CClinicalTrials.gg
Not yet recruitingNCT07482527TME-HMEUpdated Mar 19, 2026

Thoracic Mobility Versus Hip Mobility Exercises to Core Stabilization in Lumbar Spondylitis

An interventional study of Group A : Core stabilization exercises (control group) and Group B: Thoracic Mobility Exercises (1st experimental group only) in Individuals With Lumbar Spondylosis, sponsored by Cairo University. Not yet recruiting at 1 site in Egypt. Open to participants aged 40 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-03-19.

Sponsored by Cairo University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Mar 2026, 6 months ago, but the record still lists the study as not yet recruiting.
Phase
Not applicable
Study type
Interventional
Enrollment
60
Allocation
Randomized
Ages
40 Years to 60 Years
Sex
All
01

Study summary

This study is conducted to determine the effect of thoracic mobility versus hip mobility exercises to core stabilization on pain severity (NPRS-Ar), functional disability (MODI-Ar), lumbar range of motion (BROM), spinal mobility (modified schober test), quality of life (SF-36-Ar) and fear of movement (Tampa-Ar) in treatment of patients with lumbar spondylitis.

Read the detailed description

This study is conducted to determine the effect of thoracic mobility versus hip mobility exercises to core stabilization on pain severity

, functional disability , lumbar range of motion , spinal mobility , quality of life and fear of movement in treatment of patients with lumbar spondylitis.

02

Conditions studied

  • Individuals With Lumbar Spondylosis

Browse trials for

Keywords

  • lumbar spondylosis
03

In context

Spondylosis

144 studies on the registry are indexed under Spondylosis; 41 are open to participants now.

This study's planned enrollment of 60 is close to the median of 60 across 99 interventional studies indexed under Spondylosis.

Browse Spondylosis studies →

Lead sponsor

Cairo University is the lead sponsor of 4,780 studies on the registry; 1,427 are open to participants now.

Of its 36 completed or terminated interventional studies of FDA-regulated products, 5 (14%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
40 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • 1. Patients will be referred from an orthopedic surgeon with confirmed diagnosis of lumbar spondylosis with imaging findings (MRI, CT or X-ray reports within the last 6 months) (Battié et al., 2014). 2.Duration of patient's symptoms will be more than 3 months (Oliveira et al., 2022). 3. Patients' age will range from 40-60 years (Kalichman \& Hunter, 2008). 4.Localized back pain and pain radiating to lower extremities with no distal involvement below knee with an NPRS more than 3 (Thompson et al., 2021).

Exclusion criteria

Exclusion Criteria:

  1. Spinal or hip surgery history (Williams et al., 2022).
  2. Red Flags: Cauda equina syndrome, fracture, infection, malignancy (Finucane et al., 2020).
  3. Neurological Disorders: Parkinsonism, multiple sclerosis, or other neurological deficits (Odzimek et al., 2023).
  4. Inflammatory Conditions: Rheumatoid arthritis, ankylosing spondylitis, or infectious spinal disorders (Lee et al., 2018).
  5. Cognitive Impairment: Unable to understand or follow instructions (Martinez et al., 2024).
  6. Pregnancy. -
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Investigator)
Enrollment
60 participants (estimated)

Study arms

  • Experimental
    Core stabilization exercises (control group)

    Before starting the exercise, patients will be taught to reduce the lumbar lordosis by contracting and drawing in the abdominal muscles and to find the 24 lumbar and pelvic neutral position by moving the pelvis forwards and backwards (pelvic tilt, bridge, bird-dog and plank etc.). In each session, the neutral position will be found first and attention will be paid to maintain the neutral position throughout the exercise. In addition, core stability exercises including simultaneous contractions of the multifidus and pelvic floor muscles will be given in different positions such as supine, prone, crawling, bridge, kneeling, sitting and standing. The exercises will consist of 3 levels (from easy to difficult). In the advanced level exercises, patients will be asked to maintain the neutral curvature of the lumbar spine, resistance limb exercises will be added and the exercises will be completed gradually. Each exercise will be performed for 3 sets of 8-10 repetition.

    Behavioral: Group A : Core stabilization exercises (control group) · Behavioral: Group B: Thoracic Mobility Exercises (1st experimental group only) · Behavioral: Group C: Hip Mobility Exercises (2nd experimental group only)

  • Experimental
    Thoracic Mobility Exercises (1st experimental group only)

    The exercise will consist of movements in all directions of thoracic spine flexion, extension, lateral flexion, and rotation. In the thoracic spine extension exercise, both hands will be locked behind the wrists and the back will be placed on a foam roller with the feet positioned 25 flat on the floor. The knee will be maintained at 90° to perform the extension exercise on the foam roller. The hands will be locked with the elbow on a chair. After kneeling, the hip will be moved toward the heels to extend the thoracic spine. In the thoracic spine flexion exercise, the thoracic spine will be flexed by moving backward until the hip touched the heels in a quadruped position.The rotation exercise will be conducted with patients lying on their sides.The elbows will be straight and the palms will be held together. The leg facing the ceiling will be bent to the level of the stomach. Then, the arm facing the ceiling will be moved backward in a large arc to rotate the thoracic spine.

    Behavioral: Group A : Core stabilization exercises (control group)

  • Experimental
    Hip Mobility Exercises (2nd experimental group only)

    The patients will perform 8 different hip mobility exercises; reverse v-ups, butterfly, frog, internal rotation with foot rise, pike, revolved crescent lunge, pigeon, lunge on the knee. Each exercise will be performed for 2 sets of 20 seconds.

    Behavioral: Group A : Core stabilization exercises (control group)

Interventions

  • BehavioralGroup A : Core stabilization exercises (control group)

    Before starting the exercise, patients will be taught to reduce the lumbar lordosis by contracting and drawing in the abdominal muscles and to find the 24 lumbar and pelvic neutral position by moving the pelvis forwards and backwards (pelvic tilt, bridge, bird-dog and plank etc.). In each session, the neutral position will be found first and attention will be paid to maintain the neutral position throughout the exercise. In addition, core stability exercises including simultaneous contractions of the multifidus and pelvic floor muscles will be given in different positions such as supine, prone, crawling, bridge, kneeling, sitting and standing. The exercises will consist of 3 levels (from easy to difficult). In the advanced level exercises, patients will be asked to maintain the neutral curvature of the lumbar spine, resistance limb exercises will be added and the exercises will be completed gradually. Each exercise will be performed for 3 sets of 8-10 repetition.

  • BehavioralGroup B: Thoracic Mobility Exercises (1st experimental group only)

    The exercise will consist of movements in all directions of thoracic spine flexion, extension, lateral flexion, and rotation. In the thoracic spine extension exercise, both hands will be locked behind the wrists and the back will be placed on a foam roller with the feet positioned 25 flat on the floor. The knee will be maintained at 90° to perform the extension exercise on the foam roller. The hands will be locked with the elbow on a chair. After kneeling, the hip will be moved toward the heels to extend the thoracic spine. In the thoracic spine flexion exercise, the thoracic spine will be flexed by moving backward until the hip touched the heels in a quadruped position.The rotation exercise will be conducted with patients lying on their sides.The elbows will be straight and the palms will be held together. The leg facing the ceiling will be bent to the level of the stomach. Then, the arm facing the ceiling will be moved backward in a large arc to rotate the thoracic spine.

  • BehavioralGroup C: Hip Mobility Exercises (2nd experimental group only)

    The patients will perform 8 different hip mobility exercises; reverse v-ups, butterfly, frog, internal rotation with foot rise, pike, revolved crescent lunge, pigeon, lunge on the knee. Each exercise will be performed for 2 sets of 20 seconds.

06

What researchers measure

Primary outcomes

  1. Pain levels

    Pain levels in participants were assessed using the Numerical Pain Rating Scale (NPRS-Ar).

    Time frame: (pre-treatment) and after 6 weeks of intervention (post-treatment)

  2. Disability

    Using the Arabic MODI (Appendix III), Patients will be instructed to choose the best answer of the possible answers which describes the level of function and disability during daily activities in each of items of the questionnaire (Alnahdi, 2025).

    Time frame: (pre-treatment) and after 6 weeks of intervention (post-treatment)

  3. Lumbar Range of motion

    The Back Range of Motion (BROM) device will be utilized to measure the lumbar range of motion (ROM), as a valid and reliable measure of spinal motion (Kumar \& Singh, 2021; Chen et al., 2022), according to established procedures (Madson et al., 1999). After palpating and marking the spinous processes of T 12 and S1 with adhesive dots, a warm-up trial for each plane of motion will be completed by patients. The BROM device will be used to measure active ROM in the order of flexion/extension, right/left lateral flexion, and right/left rotation. Once the data for each movement was taken, the BROM device was removed, and the skin markers were reapplied after a 10-15 second rest period. Each motion will have three trials, and data from the three trials will be averaged and used for analysis in order to maximize reliability.

    Time frame: (pre-treatment) and after 6 weeks of intervention (post-treatment)

  4. Spinal mobility:

    Using the Modified Schober Test, Patient will be standing. The examiner will mark both posterior superior iliac spine (PSIS) and then will draw a horizontal line at the center of both marks. A second line is marked 5 cm below the first line. A third line is marked 10 cm above the first line. Patient will be instructed to flex forward as if attempting to touch his/her toes. The examiner re measures the distance between the top and bottom line (Rezvani et al., 2012). Three trials will be conducted and the mean of the three trials will be chosen for the purpose of data analysis

    Time frame: (pre-treatment) and after 6 weeks of intervention (post-treatment)

  5. Fear of movement

    Using the Arabic Tampa (Appendix V), Patients will be asked about any excessive, irrational, and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or re-injury (Al Shudifat et al., 2020).

    Time frame: (pre-treatment) and after 6 weeks of intervention (post-treatment)

07

Study locations

1 site
  • Faculity Og Physical Therapy in Cairo Univercity
    Cairo, Egypt
    • YAHYA S KULAYBI, MASTER DEGREE · Contact · yk-pt@hotmail.com · +966568085421
    • MOAAZ RIADH, DOCTORAL DEGREE · Contact · moaaz.elsakka@gmail.com · +201007210132
    • YAHYA S KULAYBI, MASTER DEGREE · Principal investigator
08

References and documents

Publications

  • World Health Organization, (WHO). (2023). Global health estimates 2019: Deaths by cause, age, sex, by country and by region, 2000-2019.
  • Wilson, A. & Clarke, S. (2023). Hip mobility interventions in chronic low back pain: A biomechanical analysis using 3D motion capture. Clin Biomech, 98: 105-112.
  • Wilson, A., Thompson, M. & Kumar, S. (2023). Multi-regional approach to chronic low back pain: Combining thoracic and hip interventions. J Rehabil Med, 55(4): 245-253.
  • Thompson, M., Reiman, M. P., Sylvain, J., Tenforde, A. S. & Davis, I. S. (2021). The role of hip abductor strength in people with patellofemoral pain: A systematic review and meta-analysis. Sports Health, 12(6): 552 558.
  • Skundric, G., Vukicevic, V., & Lukic, N. (2021). Effects of Core Stability Exercises, Lumbar Lordosis and Low-Back Pain: A Systematic Review. Journal of Anthropology of Sport and Physical Education, 5(1), 17-23. https://doi.org/10.26773/jaspe.210104
  • Sivakumar, R. & Hossain, S. (2025). Effects of thoracic mobility exercises combined with breathing techniques on pain, muscle strength, and self efficacy in undergraduate students with upper back pain. Int J Therap Rehabil, 32(1): 1-9. DOI:10.13140/RG.2.2.34909.01767
  • Scholtes, S. A., Gombatto, S. P. & Van Dillen, L. R. (2009). The influence of hip motion on the lumbar spine and pelvis during gait in people with and without low back pain. Phys. Ther., 89(11): 1151-1160.
  • Salah Eldeen, A. A., Rehab, N. I., Fahmy, E., Shendy, W. S. & Alsaid, H. M. (2024). Effect of thoracic spine mobilization as an adjunct to conventional physical therapy on chronic lumbosacral radiculopathy: A randomized controlled trial. Benha Int J Phys Ther, 2(2): 35 - 42. DOI: 10.21608/bijpt.2024.303076.1034
  • Rose, G., Wellman, S., Hughes, J. & DiBenedetto, M. (2020). Thoracic spine extension mobility in young adults and its relation to shoulder function. Phys. Ther. Sport, 42: 134-142.
  • Ramzy, R. (2008). Validation of the Arabic Version of the Oswestry Disability Index Developed in Tunisia for low back pain patients in the UAE. Master Thesis, Physical Therapy, Stellenbosch University.
  • Ramirez-Velez, R., Correa-Bautista, J. E., Sanders-Tordecilla, A., Ojeda Pardo, M. L., Cobo-Mejía, E. A., Castellanos-Vega, R. P., García Hermoso, A., González-Jiménez, E., Schmidt-RioValle, J. & González Ruíz, K. (2021). Yoga practice decreases levels of anxiety, depression, and perceived stress in women with breast cancer: A randomized controlled trial. J Clin Med, 8(10): 1645.
  • Rahman, M. S., Islam, M. S., Alam, M. M., Haque, A., Rahman, A. & Choudhury, M. R. (2023). Effectiveness of thoracic spine mobilization with conventional physiotherapy versus conventional physiotherapy alone in patients with lumbar spondylolisthesis. J Phys Ther Sci, 35(2): 123-128.
  • Patel, L. (2024). Effect of 4 weeks core stabilization exercise on muscle activity, range motion Fizjoterapiapolska.pl. and function in Lumbar Spondylosis. https://fizjoterapiapolska.pl/en/article/wplyw-4 tygodniowych-cwiczen-stabilizacji-centralnej-na-aktywnosc-miesni zakres-ruchu-i-funkcje-u-pacjentow-z-ledzwiowa-spondyloza/
  • Park, K. N. & Kim, S. H. (2020). Effects of real-time ultrasound-guided core strengthening exercises on muscle thickness and pain in patients with chronic low back pain. Clin Rehabil, 34(1): 98-106.
  • Park, D. & Lee, K. S. (2024). Effects of Thoracic Mobility Exercise Program on Pain, Proprioception, and Static Balance Ability in Patients with non Specific Chronic Low Back Pain. Phys Ther Rehabil Sci 2024;13:1-7. DOI: 10.14474/ptrs.2024.13.1.1
  • Page, P., Frank, C. C. & Lardner, R. (2020). Assessment and treatment of muscle imbalance: The Janda approach. Human Kinetics.
  • Odzimek M, Brola W, Opara J. Lumbar Pain in Patients with Multiple Sclerosis and Knowledge about Physiotherapeutic Methods for Combating Pain. Healthcare (Basel). 2023 Nov 29;11(23):3062. doi: 10.3390/healthcare11233062. PubMed 38063630 ↗
  • Shalamzari MH, Henteh MA, Shamsoddini A, Ghanjal A. Comparison of the effects of core stability and whole-body electromyostimulation exercises on lumbar lordosis angle and dynamic balance of sedentary people with hyperlordosis: a randomized controlled trial. BMC Sports Sci Med Rehabil. 2024 Apr 23;16(1):91. doi: 10.1186/s13102-024-00879-5. PubMed 38654368 ↗
  • McGill, S. M. (2016). Low back disorders: Evidence-based prevention and rehabilitation (3rd ed.). Human Kinetics.
  • Arevalo-Martinez A, Barbosa-Torres C, Moreno-Manso JM, Garcia-Baamonde ME, Diaz-Munoz CL. Assessing cognitive impairment in chronic pain: a cross-sectional study with healthy controls. Disabil Rehabil. 2025 Jun;47(13):3394-3401. doi: 10.1080/09638288.2024.2425057. Epub 2024 Nov 9. PubMed 39520123 ↗
  • Liebano RE, Sluka KA, Roy J, Savinelli M, Dailey DL, Riley SP. Effects of transcutaneous electrical nerve stimulation on pain, function, and descending inhibition in people with non-specific chronic low-back pain: a study protocol for a randomized crossover trial. Trials. 2024 Apr 6;25(1):242. doi: 10.1186/s13063-024-08089-7. PubMed 38582874 ↗
  • Yasuda T, Jaotawipart S, Kuruma H. Effects of Thoracic Spine Self-mobilization on Patients with Low Back Pain and Lumbar Hypermobility: A Randomized Controlled Trial. Prog Rehabil Med. 2023 Jul 22;8:20230022. doi: 10.2490/prm.20230022. eCollection 2023. PubMed 37483879 ↗
  • Kumar S, Negi MP, Sharma VP, Shukla R, Dev R, Mishra UK. Efficacy of two multimodal treatments on physical strength of occupationally subgrouped male with low back pain. J Back Musculoskelet Rehabil. 2009;22(3):179-88. doi: 10.3233/BMR-2009-0234. PubMed 20023348 ↗
  • Kumar, A. & Singh, R. (2021). Thoracic spine mobility interventions for chronic low back pain: A systematic review. Int J Sports Phys Ther, 16(2): 464-475.
  • Kim, M. H., Yoo, W. G. & Lee, R. M. (2021). Effects of hip mobility training on lumbar stability in patients with chronic low back pain. Physiother Res Inter, 26(2): 85-91.
  • Kahl, C. & Cleland, J. A. (2005). Visual analogue scale, numeric pain rating scale and the McGill pain Questionnaire: an overview of psychometric properties. Phys Ther 10.1179/108331905X55776
  • Jones, I. & Johnson, M. I. (2009). Transcutaneous electrical nerve stimulation Continuing Education in Anaesthesia Critical Care & Pain, 9(4): 130-135. DOI: 10.1093/bjaceaccp/mkp021
  • Jensen, T. S., Albert, H. B., Soerensen, J. S., Manniche, C. & Leboeuf-Yde, C. (2021). Antibiotic treatment for chronic low back pain with Modic changes: A double-blind, randomized, placebo-controlled study. Spine, 38(8): E971-E978.
  • Ishtiaq, N., Riaz, H., Tahir, M., Asghar, Z., Rasool ,A. G. & Sial, W. H. (2023). Effects of trigger point dry needling in patients with patellofemoral pain syndrome; A randomized controlled trial. Heal J Physio Rehab Sci, 3(5): 505-517. DOI: https://doi.org/10.55735/hjprs.v3i5.148
  • Hodges, P. W., Danneels, L., Cagnie, B., Hall, L., van Dillen, L. R., Guzik, A., Tsao, H., Macdonald, D., Moseley, G. L., Mullane, J., Pool Goudzwaard, A., Richardson, C., Sheeran, L., van Dieen, J. & Tucker, K. (2020). Intervertebral motion during functional movements in people with and without low back pain. Clinical Biomechanics, 22(1): 21-32.
  • Hershkovich O, Grevitt MP, Lotan R. Schober Test and Its Modifications Revisited-What Are We Actually Measuring? Computerized Tomography-Based Analysis. J Clin Med. 2022 Nov 22;11(23):6895. doi: 10.3390/jcm11236895. PubMed 36498470 ↗
  • García-López, H., Cotrina-Aliaga, J. C., Gómez-Álvarez, N., Fernández González, P., Rodríguez-Mansilla, J., González-López-Arza, M. V. & González-Sánchez, B. (2023). Effectiveness of the core stability exercises and motor control on chronic low back pain in women: A systematic review and meta-analysis. BMC Sports Sci Med Rehab, 15(1): 19.
  • Ferraz MB, Quaresma MR, Aquino LR, Atra E, Tugwell P, Goldsmith CH. Reliability of pain scales in the assessment of literate and illiterate patients with rheumatoid arthritis. J Rheumatol. 1990 Aug;17(8):1022-4. PubMed 2213777 ↗
  • Ferraresi, G., Cavazzuti, L. & Pynsent, P. B. (2022). The effect of hip mobility and strength interventions on lumbar-pelvic alignment and low back pain: A systematic review. Man Ther, 28(3), 70-79.
  • Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976). 2000 Nov 15;25(22):2940-52; discussion 2952. doi: 10.1097/00007632-200011150-00017. PubMed 11074683 ↗
  • El-Kalla, R. E., Khalaf, M. M., Saad, M. A. & Othman, E. M. (2016). Reliability of the Arabic Egyptian Version of Short Form 36 Health Survey Questionnaire to Measure Quality of Life in Burned Patient. Med J Cairo Univ, 84(2): 311-316.
  • Choi, S. H. & Kim, M. K. (2023). Effects of thoracic and hip joint mobility exercise with lumbar stabilization exercise on pain and balance in women with chronic low back pain. J Kor Orthop Manipul Phys Ther, 29(2): 1-10.
  • Alagappan Thiyagarajan. (2024). Benefits of Exercise Therapy for Lumbar Spondylosis - A Narrative Review. International Journal of Physiotherapy Research and Clinical https://doi.org/10.54839/ijprcp.v3i1.24.3
  • Yamato TP, Maher CG, Saragiotto BT, Hancock MJ, Ostelo RW, Cabral CM, Menezes Costa LC, Costa LO. Pilates for low back pain. Cochrane Database Syst Rev. 2015 Jul 2;2015(7):CD010265. doi: 10.1002/14651858.CD010265.pub2. PubMed 26133923 ↗
  • Williams FM, Popham M, Sambrook PN, Jones AF, Spector TD, MacGregor AJ. Progression of lumbar disc degeneration over a decade: a heritability study. Ann Rheum Dis. 2011 Jul;70(7):1203-7. doi: 10.1136/ard.2010.146001. Epub 2011 Mar 13. PubMed 21402564 ↗
  • Weermeijer JD, Meulders A. Clinimetrics: Tampa Scale for Kinesiophobia. J Physiother. 2018 Apr;64(2):126. doi: 10.1016/j.jphys.2018.01.001. Epub 2018 Mar 19. No abstract available. PubMed 29567379 ↗
  • Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473-83. PubMed 1593914 ↗
  • Wang XQ, Zheng JJ, Yu ZW, Bi X, Lou SJ, Liu J, Cai B, Hua YH, Wu M, Wei ML, Shen HM, Chen Y, Pan YJ, Xu GH, Chen PJ. A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PLoS One. 2012;7(12):e52082. doi: 10.1371/journal.pone.0052082. Epub 2012 Dec 17. PubMed 23284879 ↗
  • Wainner RS, Whitman JM, Cleland JA, Flynn TW. Regional interdependence: a musculoskeletal examination model whose time has come. J Orthop Sports Phys Ther. 2007 Nov;37(11):658-60. doi: 10.2519/jospt.2007.0110. No abstract available. PubMed 18057674 ↗
  • Vad VB, Bhat AL, Basrai D, Gebeh A, Aspergren DD, Andrews JR. Low back pain in professional golfers: the role of associated hip and low back range-of-motion deficits. Am J Sports Med. 2004 Mar;32(2):494-7. doi: 10.1177/0363546503261729. PubMed 14977679 ↗
  • Tousignant M, Poulin L, Marchand S, Viau A, Place C. The Modified-Modified Schober Test for range of motion assessment of lumbar flexion in patients with low back pain: a study of criterion validity, intra- and inter-rater reliability and minimum metrically detectable change. Disabil Rehabil. 2005 May 20;27(10):553-9. doi: 10.1080/09638280400018411. PubMed 16019864 ↗
  • Sung PS. A kinematic analysis for shoulder and pelvis coordination during axial trunk rotation in subjects with and without recurrent low back pain. Gait Posture. 2014 Sep;40(4):493-8. doi: 10.1016/j.gaitpost.2014.06.001. Epub 2014 Jun 16. PubMed 25008865 ↗
  • Sueki DG, Cleland JA, Wainner RS. A regional interdependence model of musculoskeletal dysfunction: research, mechanisms, and clinical implications. J Man Manip Ther. 2013 May;21(2):90-102. doi: 10.1179/2042618612Y.0000000027. PubMed 24421619 ↗
  • Shamsi M, Mirzaei M, Khabiri SS. Universal goniometer and electro-goniometer intra-examiner reliability in measuring the knee range of motion during active knee extension test in patients with chronic low back pain with short hamstring muscle. BMC Sports Sci Med Rehabil. 2019 Mar 22;11:4. doi: 10.1186/s13102-019-0116-x. eCollection 2019. PubMed 30949343 ↗
  • Schmidt CO, Raspe H, Pfingsten M, Hasenbring M, Basler HD, Eich W, Kohlmann T. Back pain in the German adult population: prevalence, severity, and sociodemographic correlates in a multiregional survey. Spine (Phila Pa 1976). 2007 Aug 15;32(18):2005-11. doi: 10.1097/BRS.0b013e318133fad8. PubMed 17700449 ↗
  • Seo J, Song C, Shin D. A Single-Center Study Comparing the Effects of Thoracic Spine Manipulation vs Mobility Exercises in 26 Office Workers with Chronic Neck Pain: A Randomized Controlled Clinical Study. Med Sci Monit. 2022 Jul 8;28:e937316. doi: 10.12659/MSM.937316. PubMed 35799408 ↗
  • Selkowitz DM, Beneck GJ, Powers CM. Which exercises target the gluteal muscles while minimizing activation of the tensor fascia lata? Electromyographic assessment using fine-wire electrodes. J Orthop Sports Phys Ther. 2013 Feb;43(2):54-64. doi: 10.2519/jospt.2013.4116. Epub 2012 Nov 16. PubMed 23160432 ↗
  • Saragiotto BT, Maher CG, Yamato TP, Costa LO, Menezes Costa LC, Ostelo RW, Macedo LG. Motor control exercise for chronic non-specific low-back pain. Cochrane Database Syst Rev. 2016 Jan 8;2016(1):CD012004. doi: 10.1002/14651858.CD012004. PubMed 26742533 ↗
  • Rezvani A, Ergin O, Karacan I, Oncu M. Validity and reliability of the metric measurements in the assessment of lumbar spine motion in patients with ankylosing spondylitis. Spine (Phila Pa 1976). 2012 Sep 1;37(19):E1189-96. doi: 10.1097/BRS.0b013e31825ef954. PubMed 22614802 ↗
  • Ravindra VM, Senglaub SS, Rattani A, Dewan MC, Hartl R, Bisson E, Park KB, Shrime MG. Degenerative Lumbar Spine Disease: Estimating Global Incidence and Worldwide Volume. Global Spine J. 2018 Dec;8(8):784-794. doi: 10.1177/2192568218770769. Epub 2018 Apr 24. PubMed 30560029 ↗
  • Paolucci T, Pezzi L, Coraci D, Tognolo L, Pantalone A, Attanasi C, Graziani G, Dalla Costa D, Arippa F, Cichelli A, Monticone M. Reliability, Concurrent Validity, and Clinical Performances of the Shorter Version of the Roland Morris Disability Questionnaire in a Sample of Italian People with Non-Specific Low Back Pain. J Pers Med. 2024 Jul 11;14(7):740. doi: 10.3390/jpm14070740. PubMed 39063994 ↗
  • Oliveira CB, Maher CG, Pinto RZ, Traeger AC, Lin CC, Chenot JF, van Tulder M, Koes BW. Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview. Eur Spine J. 2018 Nov;27(11):2791-2803. doi: 10.1007/s00586-018-5673-2. Epub 2018 Jul 3. PubMed 29971708 ↗
  • Nijs J, George SZ, Clauw DJ, Fernandez-de-Las-Penas C, Kosek E, Ickmans K, Fernandez-Carnero J, Polli A, Kapreli E, Huysmans E, Cuesta-Vargas AI, Mani R, Lundberg M, Leysen L, Rice D, Sterling M, Curatolo M. Central sensitisation in chronic pain conditions: latest discoveries and their potential for precision medicine. Lancet Rheumatol. 2021 May;3(5):e383-e392. doi: 10.1016/S2665-9913(21)00032-1. Epub 2021 Mar 30. PubMed 38279393 ↗
  • Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017 Feb 18;389(10070):736-747. doi: 10.1016/S0140-6736(16)30970-9. Epub 2016 Oct 11. PubMed 27745712 ↗
  • Madson TJ, Youdas JW, Suman VJ. Reproducibility of lumbar spine range of motion measurements using the back range of motion device. J Orthop Sports Phys Ther. 1999 Aug;29(8):470-7. doi: 10.2519/jospt.1999.29.8.470. PubMed 10444737 ↗
  • Lurie J, Tomkins-Lane C. Management of lumbar spinal stenosis. BMJ. 2016 Jan 4;352:h6234. doi: 10.1136/bmj.h6234. PubMed 26727925 ↗
  • Liu J, Yeung A, Xiao T, Tian X, Kong Z, Zou L, Wang X. Chen-Style Tai Chi for Individuals (Aged 50 Years Old or Above) with Chronic Non-Specific Low Back Pain: A Randomized Controlled Trial. Int J Environ Res Public Health. 2019 Feb 12;16(3):517. doi: 10.3390/ijerph16030517. PubMed 30759778 ↗
  • Lin I, Wiles L, Waller R, Goucke R, Nagree Y, Gibberd M, Straker L, Maher CG, O'Sullivan PPB. What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. Br J Sports Med. 2020 Jan;54(2):79-86. doi: 10.1136/bjsports-2018-099878. Epub 2019 Mar 2. PubMed 30826805 ↗
  • Liebenson C, Karpowicz AM, Brown SH, Howarth SJ, McGill SM. The active straight leg raise test and lumbar spine stability. PM R. 2009 Jun;1(6):530-5. doi: 10.1016/j.pmrj.2009.03.007. PubMed 19627942 ↗
  • Lewis CL, Sahrmann SA, Moran DW. Anterior hip joint force increases with hip extension, decreased gluteal force, or decreased iliopsoas force. J Biomech. 2007;40(16):3725-31. doi: 10.1016/j.jbiomech.2007.06.024. Epub 2007 Aug 17. PubMed 17707385 ↗
  • Lee JL, Sinnathurai P, Buchbinder R, Hill C, Lassere M, March L. Biologics and cardiovascular events in inflammatory arthritis: a prospective national cohort study. Arthritis Res Ther. 2018 Aug 7;20(1):171. doi: 10.1186/s13075-018-1669-x. PubMed 30086795 ↗
  • Kuzu S, Canli M, Valamur I, Ozudogru A, Alkan H, Hartavi A. Effects of aerobic exercise in addition to core stabilization exercises on functional capacity, physical performance and fall risk in geriatric individuals with chronic non-specific low back pain. BMC Sports Sci Med Rehabil. 2025 Jul 29;17(1):218. doi: 10.1186/s13102-025-01271-7. PubMed 40734175 ↗
  • Lin CF, Jankaew A, Tsai MC, Liao JC. Immediate effects of thoracic mobilization versus soft tissue release on trunk motion, pain, and lumbar muscle activity in patients with chronic low back pain. J Bodyw Mov Ther. 2024 Oct;40:1664-1671. doi: 10.1016/j.jbmt.2024.09.004. Epub 2024 Sep 26. PubMed 39593506 ↗
  • Kostadinovic S, Milovanovic N, Jovanovic J, Tomasevic-Todorovic S. Efficacy of the lumbar stabilization and thoracic mobilization exercise program on pain intensity and functional disability reduction in chronic low back pain patients with lumbar radiculopathy: A randomized controlled trial. J Back Musculoskelet Rehabil. 2020;33(6):897-907. doi: 10.3233/BMR-201843. PubMed 32675390 ↗
  • Koes BW, van Tulder M, Lin CW, Macedo LG, McAuley J, Maher C. An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. Eur Spine J. 2010 Dec;19(12):2075-94. doi: 10.1007/s00586-010-1502-y. Epub 2010 Jul 3. PubMed 20602122 ↗
  • Kim B, Yim J. Core Stability and Hip Exercises Improve Physical Function and Activity in Patients with Non-Specific Low Back Pain: A Randomized Controlled Trial. Tohoku J Exp Med. 2020 Jul;251(3):193-206. doi: 10.1620/tjem.251.193. PubMed 32669487 ↗
  • Kibler WB, Press J, Sciascia A. The role of core stability in athletic function. Sports Med. 2006;36(3):189-98. doi: 10.2165/00007256-200636030-00001. PubMed 16526831 ↗
  • Kalichman L, Hunter DJ. Diagnosis and conservative management of degenerative lumbar spondylolisthesis. Eur Spine J. 2008 Mar;17(3):327-335. doi: 10.1007/s00586-007-0543-3. Epub 2007 Nov 17. PubMed 18026865 ↗
  • Kamper SJ, Apeldoorn AT, Chiarotto A, Smeets RJ, Ostelo RW, Guzman J, van Tulder MW. Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis. BMJ. 2015 Feb 18;350:h444. doi: 10.1136/bmj.h444. PubMed 25694111 ↗
  • Kamper SJ, Ostelo RW, Rubinstein SM, Nellensteijn JM, Peul WC, Arts MP, van Tulder MW. Minimally invasive surgery for lumbar disc herniation: a systematic review and meta-analysis. Eur Spine J. 2014 May;23(5):1021-43. doi: 10.1007/s00586-013-3161-2. Epub 2014 Jan 18. PubMed 24442183 ↗
  • Johnson KD, Kim KM, Yu BK, Saliba SA, Grindstaff TL. Reliability of thoracic spine rotation range-of-motion measurements in healthy adults. J Athl Train. 2012 Jan-Feb;47(1):52-60. doi: 10.4085/1062-6050-47.1.52. PubMed 22488230 ↗
  • Hayden JA, Ellis J, Ogilvie R, Stewart SA, Bagg MK, Stanojevic S, Yamato TP, Saragiotto BT. Some types of exercise are more effective than others in people with chronic low back pain: a network meta-analysis. J Physiother. 2021 Oct;67(4):252-262. doi: 10.1016/j.jphys.2021.09.004. Epub 2021 Sep 16. PubMed 34538747 ↗
  • Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, Hoy D, Karppinen J, Pransky G, Sieper J, Smeets RJ, Underwood M; Lancet Low Back Pain Series Working Group. What low back pain is and why we need to pay attention. Lancet. 2018 Jun 9;391(10137):2356-2367. doi: 10.1016/S0140-6736(18)30480-X. Epub 2018 Mar 21. PubMed 29573870 ↗
  • George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk JM, Lentz TA, Gilliam JR, Hendren S, Norman KS. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. J Orthop Sports Phys Ther. 2021 Nov;51(11):CPG1-CPG60. doi: 10.2519/jospt.2021.0304. PubMed 34719942 ↗
  • Geisser ME, Wiggert EA, Haig AJ, Colwell MO. A randomized, controlled trial of manual therapy and specific adjuvant exercise for chronic low back pain. Clin J Pain. 2005 Nov-Dec;21(6):463-70. doi: 10.1097/01.ajp.0000135237.89834.23. PubMed 16215330 ↗
  • Foster NE, Anema JR, Cherkin D, Chou R, Cohen SP, Gross DP, Ferreira PH, Fritz JM, Koes BW, Peul W, Turner JA, Maher CG; Lancet Low Back Pain Series Working Group. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018 Jun 9;391(10137):2368-2383. doi: 10.1016/S0140-6736(18)30489-6. Epub 2018 Mar 21. PubMed 29573872 ↗
  • Finucane LM, Downie A, Mercer C, Greenhalgh SM, Boissonnault WG, Pool-Goudzwaard AL, Beneciuk JM, Leech RL, Selfe J. International Framework for Red Flags for Potential Serious Spinal Pathologies. J Orthop Sports Phys Ther. 2020 Jul;50(7):350-372. doi: 10.2519/jospt.2020.9971. Epub 2020 May 21. PubMed 32438853 ↗
  • De Stefano FA, Warner T, Reardon T, Jarrah R, Mayo T, Ezeudu CS, Fiani B. A Bibliometric and Visual Analysis of the Most Cited Articles on Disc Arthroplasty. Global Spine J. 2023 Oct;13(8):2516-2525. doi: 10.1177/21925682231154857. Epub 2023 Feb 3. PubMed 36734604 ↗
  • Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2021 Dec 19;396(10267):2006-2017. doi: 10.1016/S0140-6736(20)32340-0. Epub 2020 Dec 1. PubMed 33275908 ↗
  • Cook G, Burton L, Hoogenboom BJ, Voight M. Functional movement screening: the use of fundamental movements as an assessment of function - part 1. Int J Sports Phys Ther. 2014 May;9(3):396-409. PubMed 24944860 ↗
  • Cook C, Learman K, Showalter C, Kabbaz V, O'Halloran B. Early use of thrust manipulation versus non-thrust manipulation: a randomized clinical trial. Man Ther. 2013 Jun;18(3):191-8. doi: 10.1016/j.math.2012.08.005. Epub 2012 Oct 2. PubMed 23040656 ↗
  • Chen S, Chen M, Wu X, Lin S, Tao C, Cao H, Shao Z, Xiao G. Global, regional and national burden of low back pain 1990-2019: A systematic analysis of the Global Burden of Disease study 2019. J Orthop Translat. 2021 Sep 10;32:49-58. doi: 10.1016/j.jot.2021.07.005. eCollection 2022 Jan. PubMed 34934626 ↗
  • Ceballos-Laita L, Estebanez-de-Miguel E, Jimenez-Rejano JJ, Bueno-Gracia E, Jimenez-Del-Barrio S. The effectiveness of hip interventions in patients with low-back pain: A systematic review and meta-analysis. Braz J Phys Ther. 2023 Mar-Apr;27(2):100502. doi: 10.1016/j.bjpt.2023.100502. Epub 2023 Apr 5. PubMed 37037144 ↗
  • Betzler BK, Ng FYC, Huang Y, Hr BAR. The Prevalence of Coexisting Lumbar Spondylosis and Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Asian Spine J. 2022 Dec;16(6):839-847. doi: 10.31616/asj.2021.0405. Epub 2022 Apr 18. PubMed 35421911 ↗
  • Bordoni B, Zanier E. Anatomic connections of the diaphragm: influence of respiration on the body system. J Multidiscip Healthc. 2013 Jul 25;6:281-91. doi: 10.2147/JMDH.S45443. Print 2013. PubMed 23940419 ↗
  • Battie MC, Videman T, Parent E. Lumbar disc degeneration: epidemiology and genetic influences. Spine (Phila Pa 1976). 2004 Dec 1;29(23):2679-90. doi: 10.1097/01.brs.0000146457.83240.eb. PubMed 15564917 ↗
  • Al-Shudifat A, Farah K, Hawamdeh ZM, Alqudah A, Juweid ME. Psychometric testing of a short form, 11-item Tampa Scale of Kinesiophobia-Arabic version: TSK-AV-11. Medicine (Baltimore). 2020 Jun 12;99(24):e20292. doi: 10.1097/MD.0000000000020292. PubMed 32541453 ↗
  • Alnahdi AH. The Arabic Oswestry Disability Index as a Unidimensional Measure: Confirmatory Factor Analysis. Spine (Phila Pa 1976). 2025 Mar 15;50(6):E103-E109. doi: 10.1097/BRS.0000000000005223. Epub 2024 Nov 27. PubMed 39593202 ↗
  • Alghadir AH, Anwer S, Iqbal ZA. The psychometric properties of an Arabic numeric pain rating scale for measuring osteoarthritis knee pain. Disabil Rehabil. 2016 Dec;38(24):2392-7. doi: 10.3109/09638288.2015.1129441. Epub 2016 Jan 6. PubMed 26733318 ↗
  • Alghadir AH, Anwer S, Iqbal A, Iqbal ZA. Test-retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. J Pain Res. 2018 Apr 26;11:851-856. doi: 10.2147/JPR.S158847. eCollection 2018. PubMed 29731662 ↗
  • Adams MA, Freeman BJ, Morrison HP, Nelson IW, Dolan P. Mechanical initiation of intervertebral disc degeneration. Spine (Phila Pa 1976). 2000 Jul 1;25(13):1625-36. doi: 10.1097/00007632-200007010-00005. PubMed 10870137 ↗

Study documents

  • Study protocol · Mar 6, 2026

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 19, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07482527
Lead sponsor
Cairo University
Collaborators
physical therapy of cairo university
Responsible party
YAHYA ABDU S KULAYBI (YAHYA ABDU S KULAYBI, Cairo University) — Principal investigator
First posted
Mar 19, 2026
Start date
Mar 25, 2026 (estimated)
Primary completion
Mar 30, 2026 (estimated)
Completion
May 31, 2026 (estimated)
Last update
Mar 19, 2026

Study contacts

YAHYA ABDU KULAYBI, MSc
Contact
yk-pt@hotmail.com
+966568085421
RAMY GNADY KOMIR, MSc
Contact
rami33332@yahoo.com
+966553277511
MOAAZ RAGAB RIYAD, PhD
study director · CAIRO UNIVERCITY

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Feb 2026. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion