Effects of Latissimus Dorsi–Fascia Stretching, Lower Trapezius Strengthening, and Sham Control on Pain and Function in Thoracolumbar Dysfunction: A Randomized Clinical Trial

Muhammad Tahir Akram; Fatima Zehra; Sehrish Aslam; Mahrukh Siddiqui; Ashok kumar; Bharoz Shakeel; Umar Ali

doi:10.61919/pn36gj71

Authors

Muhammad Tahir Akram Public health specialist and physiotherapist, Jinnah post graduate medical centre, Karachi, Pakistan Author
Fatima Zehra Chairperson, Department of Physical Therapy, Jinnah University for Women, Karachi, Pakistan Author
Sehrish Aslam Lecturer, Jinnah University for Women, Karachi, Pakistan Author
Mahrukh Siddiqui Lecturer, Jinnah University for Women, Karachi, Pakistan Author
Ashok kumar Physiotherapist, Doctor Plaza, Karachi, Pakistan Author
Bharoz Shakeel Physiotherapy Student, Nazeer Hussain University, Karachi, Pakistan Author
Umar Ali Physiotherapist, Jinnah post graduate medical centre, Karachi, Pakistan Author

DOI:

https://doi.org/10.61919/pn36gj71

Keywords:

Chronic Mechanical Low Back Pain; Thoracolumbar Dysfunction; Latissimus Dorsi; Thoracolumbar Fascia; Lower Trapezius; Oswestry Disability Index; Randomized Clinical Trial.

Abstract

Background: Chronic mechanical low back pain is commonly associated with pain, disability, restricted lumbar mobility, and thoracolumbar dysfunction. Altered thoracolumbar fascia mobility, posterior-chain restriction, and impaired postural muscle control may contribute to persistent symptoms, supporting the need for targeted rehabilitation strategies. Objective: To compare the effects of latissimus dorsi–thoracolumbar fascia stretching, lower trapezius strengthening, and sham control on pain intensity, functional disability, and lumbar range of motion in adults with chronic mechanical low back pain associated with thoracolumbar dysfunction. Methods: This three-arm randomized clinical trial included 198 participants allocated equally into latissimus dorsi–thoracolumbar fascia stretching, lower trapezius strengthening, and sham control groups, with 66 participants in each group. Pain intensity, Oswestry Disability Index, and lumbar range of motion were assessed at baseline and after intervention. Between-group differences were analyzed using inferential statistics, with significance set at p < 0.05. Results: Pain decreased most in the latissimus dorsi–thoracolumbar fascia stretching group, from 7.42 ± 0.63 to 3.91 ± 0.84, compared with 7.43 ± 0.71 to 4.53 ± 0.91 in the lower trapezius strengthening group and 7.41 ± 0.64 to 6.43 ± 0.74 in the sham control group. Oswestry Disability Index improved from 53.66 ± 6.38 to 35.14 ± 7.12, 53.31 ± 6.61 to 39.23 ± 7.03, and 54.25 ± 6.22 to 48.59 ± 6.77, respectively. Lumbar range of motion increased from 41.22 ± 6.61 to 55.83 ± 7.39, 42.05 ± 6.04 to 53.94 ± 6.08, and 41.45 ± 5.69 to 45.73 ± 5.91, respectively. Between-group differences were significant for all outcomes (p < 0.001). Conclusion: Latissimus dorsi–thoracolumbar fascia stretching produced the greatest improvement in pain, disability, and lumbar mobility, followed by lower trapezius strengthening, while sham control showed limited benefit. Targeted thoracolumbar rehabilitation may be clinically useful for chronic mechanical low back pain associated with thoracolumbar dysfunction

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