Sacroiliac Joint Dysfunction, Muscle Energy Techniques
Conditions
Brief summary
Sacro-iliac joint act as the shock absorber of the body. It is responsible for transferring vertical load of the whole body to lower limb hence contributing to stability of pelvic girdle. However, SI joint dysfunction is one of the most common causes of low back pain among the patients suffering from non-radicular low back pain. There can be a mechanical source which is due to muscle insufficiency or instability or a non-mechanical source which is osteoarthritis, infection or any trauma. It is thought to affect females more commonly with prevalence of about 46.71% in females and with the prevalence of about 15 to 30% in general. This poses great threat to bio mechanics of the body which can significantly lead to disability that can affect mobility, daily activities and quality of life of the individual. According to a study the pain caused by SIJD caused activity limitation and participation restriction of about 25% of the individuals. Hence making it difficult for them to continue their jobs. increased pain leads to worsening of the ability to perform ADLs which ultimately effects the quality of life. Altered biomechanics also leads to alteration in spatio temporal gait parameters.This study aims to compare the effects of autogenic inhibition technique and reciprocal inhibition technique in addition with conventional therapy in reliving low back pain, improving functional disability and alteration in spatio-temporal gait parameters in patients with sacroiliac joint dysfunction. Patients with SIJD will be recruited and will be randomly divided into two groups 20 in each group. Group 1 will receive autogenic inhibition technique of iliopsas, hamstrings, erector spinae and piriformis muscles along with standard core stabilization exercises and group 2 will receive reciprocal inhibition technique on iliopsas, hamstrings, erector spinae and piriformis muscles along with standard core stabilization exercises. The treatment will be continued for 3 weeks with 4 sessions of 25 minutes per week.
Detailed description
Participants will be divided into two groups and a total of 12 sessions will be given for 3 weeks with a frequency of 4 sessions per week and a duration of 25 minutes. Group 1 will be given autogenic inhibition technique of iliopsoas, Piriformis, hamstrings and erector spinae along with core stability exercises and conentional therapy. Group 2 will be given reciprocal inhibition techniques of iliopsoas, Piriformis, hamstrings and erector spinae along with conventional treatment and core stability exercises. Group 1 Group 2 WEEK 1 4 SESSEIONS/ WEEK * TENS + hot pack ⇢10 mins * drawing in maneuver in quadruped position ⇢7 reps ⇢3 sec hold * Bridiging ⇢5 reps ⇢no hold * PIR of illiopsoas ⇢5 reps ⇢10 sec hold * PIR of PIRiformis ⇢5 reps ⇢10 sec hold * PIR of hamstrings ⇢5 reps ⇢10 sec hold * PIR of erector spinae ⇢5 reps ⇢10 sec hold • TENS + hot pack ⇢10 mins * drawing in maneuver in quadruped position ⇢7 reps ⇢3 sec hold * Bridiging ⇢5 reps ⇢no hold * RI-MET of illiopsoas ⇢5 reps ⇢10 sec hold * RI-MET of PIRiformis ⇢5 reps ⇢10 sec hold * RI-MET of hamstrings ⇢5 reps ⇢10 sec hold * RI-MET of erector spinae ⇢5 reps ⇢10 sec hold Group 1 Group 2 WEEK 2 4 SESSEIONS/ WEEK * TENS + hot pack ⇢10 mins * drawing in manuver in quadruped position ⇢7 reps ⇢6 sec hold * Bridiging ⇢5reps ⇢3 sec hold * Clam shell exercises ⇢6 reps * PIR of illiopsoas ⇢7 reps ⇢10 sec hold * PIR of PIRiformis ⇢7 reps ⇢10 sec hold * PIR of hamstrings ⇢ 7 reps ⇢10 sec hold * PIR of erector spinae ⇢7 reps ⇢10 sec hold • TENS + hot pack ⇢10 mins * drawing in manuver in quadruped position ⇢7 reps ⇢6 sec hold * Bridiging ⇢5reps ⇢3 sec hold * Clam shell exercises ⇢6 reps * RI-MET of illiopsoas ⇢7 reps ⇢10 sec hold * RI-MET of PIRiformis ⇢7 reps ⇢10 sec hold * RI-MET of hamstrings ⇢ 7 reps ⇢10 sec hold * RI-MET of erector spinae ⇢7 reps ⇢10 sec hold Group 1 Group 2 WEEK 3 4 SESSEIONS/ WEEK * TENS + hot pack ⇢10 mins * drawing in manuver in quadruped position ⇢8 reps ⇢8 sec hold * Supine Bridiging ⇢10 reps ⇢ 6 sec hold * Clam shell exercises ⇢10 reps ⇢6 sec hold * PIR of illiopsoas ⇢10 reps ⇢10 sec hold * PIR of PIRiformis ⇢10 reps ⇢10 sec hold * PIR of hamstrings ⇢10 reps ⇢ 10 sec hold * PIR of erector spinae ⇢ 10 reps ⇢10 sec hold * TENS + hot pack ⇢10 mins * drawing in manuver in quadruped position ⇢8 reps ⇢8 sec hold * Supine Bridiging ⇢10 reps ⇢ 6 sec hold * Clam shell exercises ⇢10 reps ⇢6 sec hold * RI-MET of illiopsoas ⇢10 reps ⇢10 sec hold * RI-MET of PIRiformis ⇢10 reps ⇢10 sec hold * RI-MET of hamstrings ⇢10 reps ⇢ 10 sec hold * RI-MET of erector spinae ⇢ 10 reps ⇢10 sec hold
Interventions
PROCEDUREAutogenic Inhibition
During week 1, group 1 will receive TENS + hot pack ⇢10 mins Drawing in maneuver in quadruped position Bridiging PIR of illiopsoas,Piriformis, hamstrings,erector spinae During week 2, group 1 will receive TENS + hot pack ⇢10 mins Drawing in manuver in quadruped position Bridiging Clam shell exercises PIR of illiopsoas, PIRiformis, hamstrings, erector spinae During week 3, group 1 will receive TENS + hot pack ⇢10 mins Drawing in manuver in quadruped position Supine Bridiging, Clam shell exercises, PIR of illiopsoas PIR of Piriformis, hamstrings and erector spinae
PROCEDUREReciprocal Inhibition
During week 1, group 2 will receive TENS + hot pack ⇢10 mins Drawing in maneuver in quadruped position ⇢7 reps ⇢3 sec hold Bridiging ⇢5 reps ⇢no hold RI-MET of illiopsoas, PIRiformis, hamstrings, erector spinae ⇢5 reps ⇢10 sec hold During week 2, group 2 will receive TENS + hot pack ⇢10 mins Drawing in manuver in quadruped position ⇢7 reps ⇢6 sec hold Bridiging ⇢5reps ⇢3 sec hold Clam shell exercises ⇢6 reps RI-MET of illiopsoas, PIRiformis, hamstrings, erector spinae ⇢7 reps ⇢10 sec hold During week 3, group 2 will receive TENS + hot pack ⇢10 mins drawing in manuver in quadruped position ⇢8 reps ⇢8 sec hold Supine Bridiging, Clam shell exercises ⇢10 reps ⇢6 sec hold RI-MET of illiopsoas, Piriformis, erector spinae ⇢10 reps ⇢10 sec hold
Sponsors
Foundation University Islamabad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Randomized Control trial
Eligibility
Sex/Gender
ALL
Age
25 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Patients having low back pain greater than 4 weeks * Patients with positive gaenslen's test, thigh thurst test, standing flexion test, sacral compression and distraction test. * Patients not having any other condition that can affect gait * 25-45 years * Both males and females
Exclusion criteria
* Patients having nonspecific low back * Patients with lumbosacral fusion * Patients with any neurological condition * Patients with history of trauma of spine * Patients with any other lumbar spine condition (lumbar radiculopathy, spinal stenosis, spondylolisthesis, inflammatory arthritis) * Patients with any hip joint pathology * Patients using any assistive device
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Functional disability | before treatment after after 3 weeks | It will be measured by using Denver SI joint disability questionnaire which 10 questions questionnaire consisting of scoring range from 0-5 in each item answered. 0 means no disability and 5 means maximum disability. And total score is calculated in the form of percentage. Higher the percentage greater is the disability. |
| Pain intensity | before treatment and after 3 weeks | Pain will be measured by NPRS. A line of 10 centimeters containing numbers from 0 to 10 marked. The starting point of the scale indicates 0 or no pain whereas the ending point marks the pain as 10 which means the pain is as worse as it could be. |
| Gait Speed | Assessed at baseline (before intervention) and after 3 weeks of intervention. | Gait speed will be measured by calculating the distance covered in meters divided by the time taken in seconds during walking assessment. Formula: Gait Speed (m/s) = Distance (m) × Time (s) |
| Cadance | Assessed at baseline (before intervention) and after 3 weeks of intervention. | Cadence will be measured as the number of steps taken per minute during walking assessment. Formula: Cadence (steps/min) = Steps Counted × 60 / Time (s) |
| Cycle time | Assessed at baseline (before intervention) and after 3 weeks of intervention. | Cycle time will be calculated as the time required to complete one gait cycle during walking assessment. Formula: Cycle Time (s) = Time (s) × 2 / Steps Counted |
| Stride Length | Assessed at baseline (before intervention) and after 3 weeks of intervention. | Stride length will be determined by multiplying gait speed with cycle time during walking assessment. Formula: Stride Length (m) = Speed (m/s) × Cycle Time (s) |
| Step Length | Assessed at baseline (before intervention) and after 3 weeks of intervention. | Step length will be calculated as half of the stride length obtained during gait assessment. Formula: Step Length (m) = Stride Length / 2 |
Countries
Pakistan
Contacts
CONTACTFajar Sajjad, DPT
CONTACTMarwa Asim, MS-OMPT
PRINCIPAL_INVESTIGATORFajar Sajjad, DPT
Foundation University Islamabad
Outcome results
None listed