Pelvic Stabilization Exercises & (PNF) on Pain, Disability & Functional Leg Length

NCT06108960 | Unknown

• 1 other identifier: REC/RCR & AHS/23/0159
• Study Type: interventional
• Target: 26
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of the study is to compare the effects of pelvic stabilization exercises and proprioceptive neuromuscular facilitation on pain, disability and functional leg length in patients with anterior innominate iliosacral dysfunction.

Conditions

Anterior Innominate Iliosacral Dysfunction

Keywords

Anterior innominate Iliosacral Dysfunction; Functional leg length; Pelvic Stabilization Exercise; Proprioceptive Neuromuscular Facilitation; Disability

Outcome Measures

Primary Outcomes (3)

• Numeric Pain Rating Scale NPRS

  Change from baseline the NPRS is a self-reporting or clinician-administered measuring tool that has extreme values ranging from "no pain" to "severe pain", on either horizontal or vertical line of scale. Numeric Rating Scale (NRS-11), which is an eleven-point scale in which the end points are the extremes of no pain at all (score of 0) and the worst pain the patient has ever experienced (score of 10).

  8 week

• Modified Oswestry low back pain disability Questionnaire

  Change from baseline this questionnaire has been designed to give information as to how back pain has affected the ability to manage in everyday life. It consists of total of 10 questions which are scored as follow: This scale consists of 10 items in the form of activities of daily living with each item scoring from 0 to 5 where 0 is no difficulty in performing that activity and 5 inability to do that activity.

  8 week

• Measurement of Functional Leg length: (Tape Method):

  Change from baseline the true leg length measurement or spinomalleolar distance (acceptable validity and reliability \[intraclass correlation coefficient (ICC3,3) range 0.98 - 0.99\] in measuring LLD) was used to assess the leg length of the subjects. A measuring tape will then use to measure from the apex of anterior superior iliac spine (ASIS) to the distal end of the medial malleolus in each leg and recorded in millimeter (mm). The following is the classification of the level of LLD: mild (\< 30 mm), moderate (30 - 60 mm) and severe (\> 60 mm).

  8 week

Study Arms (2)

Proprioceptive neuromuscular facilitation

EXPERIMENTAL

The patients will be positioned in supine lying and then contract relax will be performed on affected side of pelvis first in D1 pattern (anterior elevation and posterior depression) 3 times with 10 sec contractions and 5 sec relaxations in 1 set. Then in D2 pattern (posterior elevation and anterior depression) 3 times with 10 sec contractions and 5 sec relaxations in 1 set. 3 set of each diagonal pattern to be performed in 1 treatment session alternatively. Treatment will be given for a period of 4 days a week for 8 weeks

Other: Proprioceptive neuromuscular facilitation

Pelvic stabilization exercises

EXPERIMENTAL

All participants will receive training programs for the eight levels of training from static to dynamic conditions. The practiced therapy method will first taught by a physical therapist with a verbal explanation and visual aids (such as photographs) in each group. The therapist will supervise all stages of the exercise therapy to ensure the patients correctly performed the exercises. The supervised exercise intervention will be conducted 3 days a week for 8 weeks.

Other: Pelvic stabilization exercises

Interventions

Proprioceptive neuromuscular facilitation OTHER

Group A (Proprioceptive neuromuscular facilitation.) will be treated with Proprioceptive neuromuscular facilitation, before applying exercise, Hot pack will be applied for 15 minutes. (8 weeks, 4 sessions per week) The patients will be positioned in supine lying and then contract relax will be performed on affected side of pelvis first in D1 pattern (anterior elevation and posterior depression) 3 times with 10 sec contractions and 5 sec relaxations in 1 set. Then in D2 pattern (posterior elevation and anterior depression) 3 times with 10 sec contractions and 5 sec relaxations in 1 set. 3 set of each diagonal pattern to be performed in 1 treatment session alternatively. Treatment will be given for a period of 4 days a week for 8 weeks

Proprioceptive neuromuscular facilitation

Pelvic stabilization exercises OTHER

Group B (Pelvic stabilization exercises) will be treated with Pelvic Stabilization Exercise, before applying exercise we will apply Hot pack for 15minutes (8 weeks, 3 sessions per week). All participants will receive training programs for the eight levels of training from static to dynamic conditions. The practiced therapy method will first be taught by a physical therapist with a verbal explanation and visual aids (such as photographs) in each group. The therapist will supervise all stages of the exercise therapy to ensure the patients correctly performed the exercises. The supervised exercise intervention will be conducted 3 days a week for 8 weeks.

Pelvic stabilization exercises

Eligibility Criteria

• Age: 25 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patient within ages of 25 and 45 years.
• Both male and female participants will be included.
• Episode of Lumbopelvic pain within the previous 6 weeks with pain radiating till the knee and associated groin pain.
• Pain and tenderness at SIJ
• The diagnostic criteria for SJD were five clinical tests Compression, Distraction, sacral thrust, thigh thrust and Gaenslen test (patient with a minimum of 3 positive results among the 5 provocation tests)
• Positive Special test for Anterior Innominate Dysfunction (Standing flexion test, Seated flexion test, Supine to sit test and Gillet test)
• NPRS = 3 to 6

You may not qualify if:

• Any other medical/systemic illness relevant to lower back and lower extremity
• Previous major surgery for lower back and lower extremity
• SLR Less than 45°
• Pain radiating past the knee
• Pregnant and lactating females
• Had been diagnosed by physician with a diagnosis other than SIJD
• Receiving manual therapy for the sacroiliac joint in the past 3 month

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Sehat Medical Complex

Lahore, Punjab Province, 55201, Pakistan

RECRUITING

Related Publications (22)

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  PMID: 12831676 BACKGROUND

• ASAD F, HAFEEZ S, SAEED S, RIAZ S, KHAN RR, AWAN AB. Comparison of Post Isometric Relaxation of Gluteus Maximus and Static Stretching of Hip Flexors on Pain and Functional Status in Patients with Anterior Innominate Dysfunction.

  BACKGROUND

• Timm KE. Sacroiliac joint dysfunction in elite rowers. J Orthop Sports Phys Ther. 1999 May;29(5):288-93. doi: 10.2519/jospt.1999.29.5.288.

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• Oldreive WLJJoM, Therapy M. A critical review of the literature on tests of the sacroiliac joint. 1995;3(4):157-61.

  BACKGROUND

• Vaidya A, Babu VS, Mungikar S, Dobhal SJIJHS. Comparison between muscle energy technique and Mulligan's mobilization with movement in patients with anterior innominate iliosacral dysfunction. 2019;1(9).

  BACKGROUND

• Shaw J, editor The role of the sacroiliac joint as a cause of low back pain and dysfunction. The First Interdisciplinary World Congress on Low Back Pain and its Relation to the Sacroiliac Joint, San Diego, CA; 1992.

  BACKGROUND

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  PMID: 4025678 BACKGROUND

• Ribeiro S, Heggannavar A, Metgud SJIJoPT, Research. Effect of mulligans mobilization versus manipulation, along with mulligans taping in anterior innominate dysfunction-A randomized clinical trial. 2019;1(1):17.

  BACKGROUND

• Akram H, Bashir MS, Zia A, Noor R, Shakeel A. Comparison of muscle energy technique and mobilization with movement to reduce pain and improve functional status in subjects with anterior innominate ilio-sacral dysfunction. J Bodyw Mov Ther. 2024 Oct;40:1336-1341. doi: 10.1016/j.jbmt.2022.11.003. Epub 2022 Dec 5.

  PMID: 39593454 BACKGROUND

• Kumar AJN. The Effectiveness of Gluteus Maximus Activation and Kinesio Taping along with Muscle Energy Technique on Pain, Alignment and Functional Activities in Subject with Anterior Innominate Rotation Dysfunction. 2022;20(12):3650-

  BACKGROUND

• Singh K, Arora L, Arora RJIJoP. Effect of proprioceptive neuromuscular facilitation (PNF) in improving sensorimotor function in patients with diabetic neuropathy affecting lower limbs. 2016:332-6.

  BACKGROUND

• Kamali F, Zamanlou M, Ghanbari A, Alipour A, Bervis S. Comparison of manipulation and stabilization exercises in patients with sacroiliac joint dysfunction patients: A randomized clinical trial. J Bodyw Mov Ther. 2019 Jan;23(1):177-182. doi: 10.1016/j.jbmt.2018.01.014. Epub 2018 Jan 31.

  PMID: 30691749 BACKGROUND

• Sharma P. Effect of Proprioceptive Neuromuscular Facilitation (PNF) in Improving Muscle Control in Patient with Sacroiliac Joint Dysfunction: A Case Report. International Journal of Recent Advances in Multidisciplinary Topics. 2021;2(3):1-4.

  BACKGROUND

• Altaim SASIT, Shafique SJJoIIMCQ. Maitland's Mobilization versus Mulligan's Mobilization Technique to Treat Anterior/Posterior Innominate Dysfunctions.81.

  BACKGROUND

• Kahl C, Cleland JAJPtr. Visual analogue scale, numeric pain rating scale and the McGill pain Questionnaire: an overview of psychometric properties. 2005;10(2):123-8.

  BACKGROUND

• Al-Hadidi F, Bsisu I, AlRyalat SA, Al-Zu'bi B, Bsisu R, Hamdan M, Kanaan T, Yasin M, Samarah O. Association between mobile phone use and neck pain in university students: A cross-sectional study using numeric rating scale for evaluation of neck pain. PLoS One. 2019 May 20;14(5):e0217231. doi: 10.1371/journal.pone.0217231. eCollection 2019.

  PMID: 31107910 BACKGROUND

• Bashir FJIMM. Diagnosis and manipulative therapy of sacroiliac joint disorder. 2011;33(3):115-9.

  BACKGROUND

• Fritz JM, Irrgang JJ. A comparison of a modified Oswestry Low Back Pain Disability Questionnaire and the Quebec Back Pain Disability Scale. Phys Ther. 2001 Feb;81(2):776-88. doi: 10.1093/ptj/81.2.776.

  PMID: 11175676 BACKGROUND

• Sakulsriprasert P, Vachalathiti R, Vongsirinavarat M, Kantasorn J. Cross-cultural adaptation of modified Oswestry Low Back Pain Disability Questionnaire to Thai and its reliability. J Med Assoc Thai. 2006 Oct;89(10):1694-701.

  PMID: 17128846 BACKGROUND

• Wiangkham T, Rinrit P, Choprateep M, Thamrongthanakul R, Chidnok WJCMJ. Correlation between leg length discrepancy and asymptomatic sacroiliac joint dysfunction in young males. 2022;66(1):15-21.

  BACKGROUND

• Farahmand B, Ebrahimi Takamjani E, Yazdi HR, Saeedi H, Kamali M, Bagherzadeh Cham M. A systematic review on the validity and reliability of tape measurement method in leg length discrepancy. Med J Islam Repub Iran. 2019 May 26;33:46. doi: 10.34171/mjiri.33.46. eCollection 2019.

  PMID: 31456970 BACKGROUND

• Ehsani F, Sahebi N, Shanbehzadeh S, Arab AM, ShahAli S. Stabilization exercise affects function of transverse abdominis and pelvic floor muscles in women with postpartum lumbo-pelvic pain: a double-blinded randomized clinical trial study. Int Urogynecol J. 2020 Jan;31(1):197-204. doi: 10.1007/s00192-019-03877-1. Epub 2019 Apr 23.

  PMID: 31016337 BACKGROUND

MeSH Terms

Interventions

Muscle Stretching Exercises

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Faiza Amjad, M.Phil

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Imran Amjad, PHD

CONTACT

03324390125; imran.amjad@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 25, 2023
• First Posted: October 31, 2023
• Study Start: May 8, 2023
• Primary Completion: December 1, 2023
• Study Completion: January 8, 2024
• Last Updated: October 31, 2023

Record last verified: 2023-10

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)