Post Isometric Relaxation and Core Stability Exercises in Sacroiliac Joint Dysfunction
Condition: Lower Back Pain
MeSH terms: Joint Diseases; Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      There is growing evidence on the effects of post isometric relaxation exercises and core
      stability exercises on pain and disability secondary to various disorders. However, very few
      studies have explored their effects in postpartum Sacroiliac joint dysfunction. The aim of
      this study will be to compare the effects of post isometric relaxation exercises and core
      stability exercises on pain in postpartum Sacroiliac joint dysfunction.
    

Detailed description: 
      A previous study conducted by Farhadi et al. assessed that the prevalence of sacroiliac joint
      pain has been reported between 13-30% in postpartum females aged between 40-and 45 years.
      Specifically, 13% of the individuals with low back pain have the origin of their pain from
      the sacroiliac joint. It has been found that 33.6% of pregnant women have pelvic girdle pain,
      and 18.9% of post-partum women have "serious" pelvic girdle pain. In most women with
      pregnancy-related sacroiliac, joint pain resolves with time after pregnancy, but in some
      females, the pain lingers on. Patients with Sacroiliac dysfunction generally complain of pain
      in their back, and buttock or may radiate to the knee. On examination, there is pain and
      local tenderness. The symptoms increase on position change such as getting up from a sitting
      or lying position or while ascending and descending stairs. Sacroiliac pain is localized to
      the posterior pelvis and is described as stabbing pain deep.

      Terzi and Clinton et al., (2019) found thirty women diagnosed with post-partum SIJ pain,
      their age ranged from (25-35)years, their BMI ranged from (25-to 30)kg/m², and their number
      of parity ranged(from 2-to 4)times were selected randomly from the outpatient clinic of
      Al-Ahrar teaching hospital. Women were divided randomly into two equal groups, Group A
      (Control group): 15 patients, they were treated by TENS for 4 weeks 30 min\session, 3
      sessions \week. Group B(Study group):15 patient, were treated with core stability exercises
      for 4 weeks, 30 min\session, 5 sessions \week plus TENS as for group A. All participant was
      evaluated by VAS, Oswestry disability index (ODI), serum cortisol levels before and after
      treatment. The results revealed that there was a statistically significant decrease in the
      mean value of VAS in the group (B) when compared with its corresponding value in group (A).
      In spite of there being no statistically significant difference in plasma cortisol level,
      there was a clinical difference and high percent of improvement in favor of group B (8.83%)
      over group A (2.66%). Also, there was a statistically significant decrease in the mean value
      of ODI in the group (B) when compared with its corresponding value in group (A). It was
      concluded that core stability exercises could be used as a complementary treatment in
      reducing post-partum SIJ pain. Also, it could be considered a useful treatment to increase
      flexibility and range of motion.

      Shamsi et al., in 2014, found that reduced pain and increased function are outcomes when core
      stability exercises are used in the early stages of interventions. Also, Huxel et al., found
      that core exercises resulted in better outcomes measures than general exercise in the first 3
      months of interventions for LBP, as they found clinical improvements in pain perception and
      functional disability levels when the patients with LBP engaged in core-specific exercise.

      One study was done by Noelle M.Selkow et al., (2017) supports the findings of our study by
      concluding that MET is effective in decreasing pain in patients with acute low back pain.
      Another study was done by Roberts BL where he described two techniques of soft tissue
      manipulation viz neuromuscular technique and MET and found that MET can reduce Pain, muscle
      rigidity, and lengthen muscle fibers. The effect of MET on disability is supported by Fenech
      et al., (2015) determined that LBP is one of the most common musculoskeletal problems that
      affects about 60-80% of the population throughout their life expectancy. The lifetime
      prevalence of low back pain is reported to be 84% with 11-12% of the population being
      disabled by this condition. In 2010 Global Burden of Disease conducted a study on low back
      pain and estimated the global age-standardized point prevalence to be 9.4%. Low back pain is
      a self-limiting condition that can commonly be found in middle age ranging from 35 to 65
      years and 90% of the people can be cured within 3-4 months without any treatment protocol.
    

Intervention name(s): conventional physical therapy; relaxation exercise
Intervention type(s): Other; Other
Intervention description(s): core stability exercises
A total of 3 sessions per week were given for 15-20 minutes; the experimental group was given Post-isometric relaxation exercise along with core stability
A total of 3 sessions per week were given for 15-20 minutes
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: core stability; Core strengthening; chronic low back pain; therapeutic exercises