Leg Raising Research Articles

A COMPARATIVE STUDY ON THE IMMEDIATE EFFECTIVENESS OF MULLIGAN BENT LEG RAISE TECHNIQUE VS PNF HOLD-RELAX WITH AGONIST CONTRACTION IN IMPROVING HAMSTRING RANGE OF MOTION AND MUSCLE PERFORMANCE: A LITERATURE REVIEW.

Background: Hamstring tightness is a common issue that can hinder athletic performance and increase the risk of injury. Effective interventions are needed to enhance hamstring range of motion (ROM) and muscle performance. This study aims to compare two manual therapy techniques: the Mulligan Bent Leg Raise technique and the PNF Hold-Relax with Agonist Contraction technique. Objective: The primary objective is to compare the immediate effects of these two techniques on hamstring ROM and muscle performance. Secondary objectives include evaluating participants’ perceived comfort during the interventions and exploring the practical application of both techniques in clinical settings. Methods: A review of literature, focusing on randomized controlled trials involving participants aged 18–35 years, was conducted. Participants were divided into two groups: one receiving the Mulligan Bent Leg Raise technique and the other undergoing PNF Hold-Relax with Agonist Contraction. Pre- and post-intervention measurements of hamstring ROM and muscle performance were collected. Immediate effects were recorded and analyzed to compare outcomes between the two techniques. Results: Preliminary results indicate significant immediate improvements in hamstring flexibility and muscle performance for both techniques. Literature supports the effectiveness of both the Mulligan and PNF techniques in enhancing hamstring function. Conclusion: Evidence suggests that both the Mulligan Bent Leg Raise and PNF Hold-Relax with Agonist Contraction techniques effectively improve hamstring flexibility and muscle performance. Implications: This study provides valuable insights for physiotherapy practice, equipping clinicians with evidence-based strategies to address hamstring tightness and dysfunction. By integrating these techniques, physiotherapists can achieve rapid improvements and enhance overall treatment outcomes.

Effectiveness of Osteopathic Treatment in Adults with Short Hamstring Syndrome: A Systematic Review.

Background/Objective: Short hamstring syndrome is common in the general population and can lead to impaired balance, function, and posture, and increased risk of injuries. Local treatments have obtained controversial results, so it is necessary to evaluate the effectiveness of other types of therapy such as osteopathic treatment. To evaluate the efficacy of osteopathic techniques in increasing the elasticity of the hamstring musculature in short hamstring syndrome. Methods: A systematic review of randomised controlled trials was conducted in PubMed, Medline, Cinhal, Scopus, WOS, SPORTDiscuss, and PEDro. The PEDro scale was used to evaluate the methodological quality and the RoB2 for the evaluation of biases. Results: A total of eight articles were selected. Most of the participants were assessed with the Active Knee Extension or Straight Leg Raise tests. The osteopathic techniques used were the muscle energy technique, suboccipital inhibition, and vertebral mobilisations. As for the control interventions, they mainly included passive stretching and placebo. Conclusions: The results suggest that osteopathic techniques are more effective than placebo or other interventions in increasing flexibility in adult patients with short hamstring syndrome. This effect can be explained by neurophysiological (Golgi apparatus, neuromuscular spindle activity, and Hoffmann reflex) and structural factors (dura mater, posture, and myofascial chains). Nevertheless, the evidence suggests that it would be beneficial to incorporate this type of treatment into flexibility improvement programmes.

Comparison of Clinical Characteristics between Responders and Non-Responders to Hamstring Stretching in Individuals with Chronic Low Back Pain.

Background/Objectives: Hamstring muscle (HM) flexibility is frequently compromised in people with chronic low back pain (CLBP), contributing to disability and leading to a less favorable recovery. In a previous article, we presented the results of a study on the immediate effect of passive HM stretching on flexibility in 90 people with CLBP. There was considerable variability in the changes after stretching. The objective of this supplementary analysis was to compare the clinical characteristics of individuals who experienced a significant improvement in flexibility with those who did not. Methods: We fixed a threshold of 7° to indicate an improvement in passive Straight Leg Raise (SLR) angle and differentiate between 'Responders' and 'Non-responders' regarding passive HM stretching. Results: Only body mass index differed between groups; it was significantly smaller in Responders (p = 0.007). The majority of Non-responders experienced workplace accidents, but this was of marginal difference compared to Responders (p = 0.056). Conclusions: Further studies should consider a broader clinical analysis with a larger sample size to understand which factors influence the HM stretching response in CLBP patients.

Comparison of muscle tightness between knees in individuals with unilateral osteoarthritis and its relationship with pain and function.

Unilateral osteoarthritis (OA) affects single knees and presents a unique scenario where individuals experience varying degrees of symptoms between their affected and unaffected knees. This study aims to investigate differences in muscle tightness between symptomatic and asymptomatic knees in individuals with unilateral knee OA while exploring the interplay among pain, functionality, and muscle tightness. In this cross-sectional study, thirty knee OA patients underwent assessments for hamstring (Active Knee Extension, Straight Leg Raise), iliotibial band (Ober Test), and quadriceps tightness (Modified Thomas Test). Pain intensity was measured using the Visual Analog Scale (VAS), and functional limitations were evaluated via the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). A negative correlation was observed between participants' pain and AKE (p= 0.004, r=-0.515), ASLR (p= 0.27, r=-0.403), Ober (p= 0.010, r=-0.461) values. However, no significant correlation was found with the Modified Thomas value (p= 0.204, r=-0.239). There was also a negative correlation between participants' WOMAC scores and AKE (p= 0.019, r=-0.427), OBER (p= 0.004, r=-0.510), and Modified Thomas (p= 0.022, r=-0.416) values, while ASLR (p= 0.286, r=-0.202) values showed no significant correlation. Comparisons between AKE, Ober, and Modified Thomas values showed higher values in asymptomatic extremities (AKE: p= 0.025, Ober: p= 0.021, Modified Thomas: p= 0.030). This study emphasizes the significance of muscle tightness in the symptomatic extremities of individuals with unilateral knee OA. The results indicate that increased muscle tightness makes pain worse and limits movement. It's crucial for healthcare providers treating OA to focus on improving muscle flexibility, reducing pain, and enhancing overall function.

The Effects of TMR® Fab 6 on Hamstring Flexibility in Healthy Subjects; An Exploratory Observational Investigation.

Stretching programs are designed to improve hamstring flexibility by attempting to mechanically increase the length of the target tissue. However, other manual treatment approaches such as those utilized in Total Motion Release (TMR®), could be beneficial by identifying body asymmetries to assess and treat soft tissue impairments leading to diminished extensibility. The purpose of this study was to determine the effectiveness of the TMR® Fab 6 assessment and treatment to increase hamstring flexibility in healthy participants following one session of TMR®. Observational Cohort study. A convenience sample of 20 healthy participants (10 males, 10 females) were recruited from three institutions. Following collection of demographic information and a brief medical history, each participant performed a five minute warm-up on the stationary bike at a moderate intensity (80-90 RPMs) followed immediately by the bilateral performance of the Active Knee Extension Test (AKET) and Passive Straight Leg Raise (PSLR) to assess hamstring muscle length. Participants were randomly placed in the TMR® or control group. The TMR® group completed the "Fab 6" evaluation and treatment, while the control group performed one repetition of standing active hip flexion every 30-seconds for 15-minutes with both knees in full extension. Upon completion of treatment, control and TMR® groups were immediately re-evaluated on the AKET and the PSLR in the same order and fashion as baseline testing. Participants were asked to return in 24-hours for the same objective measurements as previously described. A significant time by group interaction was identified across all variables (p ≤ 0.001) for AKET and PSLR except the PSLR preferred leg from post-treatment to 24hr follow-up. The most significant increase in the AKET occurred in the TMR® group between baseline and post-treatment of the non-preferred leg (12.15°±2.94) when compared to the control group (7.15°±1.56). The results of the study suggest that implementing a regionally interdependent treatment approach like TMR® results in significant improvements in hamstring extensibility and hip ROM compared to the control group. 3.

Prognosticating Return-To-Play Time Following a Hamstring Strain Injury Using Early Flexibility Asymmetry and Musculoskeletal Ultrasound Imaging Outcomes: An Exploratory Study Among Canadian University Football Players.

Identify key flexibility and point-of-care musculoskeletal ultrasound (POCUS) measures for prognosticating return-to-play (RTP) following a first hamstring strain injury (HSI) and informing the clinical decision-making process. Exploratory prospective cohort study. Sport medicine and rehabilitation clinic of a Canadian university. One hundred and sixty-seven elite Canadian university football athletes followed over 5 seasons. Clinical and POCUS measures collected within 7 days after HSI and preseason clinical measures. Active knee extension (AKE) and Straight Leg Raise (SLR) to quantify hamstring flexibility, POCUS-related outcomes to characterize tissue alteration, and RTP until full sport resumption were documented (categorized as Early [1-40 days] or Late [>40 days] RTP). A total of 19 and 14 athletes were included in the Early RTP (mean RTP = 28.84 ± 8.62 days) and Late RTP groups (mean 51.93 ± 10.54 days), respectively, after having been diagnosed with a first HSI. For the clinical results, height and a greater flexibility asymmetry measure with the AKE or SLR when compared with both ipsilateral preseason and acute contralateral values significantly increases the chance of facing a long delay before returning to play (ie, RTP). For the POCUS-related results, the Peetrons severity score, extent of the longitudinal fibrillary alteration, and novel score lead to similar results. Early hamstring flexibility asymmetry following acute HSI, particularly the AKE, along with some POCUS-related measures are valuable in prognosticating late RTP following among Canadian university football athletes.

Lumbar and Cervical Concurrent Muscle Activity Analysis During Hamstring Length Testing to Design a Customized Treatment Plan: An Observational Cross-Sectional Study.

Hamstring length plays a significant role in a spectrum of clinical entities, from injury prevention and gait dysfunction to posture correction. Evidence suggests that the prevalence of hamstring tightness (HT)/reduced length is increasing. Despite the number of available tests and treatment protocols, HT is still a functional diagnosis. This study's primary goal is to evaluate concurrent muscle (CM) usage during these testing procedures to design a unique, customized treatment protocol. The study was conducted in two stages. In phase 1, Active Straight Leg Raise (ASLR), Active Total Knee Extension (ATKE), and Active Seated Total Knee Extension (ASTKE) were carried out. Next, two pressure gauges (PGs) were placed to align with the natural lumbar and cervical curvatures while testing ASLR and ATKE. After analyzing the results for pressure gauge placement, phase 2 data were collected for tests ASLR and ATKE with PG. The results of ASLR and ATKE, both with and without PG, indicate a high prevalence rate, whereas the results of ASTKE show no prevalence. Changes in the PG values indicate CM usage. Dichotomization revealed that participants with normal test scores (non-HT group) had increased usage of CM work. Positive and negative changes in PG indicate the involved CM group. In regular practice, most healthcare professionals and fitness trainers prefer ASTKE due to the ease of the testing procedure. Directing co-professionals on their choice of tests is challenging, whereas providing knowledge about CM use paves the way for creating customized treatment plans.

Effects of Pelvic Floor Muscle Contraction on Abdominal Muscle Activity and Pelvic Rotation Angle during Active Straight Leg Raise: Cross-Sectional Study

Effects of Pelvic Floor Muscle Contraction on Abdominal Muscle Activity and Pelvic Rotation Angle during Active Straight Leg Raise: Cross-Sectional Study

Manual traction is effective in alleviating lumbosacral spine pain: Evidence from a randomized controlled trial

BackgroundManual traction, a therapeutic technique frequently employed in healthcare, involves applying controlled pulling force by hand, usually to the spine, to stretch muscles and decompress joints, thereby alleviating pain. This method can be particularly beneficial for addressing lumbosacral spine pain exacerbated by radicular symptoms, characterized by pain radiating from the lower back due to compression or irritation of spinal nerves. PurposeThis study aimed to compare the effects of manual traction against control group in alleviating the lumbosacral spine pain caused by radicular symptoms. MethodsA randomized controlled study design was utilized with a sample of 60 patients experiencing lumbosacral spine pain, evenly distributed between an experimental group (n = 30; receiving manual traction) and a control group (n = 30). Patients underwent assessments before and after six treatment sessions, which included the Straight Leg Raise test, modified Bragard's test, Kernig's test, and the visual analogue scale for pain perception. ResultsBetween-group significant differences were found at post-intervention, favoring the experimental group on SLR – Left (°) (p = 0.004; medium effect size), SLR – Right (°) (p = 0.004; medium effect size), Modified Bragard test – Left (°) (p = 0.024; small effect size), Modified Bragard test – Right (°) (p = 0.003; medium effect size), Kernig's Test – Left (°) (p = 0.013; medium effect size) and Kernig's Test – Right (°) (p = 0.010; medium effect size). Additionally, between-group significant differences were found at post-intervention, favoring the experimental group on VAS scores at SLR left (p < 0.001; medium effect size), and right (p < 0.001); medium effect size, Modified Bragard test left (p < 0.001; medium effect size) and right (p < 0.001; medium effect size) and at Kernig's Test left (p < 0.001; medium effect size) and right (p < 0.001; medium effect size). ConclusionsIn conclusion, manual traction is recommended as an effective approach for alleviating lumbosacral spine pain in patients experiencing symptoms resulting from irritation or compression of a spinal nerve root.

Are We Always Right? Evaluation of the Performance and Knowledge of the Passive Leg Raise Test in Detecting Volume Responsiveness in Critical Care Patients: A National German Survey.

Background: In hemodynamically unstable patients, the passive leg raise (PLR) test is recommended for use as a self-fluid challenge for predicting preload responsiveness. However, to interpret the hemodynamic effects and reliability of the PLR, the method of performing it is of the utmost importance. Our aim was to determine the current practice of the correct application and interpretation of the PLR in intensive care patients. Methods: After ethical approval, we designed a cross-sectional online survey with a short user-friendly online questionnaire. Using a random sample of 1903 hospitals in Germany, 182 hospitals with different levels of care were invited via an email containing a link to the questionnaire. The online survey was conducted between December 2021 and January 2022. All critical care physicians from different medical disciplines were surveyed. We evaluated the correct points of concern for the PLR, including indication, contraindication, choice of initial position, how to interpret and apply the changes in cardiac output, and the limitations of the PLR. Results: A total of 292 respondents participated in the online survey, and 283/292 (97%) of the respondents completed the full survey. In addition, 132/283 (47%) were consultants and 119/283 (42%) worked at a university medical center. The question about the performance of the PLR was answered correctly by 72/283 (25%) of the participants. The limitations of the PLR, such as intra-abdominal hypertension, were correctly selected by 150/283 (53%) of the participants. The correct effect size (increase in stroke volume ≥ 10%) was correctly identified by 217/283 (77%) of the participants. Conclusions: Our results suggest a considerable disparity between the contemporary practice of the correct application and interpretation of the PLR and the practice recommendations from recently published data at German ICUs.

Nitroprusside Combined with Leg Raise at the Time of Right Heart Catheterization to Differentiate Precapillary from Other Hemodynamic Forms of Pulmonary Hypertension: A Single-Center Pilot Study.

Pulmonary hypertension (PH) can arise from several distinct disease processes, with a percentage presenting with combined pre- and postcapillary pulmonary hypertension (cpcPH). Patients with cpcPH are unsuitable candidates for PH-directed therapies due to elevated pulmonary capillary wedge pressures (PCWPs); however, the PCWP is dynamic and is affected by both preload and afterload. Many patients that are diagnosed with cpcPH are hypertensive at the time of right heart catheterization which has the potential to increase the PCWP and, therefore, mimic a more postcapillary-predominant phenotype. In this small pilot study, we examine the effect of nitroprusside combined with dynamic preload augmentation with a passive leg raise maneuver in hypertensive cpcPH patients at the time of right heart catheterization to identify a more precapillary-dominant PH phenotype. Patients that met the criteria of PCWP ≤ 15 mmHg with nitroprusside infusion and PCWP ≤ 18 mmHg with nitroprusside infusion and simultaneous leg raise were started on pulmonary vascular-targeted therapy. Long-term PH therapy was well tolerated, with increased six-minute walk distance, improved WHO functional class, decreased NT-proBNP, and improved REVEAL 2.0 Lite Risk Score in this precapillary-dominant PH phenotype. This small study highlights the importance of characterizing patient physiology beyond resting conditions at the time of right heart catheterization.

Occurrence of Coccydynia in Healthcare Professionals of Karachi; Pain and Straight Leg Raise Test Perspective

Coccydynia is a condition in which pain is experienced around the tailbone or coccyx region. The sitting position triggers the pain in the coccyx region especially when while patient comes from sitting to a standing position. The prevalence of coccydynia is unknown in the general population but it is more common in females than males. Objective: To determine the occurrence of coccydynia in healthcare professionals of Karachi. Methods: A cross-sectional study was conducted among healthcare professionals in Karachi from August 2023 to Feb 2024. The sample size of the study was 543 healthcare professionals. The sampling techniques which was used in this study were convenient. For the collection of data, a self-administered questionnaire was used while for the evaluation of data, two tests Visual Analog Score (VAS) and Straight Leg Raise( SLR) were used. The data were analyzed through the SPSS version 23.0 software in which we calculated the frequencies and percentages. Results: The study was done on 543 healthcare professionals between the ages of 20 to more than 59 years old who were recruited from different hospitals in Karachi. Pain intensity which was evaluated by the visual analog scale observed 223 (41.06 %) of participants found to lie in the moderate pain category while confirmation of coccydynia was done by the application of SLR and was found to be positive in 426 (78.85%) of healthcare professional's. Conclusions: The occurrence of coccydynia was found in the majority of the healthcare professionals of Karachi while the complaints of pain were found in the moderate category.

Functional Movement Screen at DKI Jakarta POPB Athletics in 2023

Functional Movement Screen (FMS) is a method for assessing a person's functional movement abilities. FMS can be used as a screening and injury prevention effort. The aim of this research is to provide information on weaknesses in functional movement patterns, FMS provides information on asymmetries and limitations in functional movement patterns between right and left and FMS helps predict the risk of injury that may occur. FMS consists of 7 movements, namely: (1) Deep Squat, (2) Hurdle Step, (3) Inline Lunges, (4) Shoulder Mobility, (5) Active Straight Leg Raise, (6) Trunk Stability Push Up, and (7) Rotary Stability. This research is quantitative descriptive. By using observation techniques to collect information. This research involves the use of tools, instruments and procedures to collect objective and systematic data. In this research, the 2023 Jakarta popb athletics athletes were involved with a total sample of 13 athletes. The results of this research show that the FMS profile of POPB DKI Jakarta athletic athletes in 2023 is 1 athlete showing points 21, namely a perfect score, 7 athletes showing points 17-20, namely good, 3 athletes showing points 14-16, namely inefficient. The average profile of POPB DKI Jakarta athletic athletes in 2023 is in good condition.

Diagnostic Accuracy of the Passive Straight Leg Raise Test in Detecting Compression of the Lower Lumbar Nerve Roots

Background: Lumbar nerve root compression is a pathological condition that occurs commonly in the low back pain population. Passive straight leg raise (SLR) is a clinical test widely used to confirm this pathological condition. Yet, its diagnostic accuracy needs further investigation. Objective: To assess the sensitivity and specificity of the passive SLR test in detecting compression of the lower lumbar nerve roots using magnetic resonance imaging as a reference standard. Design: This study is a prospective diagnostic-accuracy study. Methods: One hundred-and-twelve participants (82 males and 30 females) met the inclusion criteria and joined the study. Participants were recruited through direct communication and poster announcement and allocated into positive and negative MRI groups. A standardized passive SLR test was applied to all participants; then 2 X 2 cross-tabulation statistics were conducted to determine the sensitivity and specificity. Results: The passive SLR test was considered positive in 62 (56.36%) participants while it was negative in 50 (45.45%) participants. Sensitivity, specificity, positive and negative likelihood ratios were found to be 77.1%., 81.0%, 6.75, and 0.47 respectively. The diagnostic accuracy was found to be 80.95%. ROC curve revealed positive fair sensitivity and specificity of the test with the area under the curve equal to 0.775. Conclusion: The passive SLR test is a useful tool for the diagnosis of lower lumbar nerve root compression.

Feasibility of Fluid Responsiveness Assessment in Patients at Risk for Increased Intracranial Pressure.

Background: Effective fluid management is important for patients at risk of increased intracranial pressure (ICP). Maintaining constant cerebral perfusion represents a challenge, as both hypovolemia and fluid overload can severely impact patient outcomes. Fluid responsiveness tests, commonly used in critical care settings, are often deemed potentially hazardous for these patients due to the risk of disrupting cerebral perfusion. Methods: This single-center, prospective, clinical observational study enrolled 40 patients at risk for increased ICP, including those with acute brain injury. Informed consent was obtained from each participant or their legal guardians before inclusion. The study focused on the dynamics of ICP and cerebral perfusion pressure (CPP) changes during the Passive Leg Raise Test (PLRT) and the End-Expiratory Occlusion Test (EEOT). Results: The results demonstrated that PLRT and EEOT caused minor and transient increases in ICP, while consistently maintaining stable CPP. EEOT induced significantly lower ICP elevations, making it particularly suitable for use in high-risk situations. Conclusions: PLRT and EEOT can be considered feasible and safe for assessing fluid responsiveness in patients at risk for increased ICP. Notably, EEOT stands out as a preferred method for high-risk patients, offering a dependable strategy for fluid management without compromising cerebral hemodynamics.

The relationship between lower extremity muscle tightness and pain and disability in individuals with non-specific chronic low back pain.

Low back pain is a common health issue, and such pains are often associated with muscle tightness. Understanding the link between lower back pain and tight lower extremity muscles is essential for effective pain management and enhanced quality of life. The objective of this study was to investigate the relationship between lower extremity muscle tightness and pain and disability in individuals with non-specific low back pain (NSLBP). A total of 52 individuals with NSLBP were enrolled in this cross-sectional study. Lower extremity muscle tightness was assessed using various clinical tests, including the Active Knee Extension Test, Active Straight Leg Raise, Ober Test, and Modified Thomas Test. Pain intensity and disability were evaluated using the Visual Analog Scale and the Oswestry Disability Index, respectively. Statistical analyses were conducted to assess the correlation between muscle tightness, pain, and disability. The study found weak to moderate negative correlations between lower extremity muscle tightness and both pain intensity and disability in individuals with NSLBP (r: -0.287 to -0.526, p < 0.05). Dominant and non-dominant extremities exhibited differences in muscle flexibility, with the dominant extremity showing greater flexibility (p < 0.05). In individuals with NSLBP, lower extremity muscle tightness is closely related to pain severity and disability. These findings suggest that lower extremity muscle tightness plays a significant role in the severity of low back pain and disabilities. Additionally, the observed flexibility difference between dominant and non-dominant extremities warrants further investigation for more personalized treatment approaches.

Does the American Foregut Society Endoscopic Classification of Esophago-gastric Junction Integrity Predict Acid Reflux and Esophago-gastric Junction Disruption?

Background: Gastroesophageal reflux disease (GERD) is usually associated with disruption of the esophagogastric junction (EGJ). The endoscopic Hill classification has proven to be inadequate to assess EGJ integrity. Recently, the American Foregut Society (AFS) developed an endoscopic classification focused on hiatal hernia (L), hiatal opening (D), and the flap valve (F). While pH-monitoring remains the gold standard for the diagnosis of GERD, high-resolution manometry (HRM) can assess EGJ anatomy and competency. Aim of this study is to validate the AFS classification in patients with suspected GERD assessing its accuracy in predicting EGJ disruption and pathologic reflux. Methods: We prospectively enrolled patients with suspected GERD who underwent upper endoscopy, HRM and pH-study between November 2022 and March 2023. Demographic and clinical data were analyzed. The efficacy of the AFS classification in predicting GERD (acid exposure time, AET &gt; 6%) was assessed. Each component of the classification was compared with the corresponding HRM variable. Results: Among 56 patients (48% men, BMI 23.5 kg/m2, age 43 years), an AET &gt; 6% was found in 22 (39%), and in 0% of patients with AFS grade I, 5.9% with grade II, 52% with grade III and 77.8% with grade IV ( P &lt; .001). The L component effectively predicted the EGJ type, the D the EGJ-Contractile Integral, while the absence of the flap valve was related to a positive Straight Leg Raise maneuver. Conclusions: The new grading system is able to stratify patients with pathologic GERD. Moreover, the single components of the AFS classification are associated with manometric markers of EGJ disruption.

The Effectiveness of SLR Stretching and Pelvic Tilt Control Stretching on SLR Range Among Asymptomatic Females with Hamstring Tightness

Background: Hamstring muscle tightness is a significant factor that impedes performance in daily and sports activities, necessitating the need for effective stretching techniques to enhance hamstring flexibility. This is particularly important for an active, physically fit lifestyle, as hamstring tightness is linked to various musculoskeletal issues and injuries. Objective: This study aimed to evaluate and compare the effectiveness of Passive Straight Leg Raise (SLR) stretching and Pelvic Tilt Control Stretching in improving hamstring flexibility among asymptomatic young females with hamstring tightness. Methods: In a quasi-experimental trial conducted at the Arif Memorial Teaching Hospital and Riphah International University, Lahore, 50 female participants aged 20-40 years with unilateral hamstring tightness were randomly assigned to either the Passive SLR stretching group or the Pelvic Tilt Control Stretching group. The efficacy of the stretching techniques was assessed using the active knee extension test, measured with a goniometer, both pre- and post-treatment. Results: The Pelvic Tilt Control Stretching group showed a significant improvement in hamstring flexibility, with the mean post-treatment active knee extension significantly increasing from the pre-treatment measurement (p-value = 0.000). In contrast, the Passive SLR group showed no significant change in flexibility (p-value = 0.872). The study also highlighted the prevalence of a sedentary lifestyle among participants and its potential contribution to reduced hamstring flexibility. Conclusion: The study concludes that Pelvic Tilt Control Stretching is an effective method for improving hamstring flexibility in young, asymptomatic females, suggesting its incorporation into physical therapy practices. This finding is particularly relevant for populations prone to hamstring tightness due to sedentary lifestyles. Keywords: Hamstring Flexibility, Pelvic Tilt Control Stretching, Passive Straight Leg Raise, Young Females, Muscle Tightness, Physical Therapy, Sedentary Lifestyle.

Combination Effects of Microwave Diathermy and Mulligan Bent Leg: Raise Technique on Myogenic Low Back Pain

Myogenic Low Back Pain, commonly known as lower back pain, is caused by the muscles receiving repeated static loads which cause pain, lower back muscle spasms and limited lumbosacral mobility resulting in decreased functional activity. This research is a pre-experiment with a one group pretest-posttest design, aimed at finding out the effect of a combination of Microwave Diathermy and Mulligan Bent Leg Raise Technique on increasing the functional ability of Myogenic Low Back Pain. This research was carried out at the Physiotherapy Polyclinic at RSUD dr. La Palaloi Maros with a sample of 14 people. Results: Based on the Wilcoxon test analysis, p = 0.001 (p &lt; 0.05), which means that microwave diathermy and Mulligan bent leg raise technique interventions can significantly increase functional activity in myogenic low back pain patients. Providing microwave diathermy and mulligan bent leg raise technique can have a significant effect on increasing functional ability in sufferers of myogenic low back pain.

Effectiveness of Hamstring Release and Neural Mobilisation in Improving Walking Capability and Physical Activity Associated with Intermittent Neurogenic Claudication in Patients with Lumbar Spinal Stenosis: A Quasi-experimental Study

Introduction: In India, one of the most prevalent spinal pathologies is Lumbar Spinal Stenosis (LSS). It is characterised by the compression of neural structures in the spinal canal, resulting in symptoms such as neurogenic claudication, lower extremity radiculopathy, and gait impairment. Treatment involves various therapeutic modalities, with present study focusing on an integrated exercise method. Aim: To evaluate the potential efficacy of hamstring release and neural mobilisation in LSS patients. Materials and Methods: This quasi-experimental study was conducted at SGT Medical College Hospital and Research Institute, Gurugram, Haryana, India from September 2021 to May 2022. Total of 30 patients diagnosed with LSS were divided into two groups based on inclusion criteria: group A (experimental) and group B (control). Pain, neural flexibility, walking capacity, disability, and physical activity were assessed at baseline and after the 3rd week of the intervention. Treatment sessions were administered for 30 minutes per day, three times per week (on alternate days), for a duration of three weeks in both groups. Data analysis was done using the Windows version of Statistical Package for Social Sciences version 26.0 (SPSS, Chicago, IL, USA). The paired t-test was used to compare mean data within each group before and after the intervention. The Independent t-test formula was applied to compare pre and postintervention changes between group A and group B. Group B. A significance level of p-value &lt;0.05 was considered statistically significant. Results: Group A and group B had respective mean ages of 37.07±8.66 years and 41.07±8.66 years. Total of 30 LSS patients were treated. Significant differences were observed in the Numeric Pain Rating Scale (NPRS) (p-value&lt;0.0001), Straight Leg Raise (SLR) (p &lt; 0.001), Slump Test (p-value&lt;0.0001), and Self-paced Walking Test (SPWT) (p-value &lt;0.0001). Minimal significance was noted in the Modified Oswestry Disability Index (MODI) (p-value=0.027) and Swiss Spinal Stenosis Questionnaire (SSSQ) (p-value=0.029). Conclusion: Hamstring release and neural mobilisation improve pain, neural flexibility, walking capacity, disability, and physical activity in LSS patients.