Comparative Effects of Stabilization Exercises and Muscle Energy Techniques in Sacroiliac Joint Pain

Study Overview
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Brief Summary
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Sacroiliac joint is in pelvis. It links the iliac bone (pelvic) bone to the sacrum. This joint pain is due to hyper mobility or instability of the joint, it may also cause by damage to joint between the spine and hip. This pain is typically felt in the lower back, or hip and may radiate to groin area. The aim of this study will be to compare the effects of stabilization exercises and muscle energy techniques on pain and disability in patients with sacroiliac joint pain.

Detailed Description
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A randomized clinical trial will be conducted at Ibn- e- Siena hospital and research institute Multan and in Bakhtawar Amin hospital Multan through convenience sampling technique on 30 patients which will be allocated through simple random sampling through sealed opaque enveloped into group A and group B. After giving common treatment of hot pack and transcutaneous electrical stimulation and assessing pre-treatment patient's condition Group A will be treated with stabilization exercises in which iliopsoas, gluteal and hamstring muscles will be stabilized. Total twelve sessions will be given as three sets three times per week for four weeks. Group B will be treated with muscle energy technique, this is active form of manual therapy in which patient will exert force against physiotherapist force through autogenic inhibition and reciprocal inhibition. (20% patient force against that applied by the physiotherapist and hold contractions for 10 seconds over 5 to 12 repetitions, 3 times per week for 4 weeks). Post-treatment assessment will be done after one month. Outcome measure will be conducted through pain and disability questionnaire after 6 weeks. Data will be analyzed using SPSS software version 21. After assessing normality of data by Shapiro -Wilk test, it will be decided either parametric or non-parametric test will be used within a group or between two groups. Stabilization exercises and muscle energy techniques will be applied for comparing their effectiveness in patients with sacroiliac joint pain.

Official Title
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Comparative Effects of Stabilization Exercises and Muscle Energy Techniques on Pain and Disability in Sacroiliac Joint Patients

Conditions
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Sacroiliac Joint Somatic Dysfunction

Intervention / Treatment
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* Other: Stabilization exercises
* Other: Muscle energy techniques


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Both men and women age between 30-50 with positive Laslett's criteria. The Cluster of Laslett is a group of four test used for sacroiliac joint pain, the four tests are: Sacroiliac Distraction (Gapping) Test Thigh Thrust Test Sacroiliac Compression (Squish) Test Sacral Thrust test If a patient has three or more positive pain provocation tests, and then there is a 59% chance that the patient will have Sacroiliac joint pain. Exclusion Criteria: Trochanteric bursitis Pelvic bone fracture Pelvic implants Pregnancy Lumbosacral disc herniation Sacroiliac joint inflammation Inflammatory bowel disease Malignancy

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Stabilization exercises<br>Group A performed stabilization exercises for 4 weeks. In stabilization exercises, floor bridging, heel prop and alternate arm and leg exercises were administered in iliopsoas, gluteal and hamstring groups. | Other: Stabilization exercises<br>* Stabilization training is an active form of physical therapy designed to strengthen muscles to support the spine and help prevent lower back pain. Group A performed stabilization exercises for 4 weeks. In stabilization exercises, floor bridging, heel prop and alternate arm and leg exercises were administered in iliopsoas, gluteal and hamstring groups. On eligible participants baseline assessment was done,3 sessions were given 3days per week, post intervention assessment was taken at 4th week.<br>|
| Active Comparator: Muscle energy techniques<br>Muscle energy techniques were given to group B. These techniques are active form of manual therapy in which patient uses its own energy on request to aid in treatment. | Other: Muscle energy techniques<br>* Muscle Energy Technique (MET) is a is a form of manual therapy, widely used in Osteopathy, that uses a muscle's own energy in the form of gentle isometric contractions to relax the muscles via autogenic or reciprocal inhibition and lengthen the muscle. Muscle energy techniques were given to group B. These techniques are active form of manual therapy in which patient uses its own energy on request to aid in treatment. On eligible participants baseline assessment was done,3 sessions were given 3days per week, post intervention assessment was taken at 4th week.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numeric Pain Rating Scale (NPRS) | The Numeric Pain Rating Scale (NPRS) (an outcome measure) that is a unidimensional measure of pain intensity in adults, including those with chronic pain. The NPRS is a segmented numeric version in which a respondent selects a whole number (0-10 integers) that best reflects the intensity of pain. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. no pain) to '10' representing the other pain extreme (e.g. pain as bad as you can imagine or worst pain imaginable). The NPRS takes <1 minute to complete The NPRS is a valid and reliable scale to measure pain intensity; High test-retest reliability has been (r = 0.96 and 0.95, respectively) For construct validity, the NPRS was shown to be highly correlated: correlations range from 0.86 to 0.95. | follow up at 4th week | 
| Modified Oswestry disability index | This questionnaire has been designed to give us information as to how your back or leg pain is affecting your ability to manage in everyday life. Please answer by checking ONE box in each section for the statement which best applies to you. A score of 0-20 reflects minimal disability, 21-40 moderate disability, 41-60 severe disability, 61-80 crippled, and 81-100 bed-bound. Each section is scored on a 0-5 scale, 5 representing the greatest disability. The index is calculated by dividing the summed score by the total possible score, which is then multiplied by 100 and expressed as a percentage. Thus, for every question not answered, the denominator is reduced by 5. | follow up at 4th week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pain, disability physical, muscle strength