Mahvish Rafiq
Nosheen Zehra
Assistant Professor
Department of Community Health Sciences, Ziauddin University
Email: nosheen_zehra130@hotmail.com
Contact #: 0300-2427127
Corresponding Author
Nosheen Zehra
Assistant Professor
Department of Community Health Sciences, Ziauddin University
Email: nosheen_zehra130@hotmail.com
Contact #: 0300-2427127
Pakistan Journal of Medicine and Dentistry 2013, Vol. 1 (01): 21-33
21
ABSTRACT
Background: Low back pain is a common musculoskeletal disorder affecting 84% people once in third life time. It
may be acute or chronic. Among various available options for management of low back pain, William's flexion
exercise is one of them. Williams flexion exercises the set of physical exercises use to enhance lumbar flexion to
avoid lumbar extension, and strengthen the abdominal and gluteus musculature to manage low back pain
Objective: To assess the effectiveness of William flexion exercise in management of patients with low back pain.
Methodology: A cross sectional study was conducted among 250 patients with low back pain from different hospitals
of Karachi. Sample was selected by convenience sampling technique and data was collected on structured
questionnaire. These patients were provided Williams Flexion Exercise and changes in pain and posture were
noticed before and after exercise. Data was analyzed by SPSS version 17and P value <0.05 was considered as
significant.
Result: Pain intensity was significantly (p value = 0.03) reduced in those who took more than 5 sessions of Williams
Flexion Exercise. Of total 96 (38.4%) patients with severe pain before exercise, no Pain was found in 20 (8%)
patients after exercise. From 107 (42.8%) and 47 (18.8%) patients with moderate and mild pain respectively, no pain
was found in 9 (3.6%) and 11 (4.4%) patients respectively. Spine flexion and extension was improved completely in
45 (18%) out of 132 (52.8%) patients with mild restrictions, in 24 (9.6%) out of 93 (37.2%) patients with moderate
restrictions and in 9 (3.6%) out of 25 (10%) patients with severe restrictions.
Conclusion: William flexion exercise provided benefits to most of the participants in the study, thus it may be an
effective technique to reduce the intensity of low back pain.
Key Words: Williams Flexion Exercise, Low Back Pain
INTRODUCTION
22
damage.
Adams
bed rest.9
beneficial
MA
in
for
the
his
study
recommended
management
pain10.
of
to
avoid
lumbar
extension,
and
the
abdominal
and
gluteus
12
13
14
23
15
This
study
will
help
in
identifying
the
METHODOLOGY
24
study.
version
considered as significant.
17
RESULTS
effectiveness of William's Flexion Exercises so
there were questions on before and after
government hospitals.
16
stabbing pain.
experienced.
25
223(89.2%),
hamstring
stretch
by
stretch
by
Frequency
(%)
(n= 250)
Partial sit up
12
30
Pelvic tilt
28
70
Knee to chest
89.2
223
61.2
153
47.2
118
Squat
6.8
17
26
moderate
2).
pain.
There
was
significant
Mild Pain
Moderate
Pain
Total
n (%)
n (%)
n (%)
n (%)
6 (2.4)
22 (8.8)
2 (0.8)
30 (12)
6 to 10
18 (7.2)
115 (46)
1 (0.4)
134(53.6)
More than 10
16 (6.4)
63 (25.2)
7 (2.8)
86 (34.4)
P- Value
0.037
Mild Pain
Moderate Pain
Sever Pain
No Pain
n (%)
11 (4.4)
9 (3.6)
20 (8)
Mild Pain
n (%)
34 (13.6)
94 (37.6)
72 (28.8)
Moderate Pain
n (%)
2 (0.8)
4 (1.6)
4 (1.6)
Total
n (%)
47 (18.8)
107(42.8)
96 (38.4)
Total
40 (16)
200 (80)
10 (4)
250 (100)
of
which
0.079
(52.8%)
patients
P- Value
was
improved
27
value=
0.360)
(Fig
2)
40
34.8
35
30
27.6
25
20
18
Completely Improved
15
Slightly Improved
9.6
10
6.4
3.6
5
0
Severe
Moderate
Mild
Spine Flexion and Extension Restriction
Patients
the
(48.4%)
complete
partial improvement.
were
also
replied
that
inquired
there
about
was
DISCUSSION
to low back pain.
19
reported in literature.
20,21
28
activity.
21
Results of
before and after the treatment. Pain intensity
moderate
long-term benefit.
and
mild
pain
also
showed
20, 21,24
20, 23
strengthen
the
back
and
abdominal
29
CONCLUSION
five
sessions
showed
significant
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31
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12
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32
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33