Clinical trial NCT04161443: Effect of Quadratus Lumborum Muscle Energy Technique in Sacroilliac Joint Dysfunction.
Official title: Effect of Quadratus Lumborum Muscle Energy Technique Along With Gluteus Medius Strengthening Verus Gluteus Medius Strengthening Alone in the Management of Sacroilliac Joint Dysfunction.; A Randomized Controlled Trial.
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Sacroiliac Disorder
Keywords: MET, Quadratus lumborum, Sacroilliac joint
Lead sponsor: University of Lahore
Sponsor class: OTHER
First posted: 2019-11-13
Enrollment: 70
Sex: ALL
Minimum age (years): 30
Maximum age (years): 50
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Sacroiliac joint as a potential source of low back pain is an overlooked problem. Yet, in the existing years there has been an increasing interest in sacroiliac joint as a pain originator and more attention is being paid into its assessment and treatment in the current literature. Muscle imbalance due to postural dysfunction involves mainly gluteus medius and hamstring; however the role of quadratus lumborum working on compensatory mechanism and its treatment effect in the management of sacroiliac joint dysfunction is yet not discovered.

Detailed description: Going through current literature, it is evident that sacroiliac joint dysfunction as a postural dysfunction is highly prevalent among adult population. This dysfunction due to major muscle imbalances if not treated timely can result in serious consequences later in life where it becomes the permanent dysfunction involving the major changes in the joint itself. Muscle imbalance due to postural dysfunction involves mainly gluteus medius and hamstring; however the role of quadratus lumborum working on compensatory mechanism and its treatment effect in the management of sacroiliac joint dysfunction is yet not discovered. All patients will be assessed and screened by consultants as indicated and will refer to physiotherapy with diagnosed non- specific chronic back pain.Patients will further be screened for SIJ dysfunction by physiotherapist.Only those patients who fulfill the criteria of Quadratus lumborum tightness \& Gulteus medius weakness will randomly be selected and the sample of 70 will finally be selected for intervention.Written consent form will be taken from all study participants.Simple randomization technique will be used through "Randomization Main" software and randomization sheet will be generated. Patients will be further be assigned equally into two groups as per randomization sheet.Treatment will be performed three sessions per week for 4 weeks with postural advice and home exercise program with daily record of home diary. The selected outcome measures will be taken on initial visit (pre intervention), session 6 and final session 12 (post intervention).

Eligibility criteria: Inclusion Criteria:

* • Subjects with unilateral non-specific LBP

  * The Subjects having at least 3 pain provocative tests of SIJ positive out of 5.
  * Age 30-50 years. Both male and female.
  * Pain history greater than six weeks.
  * SIJ diagnostic scoring cut off point 4.
  * VAS cut off point mild to moderate.

Exclusion Criteria:

* Radiating pain with sensory or motor deﬁcits.
* History of fracture or any spinal surgery
* Trauma
* Any dysfunction of hip or knee
* Any systemic disease.
* Pregnancy

Primary outcomes:
measure: visual analog scale to measure the change in level of Pain intensity
timeFrame: Total duration of treatment is 4 weeks and 12 sessions, 3 sessions per week on alternate days. Patients will be assessed at baseline, at 6th session at the end of 2nd week and 12th session at the end of 4th week.
measure: Oswestry Disability Index to measure change in level of disability
timeFrame: Total duration of treatment is 4 weeks and 12 sessions, 3 sessions per week on alternate days. Patients will be assessed at baseline, at 6th session at the end of 2nd week and 12th session at the end of 4th week.
measure: SF-36 QUALITY OF LIFE to measure change in general health
timeFrame: Total duration of treatment is 4 weeks and 12 sessions, 3 sessions per week on alternate days. Patients will be assessed at baseline and 12th session at the end of 4th week.
Secondary outcomes:
measure: Hand Held Dynamometer to check gluteus medius muscle strength
timeFrame: Total duration of treatment is 4 weeks and 12 sessions, 3 sessions per week on alternate days. Patients will be assessed at baseline, at 6th session at the end of 2nd week and 12th session at the end of 4th week.
Other outcomes:
Locations:
city: Karachi
country: Pakistan
facility: Institute of physical medicine and rehabilitation, Dow University of health sciences
state: Sindh
Study officials:
affiliation: University of Lahore
name: Rabail Soomro
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Lahore
name: Hussain Kari mi
role: STUDY_CHAIR
References: