Passive versus passive-plus-active hamstring stretching for flexibility in chronic low back pain

Comparison of the Immediate Effect of Passive vs. Passive-Active Hamstring Stretching on Flexibility in Patients With Chronic Low Back Pain: Protocol for a Randomized Controlled Trial: EFIM2

Not applicable Interventional University Hospital, Clermont-Ferrand · NCT06888895

This study will see if adding active hamstring stretches to passive stretches improves flexibility for adults with chronic low back pain.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment90 (estimated)
Ages18 Years to 65 Years
SexAll
SponsorUniversity Hospital, Clermont-Ferrand Academic / other
Locations2 sites (Cébazat, France and 1 other locations)
Trial IDNCT06888895 on ClinicalTrials.gov

What this trial studies

In a randomized controlled design, 90 adults with chronic low back pain and hamstring extensibility deficits will be assigned to either combined passive-active stretching (PAS) or passive stretching (PS) alone. Measures of active knee extension (primary outcome) and secondary outcomes including fingertip-to-floor distance, straight leg raise, hamstring stiffness, and pelvic tilt will be recorded before and immediately after the single intervention. An anchor question about participants' perceived change in flexibility will be used to estimate the minimal clinically important difference (MCID). Group-by-time comparisons will determine whether PAS produces greater immediate changes than PS.

Who should consider this trial

Good fit: Adults aged 18–65 with low back pain lasting at least 3 months who have a hamstring flexibility deficit (straight leg raise <85° or fingertip-to-floor distance >5 cm) and no excluded comorbidities are ideal candidates.

Not a fit: People with radicular pain, disc inflammation (MODIC Type 1), significant neurological/cardiovascular/respiratory/oncological disease, recent major lower‑limb or lumbar surgery, or who are pregnant/breastfeeding are unlikely to be eligible or to benefit from this protocol.

Why it matters

Potential benefit: If successful, combining passive and active hamstring stretches could produce larger immediate gains in active flexibility and help refine rehabilitation techniques for people with chronic low back pain.

How similar studies have performed: Passive stretching is known to improve passive hamstring range but prior work has not shown meaningful improvements in active range of motion, and combining passive plus active stretching is a relatively novel approach with limited prior evidence.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Male or female patients aged between 18 and 65 years
* Suffering from low-back pain for at least 3 months
* Presenting with hamstring flexibility deficit (Straight Leg Raise \<85°, Fingertip-to-Floor distance \>5 cm)

Exclusion Criteria:

* Patients with radicular pain
* Disc inflammation (MODIC Type 1)
* Other relevant pathologies (neurological, cardiovascular, respiratory, or oncological diseases)
* Significant surgical history (e.g., lumbar arthrodesis, knee or hip arthroplasty)
* Pregnancy or breastfeeding
* Patients under protective legal measures

Where this trial is running

Cébazat, France and 1 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Chronic Low Back Painhamstringchronic low back painextensibility deficitpassive stretching
Last reviewed 2026-06-15 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.