activity (elevation of around 30° usually). The patient holds the leg isometrically in this manner, allowing gravity to provide resistance for 10-second, the patient allows the leg to hang slightly behind him over the back of the table. The practitioner straddles this and, cradling the pelvis with both hands (fingers interlocked over crest of pelvis), leans back to take out all slack and to ease the pelvis away from the lower ribs during an exhalation. The stretch should be held for between 10 and 30 seconds. Contraction followed by stretch is repeated with raised leg in front of, behind the trunk in order to activate different fibers and was given bilaterally
| Study group | Role | What they receive |
|---|---|---|
| Post-Isometric Relaxation (PIR) | Experimental | The practitioner stands behind the side lying patient, at waist level. The patient has the uppermost arm extended over the head to firmly grasp the top end of the table and, on an inhalation, abducts the uppermost leg until the practitioner palpates strong quadratus activity (elevation of around 30° usually). The patient holds the leg isometrically in this manner, allowing gravity to provide resistance for 10-second, the patient allows the leg to hang slightly behind him over the back of the table. The practitioner straddles this and, cradling the pelvis with both hands (fingers interlocked over crest of pelvis), leans back to take out all slack and to ease the pelvis away from the lower ribs during an exhalation. The stretch should be held for between 10 and 30 seconds. Contraction followed by stretch is repeated with raised leg in front of, behind the trunk in order to activate different fibers and was given bilaterally Receives: Other: Post-Isometric Relaxation (PIR) |
| Conventional Traetment | Active comparator | Core Stability Exercises TENS for 10 minutes Maitland's Mobilization Receives: Other: Conventional Traetment |
What is being measured
The primary outcome is the main question the study is designed to answer.
low back Pain intensity
Numeric Pain Rating Scale (NPRS):
Patient level of pain will be assessed using the NPRS. It is a tool commonly used to measure pain severity on a 0-10 scale with 0 means no pain, 1-3 means mild pain, 4-6 means moderate pain and 7-10 means severe pain . Patients rate their current level of pain and their worst and least amount of pain in the last 24 hours. The average of the 3 ratings or any single rating may be used to represent the patient's level of pain . The NPRS validity is 0.86 and reliability is 0.96
Measured: upto 4 weeks
Muscle Endurance
McGill's Torso Muscular Endurance Test:
Muscle endurance of the quadratus lumborum will be assessed using this test. McGill's test assesses core muscle endurance through trunk flexor, trunk extensor, and right and left lateral trunk musculature tests. Participants maintain isometric postures for as long as possible and the time held in each position is recorded. The scores from the subtests are summed for an overall score. The McGill test has shown excellent reliability (ICC = 0.97-0.99).
Measured: upto 4 weeks
Functional Disability
Oswestry Disability Index (ODI) Urdu Version:
The ODI is a questionnaire that scores pain-related disability in patients with LBP. It is a valid measure for disability in LBP. The ODI is made up of 10 items dealing with various functional aspects. Each item is scored from 0 to 5, with higher values representing greater disability . The ODI-U has excellent test-retest reliability for total score (ICC2,1 = 0.95).
Measured: upto 4 weeks
Lateral Flexion
Lateral Flexion Test:
To evaluate trunk lateral flexion ROM, patients stand with their backs against a wall and feet shoulder-width apart. An initial mark is made where the middle fingertip rests on the lateral thigh. Then, they flex laterally, keeping their back and shoulders against the wall. A second mark is made where the middle fingertip moves down to on the thigh. The distance between the two marks is measured in centimeters. An average is calculated using three readings per side. lateral flexion test shows strong reliability, with intraclass correlations over 0.84.
Measured: upto 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Jun 2026
- Study start6 Jun 2026 (estimated)
- Primary completion6 Aug 2026 (estimated)
- Study completion6 Sep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Quadratus LumborumStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 32 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Samrood Akram, PhD*, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07619742
- Sponsor's protocol ID
- REC/RCR&AHS/24/0143 Barira
- Status last verified
- Jun 2026
- First submitted
- 3 Jul 2025
- Last updated
- 2 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Jairakdee Y, Chansirinukor W, Sitti T. Effect of releasing quadratus lumborum muscle on hip and knee muscle length in asymptomatic individuals. J Bodyw Mov Ther. 2021 Apr;26:542-547. doi: 10.1016/j.jbmt.2020.11.008. Epub 2020 Nov 7.
PubMed 33992295
Study at a glance
From the registry record, last updated by the sponsor on 2 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Post Isometric Relaxation on Pain, Muscle Endurance and Disability in Patients With Quadratus Lumborum Syndrome
- ClinicalTrials.gov ID
- NCT07619742
- Acronym / sponsor ID
- REC/RCR&AHS/24/0143 Barira
- Conditions
- Quadratus Lumborum
- Keywords
- Pain, disability, muscle endurance
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 32 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 6 Jun 2026 (estimated)
- Primary completion
- 6 Aug 2026 (estimated)
- Study completion
- 6 Sep 2026 (estimated)
- First posted
- 2 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The most common musculoskeletal problem in both developed and developing countries is low back pain. Quadratus lumborum syndrome is a common source of low back pain, defined as a myofascial pain syndrome characterized by pain due to spasm and stiffness of the quadratus lumborum muscle. This condition often occurs when weak back muscles are compensated by the quadratus lumborum, leading to painful muscle spasms. This study aims to determine the effects of PIR on pain, muscle endurance, and disability in patients with Quadratus Lumborum Syndrome.
Detailed description
This randomized controlled trial will be conducted at Ittefaq Hospital Lahore over a 4-month period. A sample size of 32 participants, aged 20 to 45 will be selected using non-probability convenient sampling. Informed consent will be obtained from all participants. Participants will be divided into two groups: Group A will receive Post-Isometric Relaxation in addition to standard physical therapy, while Group B will receive only standard physical therapy which includes a hot pack, TENS, core stability exercises and Maitland's mobilization. Outcome measures including the Numeric pain rating scale (NPRS), McGill's torso muscular endurance test, Oswestry disability index (ODI) urdu version and Lateral flexion test for mobility will be assessed at baseline and after 4 weeks. Inclusion criteria include positive hip hike and lateral flexion tests, lumbar pain with an NPRS score of >3 to ≤7, and an ODI score of ≥5 to ≤24. Exclusion criteria include chronic pain, spondylolisthesis and previous spinal surgeries. Data will be analyzed using IBM SPSS 25.0.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Post-Isometric Relaxation (PIR) | Experimental | Other: Post-Isometric Relaxation (PIR)The practitioner stands behind the side lying patient, at waist level. The patient has the uppermost arm extended over the head to firmly grasp the top end of the table and, on an inhalation, abducts the uppermost leg until the practitioner palpates strong quadratus activity (elevation of around 30° usually). The patient holds the leg isometrically in this manner, allowing gravity to provide resistance for 10-second, the patient allows the leg to hang slightly behind him over the back of the table. The practitioner straddles this and, cradling the pelvis with both hands (fingers interlocked over crest of pelvis), leans back to take out all slack and to ease the pelvis away from the lower ribs during an exhalation. The stretch should be held for between 10 and 30 seconds. Contraction followed by stretch is repeated with raised leg in front of, behind the trunk in order to activate different fibers and was given bilaterally |
| Conventional Traetment | Active comparator | Other: Conventional TraetmentCore Stability Exercises TENS for 10 minutes Maitland's Mobilization |
Who may qualify
- Ages
- 20 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- • Age group between 20 and 45 years (2)
Key exclusion criteria (8 listed)
- • Patients will be excluded if they are diagnosed with the following conditions;
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Conventional TraetmentMaitland MobilizationPosterior-Anterior Glide will be performed on the transverse processes of the L1 to L4 vertebrae. The amplitude will initially be grade 1 and 2 for pain relief, and grade 3 and 4 will be used to improve ROM, with slow speed, smooth rhythm, and 2 to 3 oscillations per second for 30 seconds. There will be 2 to 3 sets for each vertebra | Other | Conventional Traetment |
| Post-Isometric Relaxation (PIR)The practitioner stands behind the side lying patient, at waist level. The patient has the uppermost arm extended over the head to firmly grasp the top end of the table and, on an inhalation, abducts the uppermost leg until the practitioner palpates strong quadratus activity (elevation of around 30° usually). The patient holds the leg isometrically in this manner, allowing gravity to provide resistance for 10-second, the patient allows the leg to hang slightly behind him over the back of the table. The practitioner straddles this and, cradling the pelvis with both hands (fingers interlocked over crest of pelvis), leans back to take out all slack and to ease the pelvis away from the lower ribs during an exhalation. The stretch should be held for between 10 and 30 seconds. Contraction followed by stretch is repeated with raised leg in front of, behind the trunk in order to activate different fibers and was given bilaterally | Other | Post-Isometric Relaxation (PIR) |
Primary outcome
low back Pain intensity
Time frame: upto 4 weeks
Numeric Pain Rating Scale (NPRS): Patient level of pain will be assessed using the NPRS. It is a tool commonly used to measure pain severity on a 0-10 scale with 0 means no pain, 1-3 means mild pain, 4-6 means moderate pain and 7-10 means severe pain . Patients rate their current level of pain and their worst and least amount of pain in the last 24 hours. The average of the 3 ratings or any single rating may be used to represent the patient's level of pain . The NPRS validity is 0.86 and reliability is 0.96
Muscle Endurance
Time frame: upto 4 weeks
McGill's Torso Muscular Endurance Test: Muscle endurance of the quadratus lumborum will be assessed using this test. McGill's test assesses core muscle endurance through trunk flexor, trunk extensor, and right and left lateral trunk musculature tests. Participants maintain isometric postures for as long as possible and the time held in each position is recorded. The scores from the subtests are summed for an overall score. The McGill test has shown excellent reliability (ICC = 0.97-0.99).
Functional Disability
Time frame: upto 4 weeks
Oswestry Disability Index (ODI) Urdu Version: The ODI is a questionnaire that scores pain-related disability in patients with LBP. It is a valid measure for disability in LBP. The ODI is made up of 10 items dealing with various functional aspects. Each item is scored from 0 to 5, with higher values representing greater disability . The ODI-U has excellent test-retest reliability for total score (ICC2,1 = 0.95).
Lateral Flexion
Time frame: upto 4 weeks
Lateral Flexion Test: To evaluate trunk lateral flexion ROM, patients stand with their backs against a wall and feet shoulder-width apart. An initial mark is made where the middle fingertip rests on the lateral thigh. Then, they flex laterally, keeping their back and shoulders against the wall. A second mark is made where the middle fingertip moves down to on the thigh. The distance between the two marks is measured in centimeters. An average is calculated using three readings per side. lateral flexion test shows strong reliability, with intraclass correlations over 0.84.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Jun 2026.
- Background: PubMed 33992295Jairakdee Y, Chansirinukor W, Sitti T. Effect of releasing quadratus lumborum muscle on hip and knee muscle length in asymptomatic individuals. J Bodyw Mov Ther. 2021 Apr;26:542-547. doi: 10.1016/j.jbmt.2020.11.008. Epub 2020 Nov 7.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Samrood Akram, PhD* principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Conventional Traetment and Post-Isometric Relaxation (PIR) in people with Quadratus Lumborum, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 2 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Samrood Assistant Professor, PhD Scholar (+923324806143, samrood.akram@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
low back Pain intensity (time frame: upto 4 weeks). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07619742, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Jun 2026.