Effects of Innominate Rotation Correction Compared With Sacral Torsion Correction in Patients With Sacroiliac Joint Dysfunction

NCT07176169 | Not Yet Recruiting

• 1 other identifier: FUI/CTR/2025/01
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to evaluate the comparative effects of Innominate Rotation Correction and Sacral Torsion Correction using Muscle Energy Techniques (METs) in patients with Sacroiliac Joint Dysfunction (SIJD). A total of 50 participants will be recruited, aged 18-50 yrs, with confirmed SIJD based on atleast 3 positive provocation tests. Participants will be randomized into two equal groups. Group A (Innominate Rotation Correction) and Group B (Sacral Torsion Correction). Both groups will receive Conventional Therapy (Thermotherapy, Electrotherapy and Core stabilization exercises). Study variables include:

• Independent Variable: Type of MET applied (Innominate vs Sacral Torsion)
• Dependent Variables: Pain (measured by Visual Analog Scale), Functional Disability (assessed via Denver SIJ Disability Questionnaire)
• Control Variables: Age, Gender, BMI, Baseline Pain/ Disability Scores The intervention will last 4 weeks with 8 sessions (2 sessions per week). Assessments will be conducted at baseline (Week 1, Pre-treatment) and Post every second session. Data will be analyzed to compare immediate and short-term effects of the two interventions. This study aims to provide evidence for targeted manual therapy approaches in SIJD, potentially guiding clinicians toward the most effective technique for pain reduction and functional improvement.

Conditions

Sacroiliac Joint Dysfunction

Outcome Measures

Primary Outcomes (2)

• JOINT DISABILITY

  The Denver Sacroiliac Joint Disability Questionnaire (DSIJQ) comprises 10 items that assess various aspects of SIJ-related disability, including pain intensity, mobility, self-care, and social participation. Each item is scored on a 6-point Likert scale ranging from 0 to 5. (0 - No Disability; 5 - Unable to perform activity). To calculate the total percentage, the obtained score is divided by 50 and multiplied by 100 to calculate total percentage. Then it is compared with an Ordinal Scale grading, shown as follows: * 0-20% = Minimal Disability * 21-40% = Moderate Disability * 41-60% = Severe Disability * 61-80% = Crippled * 81-100% = Bed-bound or Exaggerating symptoms

  Before and After 4 weeks.

• JOINT PAIN

  The Visual Analog Scale (VAS) is a simple patient-reported measure of current Pain Intensity. Scoring - Patients mark their pain on a 10-cm horizontal line, anchored by "No Pain" (0-cm) and "Worst Possible Pain" (10-cm), and the distance between 0-cm to the Point of Pain perception is marked as the recorded score (in millimeters or centimeters). High Value means Severe Pain and vice versa.

  Before Treatment and After 4 weeks

Study Arms (2)

Group A: Sacral Torsion Correction

ACTIVE COMPARATOR

Participants allocated to this arm will receive Muscle Energy Techniques (METs) for Sacral Torsion Correction. Covering Patterns: * Left-on-Left Torsion * Right-on-Right Torsion * Left-on-Right Torsion * Right-on-Left Torsion * Bilateral Nutation * Bilateral Counternutation Each participant will undergo 8 sessions over 4 weeks (2 Sessions/week), and receive Conventional Physiotherapy

Procedure: Muscle Energy Technique for Sacral torsion

Group B: Innominate Rotation Correction

EXPERIMENTAL

Participants allocated to this arm will receive Muscle Energy Techniques (METs) for Innominate Rotation Correction along with Conventional Treatment. * Anterior Rotation * Posterior Rotation Each participant will undergo 8 Sessions over a period of 4 weeks (2 Sessions/week).

Procedure: Muscle Energy Technique for Innominate rotation

Interventions

Muscle Energy Technique for Sacral torsion PROCEDURE

Conventional management including Electrotherapy by application of Thermotherapy or Cryotherapy, Transcutaneous Electrical Nerve Stimulation (TENS) for 20 minutes, Core-stabilization Exercises, * Clamshells * Four Point Kneeling * Bridging/Side Bridges * Bird-Dog Pose * Dead Bugs * Dynamic Core Stability (Unstable Surfaces) For Sacral Torsions, Six MET protocols address Forward and Backward torsions on Left and Right Oblique axis using patient generated force in Prone or Side-lying positions. Left-on-Left (LOL) Forward Torsion, Right -on-Right (ROR) Forward Torsion, Right-On-Left (ROL) Backward Torsion, Left-on-Right (LOR) Backward Torsion, Bilateral Sacral Nutation, Bilateral Sacral Counternutation

Group A: Sacral Torsion Correction

Muscle Energy Technique for Innominate rotation PROCEDURE

Conventional management including Electrotherapy by application of Thermotherapy or Cryotherapy, Transcutaneous Electrical Nerve Stimulation (TENS) for 20 minutes, Core-stabilization Exercises, • Clamshells • Four Point Kneeling • Bridging/Side Bridges • Bird-Dog Pose • Dead Bugs • Dynamic Core Stability (Unstable Surfaces). Anterior Innominate Rotation and Posterior Innominate Rotation.

Group B: Innominate Rotation Correction

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Dysfunction based on at least 3 of the following tests
• Distraction Test
• Compression Test
• Gaenslen's Test
• Thigh Thrust Test
• Sacral Thrust Test
• Presence of Pain in Buttock, Posterior Pelvis, or Lower Lumbar Region for more than 2 weeks
• Confirmed Pelvic Asymmetry through Palpation (i.e., ASIS/PSIS Landmarks, Gillet's Test)

You may not qualify if:

• History of Lumbar or Pelvic Fracture, Recent Surgery, or Hip/Knee Pathology affecting Gait/Posture.
• Pregnancy or Post-partum less than 6 months - due to Hormonal Laxity \& Altered Biomechanics
• Systemic Inflammatory conditions - Rheumatoid Arthritis, Ankylosing Spondylitis
• Neurological Deficits - Cauda Equina Syndrome, Radiculopathy with Motor Loss
• Ongoing Physiotherapy treatment for Low Back Pain in past 4 weeks
• Inability/Contraindications to tolerate Manual Therapy - Osteoporosis
• Leg Length Discrepancy - \>1.5 cm or Structural Scoliosis
• BMI \> 35 (ASIA) - it may affect assessment validity due to obesity

Sponsors & Collaborators

• Foundation University Islamabad: lead

Study Sites (1)

Foundation University College of Physical Therapy

Islamabad, Punjab Province, 46000, Pakistan

Location

Study Officials

• Muhammad Shafay Ali, DPT

  Foundation University Islamabad

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Muhammad Shafay Ali, DPT

CONTACT

+923064259537; muhammadshafayaliii@gmail.com

Muhammad Furqan Yaqoob, MS MSK-PT

CONTACT

+923465333101; furqan.yaqoob@fui.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Participants will be randomly assigned into two parallel groups: * Group A will receive Sacral Torsion Correction (via METs + Conventional Therapy) * Group B will receive Innominate Rotation Correction (via METs + Conventional Therapy) Both groups will undergo interventions simultaneously over a 4-week period (8 sessions total, 2 sessions/week). Outcomes will be assessed at baseline, after every second session and post-intervention, with results compared between the two groups.

Study Record Dates

• First Submitted: September 9, 2025
• First Posted: September 16, 2025
• Study Start: December 30, 2025
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): June 1, 2026
• Last Updated: January 2, 2026

Record last verified: 2025-09

Locations

PA (1)