Comparison of the Effectiveness of Mobilization and Myofascial Release Techniques in Patients With Sacroiliac Joint Dysfunction

NCT07310368 | Recruiting

• 1 other identifier: 52066301980*
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

Sacroiliac joint dysfunction (SIED) is one of the major causes of chronic mechanical low back pain and is associated with pain, postural control impairment, and functional limitations. While manual therapy approaches are commonly used in the treatment of sacroiliac joint pain, evidence regarding the clinical superiority of different manual techniques is limited. This study was designed as a prospective, randomized controlled trial to compare the effects of myofascial release techniques and sacroiliac joint mobilizations, applied in addition to a traditional physical therapy program, on pain intensity, spinal mobility, postural control, and functional status in women diagnosed with sacroiliac joint dysfunction. The study plans to include female individuals aged 18-65 years with a Visual Analog Scale (VAS) score ≥3 who have been diagnosed with sacroiliac joint dysfunction according to international diagnostic criteria. Participants will be randomly assigned to two groups: one group will receive traditional treatment combined with myofascial release techniques, while the other group will receive traditional treatment combined with sacroiliac joint mobilizations. Interventions will be performed three days per week for six weeks. Primary and secondary outcome measures will include pain intensity (VAS), postural control (Biodex Balance System), spinal mobility, and postural endurance (Spinal Mouse) assessments. Participants will be randomly assigned to two groups: one group will receive traditional treatment combined with myofascial release techniques, while the other group will receive traditional treatment combined with sacroiliac joint mobilizations. Interventions will be performed three days a week for six weeks. Primary and secondary outcome measures will include pain intensity (VAS), postural control (Biodex Balance System), spinal mobility, and postural endurance (Spinal Mouse) assessments. All assessments will be conducted before treatment and at the end of the six-week intervention period. This study aims to provide clinical evidence regarding the comparative effectiveness of manual therapy approaches in the conservative treatment of sacroiliac joint dysfunction and to contribute to clinical decision-making processes.

Conditions

Sacroiliac Joint Dysfunction

Keywords

Sacroiliac Joint Dysfunction; Mobilization; myofascial release

Outcome Measures

Primary Outcomes (2)

• Postural control assessment

  Postural control will be assessed statically and dynamically. The Biodex balance system (Biodex Medical System Inc., NY, USA, SW45 30D E6N Model, SD 950 304) will be used. This device creates stability indices by evaluating movements in the overall, anterior-posterior, and medial-lateral directions. For static balance assessment, the subject is asked to hold a small circle containing a black dot representing their center of gravity without moving it for 20 seconds, repeated 3 times. For dynamic assessment, the floor movement level is set to 12 at the start and gradually reduced to 9 throughout the test. At these levels, the subject attempts to keep their center of gravity balanced within the small circle. Total, anterior-posterior (A-P), and medial-lateral (M-L) values are recorded. Increased values indicate worsening balance activity

  6 week

• Posture and spinal mobility

  It was measured using the computer-assisted wireless Spinal Mouse device (the Spinal Mouse System, Idiag, Fehraltorf, Switzerland). The Spinal Mouse device is moved over the spine using its wheel, measuring the length of the spine, posture, and joint movements, and transferring this sequence to a computer environment. It is a reliable method that can noninvasively measure the physical characteristics and movement of the spine in a practical way. Measurements are taken from the spinous process of the seventh cervical vertebra to the third sacral vertebra. For spinal mobility, the trunk flexion posture is recorded. For postural competence values, an upright posture measurement is performed, and then a weight equal to 5% of the person's body weight is held parallel between the shoulders for 30 seconds. After the weight is still in the person's hands, the upright posture is measured again

  6 week

Secondary Outcomes (2)

• Pain level

  6 week

• Disability

  6 week

Study Arms (2)

Myofascial Release

EXPERIMENTAL

The myofascial release time for each muscle was 90 to 120 seconds, applied twice per session. 1. Myofascial release of the erector spinae muscles: the patient assumed a prone position; and the therapist stood at the patient's pelvis on the treatment side, applying the cross-hand technique. 2. Myofascial release of the quadratus lumborum muscle and thoracolumbar fascia: to increase the stretching force on the muscle, the patient lay on their side on the untreated side and placed a pillow under their lower back. The therapist stood behind the patient at the level of the patient's pelvis, applying the cross-hand technique. 3. Myofascial release of the piriformis muscle: The patient assumed a lateral recumbent position with the treated side on top. To increase muscle tension, the upper lower extremity was placed in hip flexion and adduction in front of the patient's lower extremity.

Other: Traditional treatment program; Other: myofascial relaxation

Mobilization

EXPERIMENTAL

Patients lay on their side with the sacroiliac joint restricted at the top, and sacroiliac manipulation was performed. Then, the physiotherapist flexed the lumbar spine by moving toward the upper part of the thigh, applying an impulse using the intermittent stretching technique in the direction of the major thoracanthus from the iliac crest. In the prone position, caudal traction, traction of the sacrum relative to the ilium, and traction stretches from the iliac crests will be applied.

Other: Traditional treatment program; Other: Mobilization

Interventions

myofascial relaxation OTHER

The myofascial release time for each muscle was 90 to 120 seconds, applied twice per session. 1. Myofascial release of the erector spinae muscles: the patient assumed a prone position; and the therapist stood at the patient's pelvis level on the treatment side, applying the cross-hand technique. 2. To increase muscle tension, the patient's lower extremity was placed in hip flexion and adduction at the highest point. The therapist stood behind the patient, at the level of the patient's pelvis, and applied the transverse tapping technique using the knuckles. 4. Myofascial release of the gluteus medius muscle: The patient assumed a lateral recumbent position on the untreated side. The therapist stood behind the patient, at the level of the patient's pelvis, and applied the vertical tapping technique using the knuckles.

Myofascial Release

Mobilization OTHER

Patients lay on their side with the sacroiliac joint restricted at the top, and sacroiliac manipulation was performed. Then, the physiotherapist flexed the lumbar spine by moving toward the upper part of the thigh, applying an impulse using the intermittent stretching technique in the direction of the major thoracanthus from the iliac crest. In the prone position, caudal traction, traction of the sacrum relative to the ilium, and traction stretches from the iliac crests will be applied.

Mobilization

Traditional treatment program OTHER

Bridge exercises, back extension exercises, and sit-up exercises as strengthening exercises. These exercises will be preferred to strengthen the abdominal and back muscles. Ultrasound will be applied to the sacroiliac region in the prone position. The practitioner will rotate the ultrasound head in a circular motion at a 90-degree angle to apply ultrasound to the right and left sacroiliac joints. A 4 cm wide probe will be used to apply continuous ultrasound at 1 MHz and 1.5 watts/cm2 for 8 minutes.

Mobilization; Myofascial Release

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Being a female individual between the ages of 18 and 65.
• Having been diagnosed with sacroiliac joint dysfunction (according to the International Association for the Study of Pain criteria).
• Having localized pain in the sacroiliac joint region and pain that may radiate to the hip, groin, or lower extremities.
• Positivity in at least 3 out of 5 sacroiliac joint-specific provocation tests (Vorlauf, Gillet, irritation point positivity, posterior shear test, compression test).
• Pain intensity of ≥3 as assessed by the Visual Analog Scale (VAS).
• Volunteering to participate in the study and providing written informed consent.

You may not qualify if:

• History of surgery involving the spine, pelvis, or lower extremities.
• Presence of lumbar disc herniation, spinal stenosis, or acute pathologies of the hip joint.
• Diagnosis of piriformis syndrome or low back/hip pain originating from sources other than the sacroiliac joint.
• Known central or peripheral nervous system disease or progressive neurological deficit.
• History of rheumatological disease (rheumatoid arthritis, ankylosing spondylitis, etc.).
• Pregnancy or the presence of a serious systemic disease that could prevent participation in the study.

Sponsors & Collaborators

• Kirsehir Ahi Evran Universitesi: lead

Study Sites (1)

Kirşehir Ahi Evran University

Center, Kirşehi̇r, Turkey (Türkiye)

RECRUITING

Study Officials

• Şafak KUZU

  Kirsehir Ahi Evran Universitesi

  STUDY DIRECTOR

Central Study Contacts

Şafak KUZU, PhD

CONTACT

+905068490542; safak.yumusak@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assist. Prof.

Model Details: Randomized controlled trials

Study Record Dates

• First Submitted: December 16, 2025
• First Posted: December 30, 2025
• Study Start: January 19, 2026
• Primary Completion: March 20, 2026
• Study Completion: April 20, 2026
• Last Updated: February 27, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)