Efficacy of Pelvic Repositioning Exercises on Pain, Hip and Shoulder Range of Motion and Disability of the Patients with Chronic Nonspecific Low Back Pain: A Single Blinded Randomized Controlled Trial

Background: Chronic non-specific low back pain (LBP) is one of the most controversial issues of experts. Positive Ober`s test was considered a contributing factor to LBP. Common intervention to address such problems was surgery or iliotibial band stretching. Recently, it was suggested that pelvic malalignment is the contributing factor to Positive Ober`s test. Pelvic repositioning exercises was argued as a solution for the treatment of chronic LBP followed by pelvic malalignment. Methods: In this single-blinded randomized controlled trial, 18 patients participated and were assigned into the control and treatment groups using the block randomization method. One side Positive Ober`s test as an indicator of pelvic malalignment was used as an inclusion criterion to employ the patients who have pelvic malalignment and asymmetry. Patients were asked to complete the Oswestry disability questionnaire to assess their disability. Hip internal and external rotation and shoulder internal and external rotation ROM measured by a standard goniometer. An inclinometer measures hip adduction and abduction ROM. Outcome measures were reassessed after 12 days. Data were analyzed using the ANCOVA test to compare among groups. Results: Patients in treatment group showed significant improvement of pain (P=0.01), ipsilateral hip adduction (P=0.00) and internal rotation (P=0.02) ROM and contralateral hip abduction (P=0.00) and shoulder internal rotation (P=0.00) ROM and Glenohumeral internal rotation deficit (GIRD) (P=0.001) compared with control group. There was no difference among groups for disability (P=0.34) and contralateral hip external rotation (P=0.06) and also there was no difference for contralateral shoulder external rotation (P=0.85) and ipsilateral shoulder internal (P=0.13) and external rotation (P=0.58). Conclusion: Pelvic repositioning exercises are an effective treatment to reduce chronic LBP via improving pelvic alignment. These exercises improve GIRD and increase shoulder internal rotation ROM, contralateral to positive Ober`s test.