MAHTAB AHMED MUKHTAR PATAFI, SURIYAKALA PERUMAL CHANDRAN, MAZHAR ALI BHUTTO, NASIR MEHMOOD, MUHAMMAD SHAHZAIB ALAM, MUHAMMAD ASIF, SHAFIA ARSHAD, MUHAMMAD ATIF KHAN
DOI: https://doi.org/10.5281/zenodo.17710515Background: Non-specific low back pain (NSLBP) is a prevalent musculoskeletal disorder strongly associated with anterior pelvic tilt (APT) and impaired quality of life. Traditional unimodal physiotherapy approaches often yield limited benefits.
Objective: To evaluate the comparative effectiveness of a multimodal physiotherapy program, soft tissue mobilization (STM), manual therapy (MM), and stretching, versus conventional care in improving pain (NPRS), pelvic alignment (APT), and health-related quality of life (SF-36).
Methods: Fifty participants with NSLBP and confirmed APT were randomized into an intervention group (STM, MM & Stretching, n = 25) or control (Conventional Physiotherapy, n = 25). Interventions were delivered twice weekly for four weeks. Outcomes included NPRS, APT angle (digital photography), and SF-36, measured at pre, mid, and post-intervention.
Results: The intervention group showed significantly greater improvements in pain (NPRS: –4.68 points, p < 0.001), pelvic alignment (APT: –5.34°, p < 0.001), and multiple SF-36 domains, with large effect sizes in Physical role limitation (η² = 0.238), Social Functioning (η² = 0.219), Pain (η² = 0.202), and General Health (η² = 0.167). No significant baseline demographic differences were observed between groups.
Conclusion: A multimodal physiotherapy program combining soft tissue mobilization (STM), manual therapy, and stretching provides clinically significant benefits in pain, pelvic alignment, and quality of life among patients with NSLBP. This supports integrative rehabilitation strategies for biomechanical and psychosocial recovery.
Trial Registration: The study clinical trial has been registered at PRS clinical trial registry USA on 1st August 2025 (ID: NCT07098741).
