COMPARATIVE EFFECT OF DRY NEEDLING ASSISTED GLUTEUS MAXIMUS ACTIVATION ON PAIN, DISABILITY AND MUSCLE STRENGTH IN LOW BACK PAIN DUE TO GLUTEAL AMNESIA: AN EXPERIMENTAL STUDY

Abstract

Background
Low back pain is commonly associated with altered lumbopelvic mechanics, poor hip control and
compensatory overactivity of lumbar extensor muscles. Gluteal amnesia, characterized by reduced or
delayed activation of the gluteus maximus, may increase lumbar loading during daily activities such as
standing, walking, bending, lifting and stair climbing. Dry needling may reduce myofascial irritability and
assist neuromuscular activation when combined with a structured gluteus maximus exercise protocol.
Objective
To compare the effect of a home exercise program with dry needling assisted gluteus maximus activation
combined with a specific exercise protocol on pain intensity, functional disability and gluteus maximus
strength in individuals with low back pain due to gluteal amnesia.
Methods
An experimental comparative study was conducted among 60 participants with low back pain associated
with gluteal amnesia. Participants were divided into two groups of 30 each. Group A received a structured
home exercise program, while Group B received dry needling activation of the gluteus maximus along with
a progressive specific exercise protocol. Outcome measures included Visual Analogue Scale (VAS),
Oswestry Disability Index (ODI) and gluteus maximus strength measured by manual muscle testing. Pre-
intervention and post-intervention scores were recorded and analyzed using paired t-test and independent t-
test with significance set at p < 0.05.
Results
Both groups showed statistically significant improvements after intervention. Group A showed reduction in
VAS from 7.04 +/- 1.06 to 4.93 +/- 1.20, while Group B improved from 6.72 +/- 1.02 to 3.02 +/- 1.17. ODI
reduced from 46.35 +/- 7.98% to 32.43 +/- 9.07% in Group A and from 46.94 +/- 6.87% to 22.68 +/-
9.31% in Group B. Gluteus maximus strength improved from 3.24 +/- 0.35 to 3.94 +/- 0.46 in Group A and
from 3.12 +/- 0.40 to 4.36 +/- 0.42 in Group B. Between-group comparison showed significantly greater
improvement in Group B for VAS, ODI and strength gain.
Conclusion
Dry needling assisted gluteus maximus activation combined with a specific progressive exercise protocol
produced greater improvement in pain, disability and gluteus maximus strength than the home exercise
program alone. The findings support the use of targeted gluteal activation strategies in selected patients
with low back pain due to gluteal amnesia.