Additional Effects of Mulligan Mobilization With Movement Along With Core Strengthening Exercises in Postpartum Females With Sacroiliac Joint Dysfunction

NCT07526038 | Recruiting

• 1 other identifier: FUI/FUCP/CTR/05.26/RidaZainab
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to evaluate the combined effectiveness of Mulligan mobilization and core strengthening exercises in managing postpartum sacroiliac joint dysfunction (SIJD). Postpartum SIJD is a common condition resulting from biomechanical and hormonal changes during pregnancy, often leading to pelvic instability and pain. Mulligan mobilization, a manual therapy technique, aims to correct joint alignment and restore pain-free movement. For the SIJ, Mulligan MWM aims to correct subtle positional faults or movement restrictions that may cause pain and dysfunction-especially common postpartum due to ligamentous laxity, hormonal changes, and altered biomechanics.The core muscles provide stability to the pelvis and lumbar spine. When these muscles are weak or imbalanced, it can lead to increased strain on the SIJ, contributing to pain and dysfunction. Strengthening the core improves load transfer through the pelvis and enhances neuromuscular control, thereby reducing SIJ stress and symptoms. Core strengthening exercises enhances outcomes by targeting both mechanical alignment and muscular stability. Core strengthening exercises target muscles that support pelvic stability, including the transverse abdominis and pelvic floor. The study hypothesizes that integrating Mulligan mobilization with core strengthening may provide superior outcomes in pain reduction, joint function, and overall quality of life compared to core exercises alone.

Conditions

Sacro Iliac Joint Pain; Post Partum; Strength Training

Outcome Measures

Primary Outcomes (3)

• Pain Intensity

  It will be measured using numeric pain rating scale. '0' shows no pain whereas '10' represents worst pain.

  Baseline, and 4th week

• Sacroilaic Joint Disability

  It will be measured using Denver SI Joint Questionnaire (DSIJQ). It is a 10 item questionnaire with 6 options to choose from.

  Baseline, and 4th week

• Lumbar Range of Motion

  Lumbar ROM will be assessed using a dual inclinometer.

  Baseline, and 4th week

Study Arms (2)

Movement with mobilization with core strengthening exercise

EXPERIMENTAL

movement with mobilization along with Core strengthening exercises Moist Heat (10 mins)TENS(10 mins) Movement with mobilization * SIJ belt-assisted MWM (supine/standing)- Therapist-applied posterior glide with pain-free hip flexion Core strengthening exercises (4 sets of 4 repetition per session) Clamshell pelvic tilt bridge side leg raises abdominal drawing in. Progression of exercises * Dead bug (with pelvic floor engagement)- Bridge with pelvic floor cue- Clamshells (side-lying, glute med targeting)- Modified side plank (knees down) * Bird-dog- Full bridge (add band if ready)- Side plank (full or modified)- Functional pelvic floor: squat with exhale/lift * Single-leg bridge- (core + pelvic floor engaged)- Wall sits or squats

Procedure: Mulligan Mobilization with Movement along with core strengthening exercises

Core strengthening exercises

ACTIVE COMPARATOR

Core strengthening exercises * Diaphragmatic breathing- Pelvic floor contraction + TA co-activation- Supine pelvic tilts- * Dead bug (with pelvic floor engagement)- Bridge with pelvic floor cue- Clamshells (side-lying, glute med targeting)- Modified side plank (knees down) * Bird-dog- Full bridge (add band if ready)- Side plank (full or modified)- Functional pelvic floor: squat with exhale/lift * Single-leg bridge- (core + pelvic floor engaged)- Wall sits or squats

Procedure: Core & Pelvic Floor Exercises

Interventions

Mulligan Mobilization with Movement along with core strengthening exercises PROCEDURE

Week 1 Pain relief \& gentle activation- SIJ belt-assisted MWM (supine/standing)- Therapist-applied posterior glide with pain-free hip flexion Week 2 Core re-engagement \& stability- Standing hip flexion with MWM (with belt)- Low step-up + MWM Week 3 Functional integration- Sit-to-stand + MWM- Lateral step-down with therapist-assisted MWM Week 4 Load, endurance \& return to function - Self-mobilization (belt or resistance band)- Light weighted lunges/step-ups (if cleared)

Movement with mobilization with core strengthening exercise

Core & Pelvic Floor Exercises PROCEDURE

Week 1- Diaphragmatic breathing- Pelvic floor contraction + TA co-activation- Supine pelvic tilts- Week 2- Dead bug (with pelvic floor engagement)- Bridge with pelvic floor cue- Clamshells (side-lying, glute med targeting)- Modified side plank (knees down) Week 3- Bird-dog- Full bridge (add band if ready)- Side plank (full or modified)- Functional pelvic floor: squat with exhale/lift Week 4- Single-leg bridge- (core + pelvic floor engaged)- Wall sits or squats

Core strengthening exercises

Eligibility Criteria

• Age: 20 Years - 40 Years
• Gender Eligibility Details: Postpartum females(both normal delivery \& C-section) aged 20-40 years * Parity level: Multiparous * Duration: 6 weeks to 6 months postpartum * At least three Positive SIJ provocation tests (e.g., stork test, compression, distraction, thigh thrust, Ganslen's and sacral thrust)
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Postpartum females(both normal delivery \& C-section) aged 20-40 years
• Parity level: Multiparous
• Duration: 6 weeks to 6 months postpartum
• At least three Positive SIJ provocation tests (e.g., stork test, compression, distraction, thigh thrust, Ganslen's and sacral thrust)

You may not qualify if:

• Pelvic fractures or recent surgery
• Neurological or rheumatologic disorders
• Inability to participate in active exercise or manual therapy due to medical or psychological reasons

Sponsors & Collaborators

• Foundation University Islamabad: lead

Study Sites (1)

Foundation University College of Physical Therapy

Islamabad, Punjab Province, 46000, Pakistan

RECRUITING

Study Officials

• Rida Zainab, DPT

  Foundation University Islamabad

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Rida Zainab, DPT

CONTACT

03045000297; doczaini786@gmail.com

Muhammad Furqan Hassan, MS-OMPT

CONTACT

0333-4056768; furqan.hassan@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

Study Record Dates

• First Submitted: April 6, 2026
• First Posted: April 13, 2026
• Study Start: May 20, 2026
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): July 15, 2026
• Last Updated: May 20, 2026

Record last verified: 2026-05

Locations

PA (1)