Comparative Effect of Sahrmann's Exercises and Core Stabilization Exercises on Low Back Pain in Individuals With Lumbar Lordosis

Low Back pain is the most usual cause of disability and is worsening on a global scale. The prevalence of Low back pain is reported to be about 80%. Lumbar lordosis has significance because of its distinctive position and its direct contact with the pelvis. Increased lordosis leads to excessive compression of apophyseal joint. Sahrmann's exercises refers to address the muscular component by shortening long muscles, reducing the load on weak or long muscles, supporting weakened using specific muscles to train the patient to activate specific muscles in a precise manner, and emphasize correct use of muscles in postural positioning activity and functional activity. The commonly used core stability training programs is the McGill Big 3 core stability exercise which was introduced by McGill and Karpowicz. Core stability has an impressive effect even on prevention of low back and lumbar lordosis. Core stability training has been widely used in physical therapy as treatment of low back pain.

• Sahrmann's Exercises (Other), also known as Exercise: Sahrmann's Exercises include exercises like Pelvic Clock which strengthen transverse abdominis and improve pelvic alignment. Its positions includes; Pelvic tilt (12 o'clock), Lateral pelvic shift (3 o'clock and 9 o'clock), Posterior pelvic tilt (6 o'clock) with 3 sets of 10-15 repetitions. Lumbar Extensions which enhance lumbar lordosis and strengthen erector spinae. Bridging which strengthen gluteus maximus and improve hip-pelvic alignment. Knee to Chest stretch which improves lumbar flexibility, mobility, enhances strength of hip and pelvic muscles.
• Core Stabilization Exercises (Other), also known as Exercise: Core Stabilization Exercises includes; Curl-Up which strengthen the rectus abdominis and transverse abdominis muscles with 3 sets of 10-15 repetitions. Bird Dog which strengthen the extensor muscles, including the erector spinae and latissimus dorsi. Side Plank (Modified Plank) which strengthen the transverse abdominis and oblique muscles.

Primary outcomes

• Pain Intensity [Baseline and 4th week]: The intensity of pain was measured by a numerical pain rating scale is an accurate and reliable tool for measuring pain intensity. It is a scale rating from 0 to 10 (no pain to moderate pain and to severe pain).

Secondary outcomes

• Disability [Baseline and 4th week]: Disability was measured by Oswestry disability index is a questionnaire includes total 10 sections and each section has 5 further statements related daily routine activities e.g. lifting, washing, walking, traveling, sitting etc. The possible score is 5 for each section. The score ranges from 0 (minimum disability) to 50 (maximum disability) indicating disability index.

Sex: All, ages: 20 Years to 60 Years

Inclusion Criteria:

* Male and Female patients
* Age 20-60
* Low back pain
* Functional disability

Exclusion Criteria:

* Pathological signs, Ankle injury, pregnant females, previous surgery
* History of any specific medication
* Regular high intensity exercise

• LAURIN, E., MINERBI, A., BESEMANN, L. M., COURCHESNE, C. I. & GUPTA, G. 2022. The McGill Approach to Core Stabilization in the Treatment of Chronic Low Back Pain: A Review. medRxiv, 2022.01. 21.22269311.
• NIROOMAND, T., RABIEI, M. & MOHAMMADI, B. 2023. Investigating the Effects Janda's and Sahrmann's Correcting Exercise Approaches on Trunk Muscles Function in Young Girls with Lower Crossed Syndrome. Journal of Advanced Sport Technology, 7, 48-58.