Clinical trial NCT05347589: PIR of Quadratus Lumborum With and Without Gluteus Maximus Activation in Innominate Upslip Suprapubic Dysfunction
Official title: Effects of Post Isometric Relaxation of Quadratus Lumborum With and Without Gluteus Maximus Activation on Pain, Disability and Pelvic Tilt Angle in Patients With Innominate Upslip Suprapubic Dysfunction
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: NA
Conditions: Innominate Upslip Suprapubic Dysfunction
Keywords: sacroiliac joint
suprapubic dysfunction
Muscle pain
Innominate upslip
pelvis
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2022-04-26
Enrollment: 30
Sex: ALL
Minimum age (years): 20
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The innominate up slip dysfunction is the most common in athletes and non-athletes, who present with low back pain and sacroiliac dysfunction. The main muscular structure that forms the force closure of the joint involves the bicep femoris and gluteus maximus that are involved in the stability of the of the pelvis through immense attachments through the Sacro-tuberous ligament. The objective of this study is to determine the effectiveness of Post Isometric Relaxation (PIR) of Quadratus lumborum with and without Gluteus maximus activation on pain, disability and pelvic tilt angle in patients with innominate upslip suprapubic dysfunction.

The study will be a randomized controlled trial involving 34 patients both males and females aged 20 to 40 years with history of unilateral pelvic pain not radiating to L5 or above, Positive finding of sitting flexion test, standing flexion tests, stork test and Positive active straight leg raise test will be randomly recruited by consecutive sampling technique. The subjects having ankylosing spondylitis, lumbar radiculopathy, spinal pathologies, or any lumbar fracture will be excluded. All the patients in the study will be randomly assigned into two groups where Group A will be given muscle energy technique of quadratus lumborum along with gluteus maximus activation and Group B will be a control group treated with muscle energy technique only. Both groups will be given buttock squeezing and drawing in maneuver as common treatment along with muscle energy technique. Each session will be repeated for 20 minutes thrice a week. The treatment duration will be 4 weeks. Outcomes will be measured at the first day and then at the end of the 4th week by numeric pain rating scale, modified Oswestry disability index and iHandy inclinometer application. .


Eligibility criteria: Inclusion Criteria:

1. Patients aged 20 to 40 years
2. Both males \& females
3. History of unilateral pelvic pain not radiating to L5 or above
4. Positive finding of sitting flexion test, standing flexion tests, stork test.
5. Positive active straight leg raise test

Exclusion Criteria:

1. Subjects diagnosed with ankylosing spondylitis.
2. Lumbar radiculopathy
3. Spinal pathologies including spondylosis and spondylolisthesis.
4. Subjects immediately post pregnancy.
5. Disc herniation
6. Lumbar fractures or spinal surgeries

Primary outcomes:
measure: Numeric Pain Rating Scale (NPRS)
timeFrame: 4 weeks
measure: Modified Oswestry disability index (MODI)
timeFrame: 4 weeks
measure: I-Handy level inclinometer mobile app
timeFrame: 4 weeks
Secondary outcomes:
Other outcomes:
Locations:
city: Lahore
country: Pakistan
facility: Ghurki Trust Teaching Hospital
state: Punjab
Study officials:
affiliation: Riphah International University
name: Saima Zahid, PhD*
role: PRINCIPAL_INVESTIGATOR
References:
citation: Garcia-Penalver UJ, Palop-Montoro MV, Manzano-Sanchez D. Effectiveness of the Muscle Energy Technique versus Osteopathic Manipulation in the Treatment of Sacroiliac Joint Dysfunction in Athletes. Int J Environ Res Public Health. 2020 Jun 22;17(12):4490. doi: 10.3390/ijerph17124490.
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citation: Ghasemi C, Amiri A, Sarrafzadeh J, Dadgoo M, Jafari H. Comparative study of muscle energy technique, craniosacral therapy, and sensorimotor training effects on postural control in patients with nonspecific chronic low back pain. J Family Med Prim Care. 2020 Feb 28;9(2):978-984. doi: 10.4103/jfmpc.jfmpc_849_19. eCollection 2020 Feb.
citation: Sanika V, Prem V, Karvannan H. Comparison of Glutues Maximus Activation to Flexion Bias Exercises Along with MET Technique in Subjects with Anterior Rotated Sacroiliac Joint Dysfunction-a Randomised Controlled Trial. Int J Ther Massage Bodywork. 2021 Mar 1;14(1):30-38. eCollection 2021 Mar.
citation: Copay AG, Cher DJ. Is the Oswestry Disability Index a valid measure of response to sacroiliac joint treatment? Qual Life Res. 2016 Feb;25(2):283-292. doi: 10.1007/s11136-015-1095-3. Epub 2015 Aug 6.
citation: Cana-Pino A, Espejo-Antunez L, Adsuar JC, Apolo-Arenas MD. Test-Retest Reliability of an iPhone(R) Inclinometer Application to Assess the Lumbar Joint Repositioning Error in Non-Specific Chronic Low Back Pain. Int J Environ Res Public Health. 2021 Mar 3;18(5):2489. doi: 10.3390/ijerph18052489.