Comparative Effects of Plank Exercises and Muscle Energy Techniques in Patients with Lower Cross Syndrome

Abstract

Background: Lower Cross Syndrome (LCS), characterized by muscle imbalance involving tight hip flexors and lumbar extensors alongside weak abdominals and gluteal, contributes significantly to chronic nonspecific low back pain (LBP). Effective management of LCS requires targeted interventions that address these specific muscular dysfunctions; however, comparative evidence on the effectiveness of plank exercises versus muscle energy techniques (METs) remains limited. Objective: To compare the effects of plank exercises and METs on pain intensity and functional disability in patients with LCS. Methods: A randomized clinical trial was conducted with 54 participants aged 20–50 years diagnosed with LCS, allocated equally to a plank exercise group or a MET group. Interventions were delivered thrice weekly for six weeks. Pain and disability were assessed at baseline, week 4, and week 6 using the Numeric Pain Rating Scale (NPRS) and Modified Oswestry Disability Index (MODI). Nonparametric analyses evaluated within- and between-group differences, with p<0.05 considered statistically significant. Results: Both groups exhibited significant within-group improvements in NPRS and MODI scores over six weeks (p<0.001). Between-group comparisons revealed greater reductions in the MET group, with NPRS at week 6 significantly lower than the plank group (1.59±1.04 vs 6.70±1.69; p=0.001) and MODI also favoring MET (24.85±6.65 vs 29.07±5.71; p=0.041). Conclusion: METs resulted in significantly greater improvements in pain and functional disability compared to plank exercises among patients with LCS, supporting their clinical superiority as a first-line intervention for this condition.