Mulligan Mobilization With Movement in Patients With Unilateral Anterior Sacral Nutation.

NCT07441018 | Completed

• 1 other identifier: S24C14G30003
• Study Type: interventional
• Target: 41
• Locations: 1 country
• Sites: 1

Brief Summary

Somatic Dysfunction of the SIJ is defined as hypo or hyper-mobility of the joint in addition to a malalignment or change of positioning of the sacrum and ilium bones (e.g. Forward sacral torsion, backward sacral torsion, bilateral anterior or posterior sacral nutation, Unilateral anterior and posterior sacral nutation). The classic physical signs for a dysfunction of the sacroiliac joint in which a unilateral anterior nutation of the sacrum or ilium has occurred in the sagittal plane about a transverse axis are: Sacral sulcus seen deeper, PSIS seen Caudad, Inferior lateral angle (ILA) seen Posterior, Pubic tubercle seen as Cephalad, ASIS as Cephalad, Sacroiliac joint seen upper pole and tender, Sacrospinous and Sacrotuberous ligament are under tension and gait abnormality seen due to leg length discrepancy.

Conditions

Core Stability; Exercise Therapy; Low Back Pain; Mulligan Mobilization; Sacroiliac Joint

Keywords

Core Stability; Exercise Therapy; Low back pain; Mulligan mobilization; Sacroiliac joint

Outcome Measures

Primary Outcomes (3)

• Mitchell Model for Unilateral Anterior Sacral Nutation

  Osteopathic authors have adopted several models to assess and diagnose the presence of sacroiliac dysfunction. The Mitchell model recommends static bony palpatory findings combined with motion tests as a basis for determining the presence and nature of SIJD (25). Physiotherapists employed diagnostic techniques congruent with Mitchell's model, but they also frequently added additional motion tests, measured tenderness, and used pain provocation techniques

  8 weeks

• Numerical Pain Rating Scale (NPRS)

  Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates "no pain" and 10 indicates "worst pain". Clinicians can be confident that a 2point change on the NPRS represents clinically meaningful change that exceeds the bounds of measurement error. NPRS shave shown high test-retest reliability(r=0.96)

  8 weeks

• Modified Oswestry Disability Index (MODI)

  MODQ is a valid and reliable tool for the assessment of the disability following low back pain. The thorough questionnaire demonstrated good reliability, good internal consistency, and confirmed convergent validity. The physical component domain of the SF-36 (r=-0.55, p\<0.001) showing that MODI is measuring what it is supposed to measure in terms of disability and physical function.

  8 weeks

Secondary Outcomes (1)

• Goniometer

  8 weeks

Study Arms (2)

Mulligan Mobilization with conservative treatment.

EXPERIMENTAL

Participants receive Mulligan mobilization and baseline physical therapy.

Other: Mulligan mobilization with movement.

Only conservative treatment.

ACTIVE COMPARATOR

Participants receive baseline physical therapy intervention.

Other: Conservative Physical Therapy.

Interventions

Mulligan mobilization with movement. OTHER

Participants receive Mulligan mobilization (10 Repetitions of 3 sets with 5 minutes rest period between each set) and baseline physical therapy intervention.Joint mobilization will be accomplished by using the posterior innominate (on affected side) and anterior innominate (on unaffected side) techniques (Mobilization with Movement).

Mulligan Mobilization with conservative treatment.

Conservative Physical Therapy. OTHER

* Hot pack for 10 minutes (32). (Electric Medicare Heating pad) * TENS with frequency of 120Hz at low intensity below the local painful sensory threshold with pulse of width 50-200 μs for 10 minutes (33). * SIJ Stretching Exercises (hamstring stretches, hip adductor stretch, piriformis stretch, quadriceps stretch, one knee to chest stretch, both knees to chest stretch, lower trunk rotation, and pelvic rotation stretch) (1). * Core Strengthening Exercises (Isometric hip abduction/adduction strengthening)

Only conservative treatment.

Eligibility Criteria

• Age: 20 Years - 30 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Numeric pain rating score from 3 to 7 (Pain around or close to the sacral sulcus)
• Patients with a minimum of 3 positive results from among the 5 provocation tests that show sacroiliac joint dysfunction.
• Fuctional Leg length discrepancy.
• Using no other nonsteroidal anti-inflammatory drugs during the therapy.

You may not qualify if:

• Prolapsed intervertebral disc (PIVD)
• Lumbar canal stenosis
• Tumors or any traumatic condition to pelvis and lower limb.
• Lumbar surgery within a year prior to the study or reported vertebral fracture,
• Pregnancy
• Ankylosing spondylitis

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Gosh-e-Shifa Hospital and Al Raheem Physiotherapy Centre, Lahore.

Lahore, 56700, Pakistan

Location

MeSH Terms

Conditions

Low Back Pain

Interventions

Movement

Condition Hierarchy (Ancestors)

Back Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Physiological Phenomena; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Faiza Taufiq

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

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

Model Details: Patients receive mulligan mobilization with movement along with standardized physiotherapy intervention.

Study Record Dates

• First Submitted: February 23, 2026
• First Posted: February 27, 2026
• Study Start: February 15, 2025
• Primary Completion: January 15, 2026
• Study Completion: January 15, 2026
• Last Updated: February 27, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)