Effect of Hip Extension Mobilization on Functional Disability in Patients With Spondylolisthesis

this study will be conducted to investigate the effect of hip extension mobilization on lumber disability, pain and flexion range of motion in patients with spondylolisthesis

Spondylolisthesis is a kind of low back pain (LBP) that involves displacement of one vertebral body relative to the vertebra below it. Spondylolisthesis is derived from the Greek words spondylosis, which means vertebra, and olisthisis, which means slippage. The displacement of the cranial vertebra can be anterior (also known as anterolisthesis), lateral, or posterior (retrolisthesis) to the more caudal vertebra., most commonly occurring as an anterior slippage at the lumbosacral junction(L5-S1). The condition can result from several etiologies including congenital, isthmic, degenerative, traumatic, or pathologic causes. The clinical presentation of spondylolisthesis encompasses a broad spectrum, ranging from asymptomatic cases to those involving debilitating pain, neural compromise, and functional limitations. Degenerative spondylolisthesis (DS) predominantly affects older adults, with a marked predilection for females. A cross-sectional epidemiological survey involving over 4,000 patients reported a prevalence of 2.7% in men and 8.4% in women, underscoring a significant sex disparity.The most common site for degenerative spondylolisthesis is the L5 to S1 level. Mobilization increases hip range of motion, decreases pain and improves hip function more than non-weight bearing exercises.

Inclusion Criteria: * Chronic female Patients diagnosed as grade 1 lumbar degenerative spondylolisthesis (anterolisthesis) referred from Orthopedists was confirmed by lumbosacral x-ray * Patients age ranged from 40 to 60 years. * BMI(25:35) * Ambulant patient with or without cane. * Cooperative patients with ability to understand instructions and follow simple verbal commands. Exclusion Criteria: * Osteoporosis. * Pregnancy. * Signs consistent with nerve root compression (reproduction of low-back or leg pain with a straight leg raise at less than 45°, muscle weakness involving a major muscle group of the lower extremity, diminished lower extremity muscle stretch reflex, or diminished or absent sensation to pinprick in any lower extremity dermatome). * General tumors, spinal tumor, fracture, cauda equina syndrome, and previous surgery. * Other causes of spondylolisthesis. * Patients with (BMI ≥ 35) * Severe or life-threatening psychiatric illness.