Exploring The Effectiveness Of Janda’s Approach And Global Postural Re-Education In Managing Lower Cross Syndrome With Non-Specific Low Back Pain: A Narrative Review

Abstract

Background: Lower cross syndrome (LCS) is defined by weakness in the abdominals and gluteal maximus along with tightness in the lumbar extensors and hip flexors resulting in biomechanical imbalances with mechanical stress on joints contributing to non-specific low back pain (NSLBP). Various interventions like sciatic nerve neurodynamics sustained natural apophyseal glides (SNAGs), Brugger’s Exercise, Janda’s approach and global postural re-education (GPR) are mentioned in literature for LCS with or without NSLBP.

Aim: To compare the effectiveness of various interventions, explore gaps and identify most effective available management of LCS in NSLBP patients.

Methods: A search was conducted on several databases including PubMed, Scopus, CINAHL, and Google Scholar by using MeSH terms and Boolean operators: “lower cross syndrome,” “Non-Specific Low Back Pain,” “Janda’s Approach,” and “Global Postural Re-education” identified 657 articles. Using Population, Intervention, Comparison, and Outcome (PICO) eligibility criteria 12 studies published in English between 2014 to 2024 focussing on LCS management were included and narratively analysed for key findings, gaps and outcomes like pain relief, postural correction, functional disability and quality of life. Current narrative review focuses on a broad overview of existing literature without a formal quality assessment.

Results: Among all interventions, Janda’s Approach and GPR gave more promising results when LCS was paired with NSLBP. Janda’s Approach is based on correcting dysfunctional movement patterns, while GPR focuses on restoring postural alignment.

Conclusion: Both, Janda’s Approach and GPR are effective strategies for LCS. However, direct comparison is limited. Further comparative research is required to establish most effective management available for guiding clinical decision making.

Implications: Janda’s Approach and GPR corrects muscular imbalances, improving outcomes in postural dysfunctions and offering comprehensive management for NSLBP.