title: The clinical and biomechanical effects of fascial-muscular lengthening therapy on tight hip flexor patients with and without low back pain.
abstract: BACKGROUND
  Many patients have tight hip flexors with or without low back pain. Manual fascial-muscular lengthening therapy (FMLT) is one commonly used treatment for this population.
  
  
  OBJECTIVE
  Investigate the clinical and biomechanical effects of manual FMLT on tight hip flexor patients with and without low back pain.
  
  
  METHODS
  A nonrandomized trial, before-and-after experiment with multiple baselines conducted on two different patient populations: 1) Mechanical low back pain patients with tight hip flexors (n = 10) and 2) Asymptomatic group with tight hip flexors (n = 8). Four treatments of manual FMLT were performed on the hip flexor of the two groups of patients over a two-week period. Primary outcome measures over the two-week period were 1) Maximum voluntary trunk flexor and extensor moments, 2) Disability (Roland Morris Disability Questionnaire) and pain (10-cm Visual Analogue Scale), 3) Passive hip extension mobility.
  
  
  RESULTS
  Primary outcome analysis involved within-groups comparisons. Maximum voluntary trunk extension demonstrated increases for the low back pain patients. The low back pain patients demonstrated a small, but significant, reduction in disability and pain. Both groups demonstrated an increase in passive hip extension measurements.
  
  
  CONCLUSIONS
  This preliminary study demonstrated interesting results from manual FMLT on two tight hip flexor patient populations with and without low back pain. However, there were several significant limitations from this study, which restrict the ability to generalize the results.
authors.affiliation: Private Practice, Email: Dr.DanAvrahami@gmail.com.
authors.forename: Daniel
authors.initials: D
authors.lastname: Avrahami
authors.affiliation: Department of Kinesiology, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, phone (905) 525-9140 x23004 fax (905) 523-6011 potvinj@mcmaster.ca.
authors.forename: Jim R
authors.initials: JR
authors.lastname: Potvin
keywords: back pain; biomechanics; fascial-muscular; hip flexor; iliopsoas; myofascial; rehabilitation; stretching