Comparison Between Strain-counterstrain and Muscle Energy Technique in Sacroiliac Joint Dysfunction

NCT04717401 | Completed DMC

• 1 other identifier: sacroiliac dysfunction
• Study Type: interventional
• Target: 56
• Locations: 1 country
• Sites: 1

Brief Summary

Examine the effect of strain-counter strain (SCS) versus muscle energy technique (MET) on pain pressure threshold (PPT), functional disability, and the innominate angle tilt with SIJ dysfunction.

Conditions

Sacroiliac Joint Somatic Dysfunction

Keywords

Strain-counterstrain; Muscle energy technique

Outcome Measures

Primary Outcomes (2)

• Pain Pressure Threshold(PPT) via Digital Pressure Algometer (Wagner Model FDIX)

  The algometry (Wagner model FDIX) is an analogue mechanical pressure dynamometer with half circular compression rubber tip (1 cm²). The dial ranges from 2.0 to 20.0 kg (kilogram-force). The value of the kilogram-force is equal to a kilogram per square centimeter. PPT will be considered abnormal when it is equal to 3.0 kg or less Two measure points will be marked 2 cm cranially (first point) and 2 cm laterally (second point) from reference point located 1 cm medially and caudally from the posterior superior iliac spine (PSIS) which shows the most painful points in SIJ patients. Anatomically, the first point is related to the attachment of gluteus maximus to the iliac crest while the second point is related to the erector spinae muscle and posterior sacroiliac ligament.

  10 minutes

• Pelvic tilting via Palpation Meter (PALM)

  Palpation Meter (PALM) was developed to measure pelvic torsion, pelvic tilting and leg length discrepancy (LLD). The body of the PALM contains a bubble level in a semi-circular arc with one-degree gradations that range from zero degree to thirty degrees on either side of the midline. The caliper arms are placed in bony landmarks and the degree of deviation from horizontal is read from the inclinometer

  15 minutes

Secondary Outcomes (1)

• Functional disability via the Oswestry Disability Index ( ODI):

  15 minutes

Study Arms (2)

Strain-counterstrain Group A

EXPERIMENTAL

Strain Counterstrain (SCS) is a passive positional technique which aims to relieve musculoskeletal pain and dysfunction by indirect manipulation .

Procedure: Strain-Counterstrain

Muscle Energy Technique Group B

EXPERIMENTAL

MET is a gentle manual therapy for the restricted mobility of the spine and extremities and is an active procedure in which the corrective force is regulated by the patient, not the clinician. This technique requires the patient to perform voluntary muscle contractions of varying intensity, in a specific direction, while the clinician uses a counter-force that does not allow movement to occur The physiological mechanism underlying SCS is unknown though. It has hypothesized that muscle tone inhibition occurs by stimulation of the target muscle's Golgi tendon organ by physical approximation of muscle origin and insertion.

Procedure: Muscle Energy Technique

Interventions

Strain-Counterstrain PROCEDURE

Strain-counterstrain will be applied to four muscle which are . Tender point of each muscle will be identified then the muscle will be positioned passively in the most relaxed position which will be held for 90 sec. This procedure will repeated 3 times for each muscle

Also known as: Positional Release

Strain-counterstrain Group A

Muscle Energy Technique PROCEDURE

Muscle energy technique will be applied to four muscles which are quadratus Lumborum, iliacus, piriform and erector spinae. Each muscle will be positioned passively in stretched position the patient asked to push against the therapist isometrically while holding breath for 5-10sec. After exhalation, the muscle will be moved into a new barrier. This procedure will repeated 3 times for each muscle

Muscle Energy Technique Group B

Eligibility Criteria

• Age: 20 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Male and female patients aged from 20 years to 60 years.
• Positive Fortin's sign (pain around PSIS and sacral sulcus).
• Positive three posterior provocation tests of four including Thigh thrust test, Compression test, Distraction Test, and Patrick test.
• Pain in lower back below level L5 vertebra and buttocks.
• Self-reported disability due to SIJ pain on the Oswestry Disability Index (ODI) scores at least 30%.

You may not qualify if:

• Acute injury or fracture of the lower limb and spine.
• Systemic diseases such as Rheumatoid arthritis (R.A) or ankylosing spondylitis.
• Previous major lumbar or hip surgery.
• Pregnancy or delivery for less than 6 months ago.
• Lumbar stenosis or spondylolisthesis or disc disease.
• Congenital spinal deformity.

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Warraq Central hospital

Giza, Egypt

Location

Study Officials

• Bassem G El- Nahaas, Professor

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: The patients will be assigned randomly to the 2 groups by using opaque, sealed envelopes, containing the name of one of each groups (SCS or MET). A colleague who will be not participating in recruiting, treating or evaluating participants will select the envelopes. After the initial assessment but before the first therapy session, group allocation will be carried out.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer of Physical Therapy

Study Record Dates

• First Submitted: January 1, 2021
• First Posted: January 22, 2021
• Study Start: August 8, 2020
• Primary Completion: June 30, 2021
• Study Completion: September 30, 2021
• Last Updated: March 8, 2022

Record last verified: 2022-03

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)