Effects of Modified Clamshell Training Versus Sling System Training on Pain, Functional Disability, and SIJ Nutation Control in Postpartum Women With SIJ Dysfunction

NCT07852741 | Completed DMC

• 1 other identifier: REHAB/04/26/MS/RS-4092
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

Sacroiliac joint dysfunction (SIJD) is a common musculoskeletal condition that can occur during the postpartum period due to pregnancy-related biomechanical, hormonal, and lumbopelvic changes. It may cause pain around the sacroiliac region, impaired pelvic stability, and functional disability, which can affect daily activities and quality of life. This randomized controlled trial will evaluate the effectiveness of Modified Clamshell Training (MCT) compared with Sling System Training (SST) in postpartum women with SIJ dysfunction. The study will assess the effects of both interventions on pain, functional disability, and SIJ nutation control. A total of 36 postpartum women with SIJ dysfunction will be randomly allocated into two groups, with 18 participants receiving MCT and 18 receiving SST. Both groups will receive the same baseline treatment, and the interventions will be delivered for 6 weeks, 3 sessions per week. Outcomes will be assessed before and after the intervention to determine changes in pain, functional disability, and SIJ nutation control.

Conditions

Sacroiliac Joint Dysfunction; Postpartum Women

Keywords

Sling system training; Functional Disability; nutation control

Outcome Measures

Primary Outcomes (1)

• Numeric Pain Rating Scale for pain

  Numeric Pain Rating Scale (NPRS): Pain intensity will be assessed using the 11-point Numeric Pain Rating Scale, ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst possible pain. Participants will be asked to rate their current level of pain based on their symptoms related to sacroiliac joint dysfunction. The NPRS score will be recorded at baseline and after the 6-week intervention to determine changes in pain intensity.

  Baseline and after 6 weeks

Secondary Outcomes (2)

• Pelvic Girdle questionnaire for Functional Disability

  Baseline and after 6 weeks

• Digital Incliometer

  Baseline and after 6 weeks

Study Arms (2)

Modified Clamshell Training

ACTIVE COMPARATOR

Participants will receive a 6-week modified clamshell training program aimed at improving hip muscle activation and lumbopelvic stability in postpartum women with sacroiliac joint dysfunction. The exercise program will be performed three times per week. Each session will last approximately 30-40 minutes, with 3 sets of 12-14 repetitions. Participants will also receive the same baseline treatment provided to both groups, including hot pack and sacroiliac joint range-of-motion exercises.

Other: Modified Clamshell training

Sling system training

ACTIVE COMPARATOR

Participants will receive a 6-week Sling System Training program targeting lumbopelvic stability and SIJ nutation control. The program will include exercises targeting the posterior oblique sling, lateral sling, and deep longitudinal sling. Exercises will include bridge with contralateral arm movement, single-leg bridge, side-lying hip abduction, resisted lateral walking, side lunges, single-leg Romanian deadlift, and bridge/hamstring exercises. Training will be performed 3 sessions per week for 6 weeks, with 3 sets of 12-14 repetitions per exercise and each session lasting approximately 30-40 minutes. Participants will also receive the same baseline treatment of hot pack and SIJ range-of-motion exercises

Other: Sling System Training

Interventions

Sling System Training OTHER

ling System Training Description: Participants will receive a 6-week Sling System Training program targeting lumbopelvic stability and SIJ nutation control. The program will include exercises targeting the posterior oblique sling, lateral sling, and deep longitudinal sling. Exercises will include bridge with contralateral arm movement, single-leg bridge, side-lying hip abduction, resisted lateral walking, side lunges, single-leg Romanian deadlift, and bridge/hamstring exercises. Training will be performed 3 sessions per week for 6 weeks, with 3 sets of 12-14 repetitions per exercise and each session lasting approximately 30-40 minutes. Participants will also receive the same baseline treatment of hot pack and SIJ range-of-motion exercises

Sling system training

Modified Clamshell training OTHER

Participants will receive a 6-week Modified Clamshell Training program aimed at improving hip muscle activation and lumbopelvic stability in postpartum women with sacroiliac joint dysfunction. The exercise program will be performed 3 times per week for 6 weeks. Each session will last approximately 30-40 minutes and will consist of 3 sets of 12-14 repetitions. Participants will also receive the same baseline treatment provided to both groups, including hot pack and sacroiliac joint range-of-motion exercises.

Modified Clamshell Training

Eligibility Criteria

• Age: 20 Years - 35 Years
• Gender Eligibility Details: Postpartum women
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Females aged 20-35 years. Postpartum period of 6 weeks to 6 months following normal vaginal delivery. Presence of unilateral sacroiliac joint dysfunction (SIJD). SIJ dysfunction is confirmed through clinical assessment according to Laslett's criteria, including the distraction test, compression test, thigh thrust, sacral thrust, and Gaenslen test.
• Participants were assessed for SIJ nutation using a digital inclinometer

You may not qualify if:

• Women experiencing lower-back/waist or leg pain due to other etiologies. History of SIJ sprain with relevant abnormal findings. Tuberculosis affecting the SIJ or spine. Tumor, fracture, or ankylosing spondylitis. Inability to understand the study procedures or provide informed consent. �

Sponsors & Collaborators

• Dr Aneeqa Sultan: lead

Study Sites (1)

Rehab Healthcare Clinic and Hazrat Ayesha saddiqua Hospital

Lahore, Punjab Province, 33510, Pakistan

Location

Study Officials

• Quratulain Ashfaq

  Superior University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Single (Outcome Assessor)
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Reserach Associate

Model Details: Parallel Assignment

Study Record Dates

• First Submitted: September 25, 2026
• First Posted: October 1, 2026
• Study Start: October 20, 2025
• Primary Completion: May 27, 2026
• Study Completion: May 28, 2026
• Last Updated: October 1, 2026

Record last verified: 2026-09

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)