Post Facilitatiion Stretch and Dry Needling on Hamstring Tightness in Chronic Low Back Pain

Summary

The aim of this research is to compare the effects of post-facilitation stretch and dry needling on hamstring flexibility, pain, lumbar range of motion, pelvic tilt, and functional status in patients with chronic low back pain. This randomized clinical trial will be conducted at Spine Care Physical Therapy and Rehabilitation Centre (SPRC), Peshawar. The sample size will be 36 participants, who will be randomly divided into two groups: 18 participants in the post-facilitation stretch group and 18 participants in the dry needling group. The study duration will be 3 weeks, with interventions applied three times per week. The sampling technique used will be non-probability purposive sampling, followed by random allocation using the sealed opaque envelope method. Participants aged 20-50 years diagnosed with chronic nonspecific low back pain and having hamstring tightness will be included. Outcome measures used in the study will be Active Knee Extension Test (goniometer) for hamstring flexibility, Numeric Pain Rating Scale (NPRS) for pain, goniometer for lumbar flexion and extension, pelvic inclinometer for pelvic tilt, and Modified Oswestry Disability Index (MODI) for functional disability.

Conditions

• Low Back Pain

Interventions

OTHER

Dry Needling along with Conventional Therapy

Patient in prone position with pillow under ankle. After skin antisepsis, a sterile filiform needle (0.25 × 40 mm) will be inserted into identified myofascial trigger points in the hamstrings. Local twitch responses will be elicited with 5-10 positioning movements. Needle retention 30-60 seconds per point for 3 weeks 3 session per week.The patient was positioned in supine lying on the treatment plinth with the contralateral limb extended and the treated limb raised with the knee extended for static hamstring stretching. The pelvis was stabilized to prevent compensatory movements.For the moist heat pack, the patient remained in prone lying, with the heat pack applied over the posterior thigh (hamstring region) and properly secured for comfort and safety

OTHER

Post Facilitation Stretch along with Conventional Therapy

Post-Facilitation Stretch with Conventional Physiotherapy. Participants in this group will receive post-facilitation stretch combined with conventional physiotherapy. Post-facilitation stretch will be performed with the patient in supine lying. The therapist will passively stretch the hamstring muscle to the point of first resistance, followed by a maximal isometric contraction (100% effort) for 7-10 seconds. After a brief relaxation period of 1-2 seconds, a rapid, controlled stretch will be applied and held for 15-20 seconds. This sequence will be repeated 3-5 times per session. Conventional physiotherapy will include a 5-minute moist heat pack applied to the posterior thigh before treatment, followed by static hamstring stretching (3 repetitions × 20 seconds) after the session. Sessions will be conducted three times per week for 3 weeks, with a total of 9 sessions, each session lasting approximately 30 minutes.

Sponsors & Collaborators

• Riphah International University

  lead OTHER

Principal Investigators

• Muhmmad Affan Iqbal, PhD* · Riphah International University, Islamabad

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

20 Years

Max Age

50 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-02-02

Primary Completion

2026-07-31

Completion

2026-08-31

Countries

• Pakistan

Study Locations