Effects of Pelvic Floor Exercises and Muscle Energy Techniques on Pain and Disability in Sacroiliac Joint Dysfunction

Official title

Combined Effects of Pelvic Floor Exercises and Muscle Energy Techniques on Pain and Functional Disability in Patients With Sacroiliac Joint Dysfunction: A Randomized Controlled Trial

Overview

This clinical trial aims to evaluate whether combining pelvic floor exercises with muscle energy techniques provides greater improvement in pain and functional disability in adults with sacroiliac joint dysfunction compared to muscle energy techniques alone. The study examines whether the addition of pelvic floor training enhances pain reduction and functional outcomes beyond the effects of muscle energy techniques applied to the hamstrings, gluteus medius, piriformis, and iliopsoas muscles. Participants will be assigned to either an experimental group receiving both pelvic floor exercises and muscle energy techniques or a control group receiving muscle energy techniques only, and will complete standardized assessments of pain and disability before and after the intervention.

Detailed description

This clinical trial is designed to evaluate the combined therapeutic effects of pelvic floor muscle exercises and muscle energy techniques on pain intensity and functional disability in individuals with sacroiliac joint dysfunction. It is commonly linked to altered lumbopelvic mechanics and impaired stability, and interventions that target both joint alignment and deep stabilizing musculature may offer improved clinical outcomes. All participants will undergo baseline assessment, including sacroiliac joint pain provocation tests, pain intensity measured with the Numeric pain rating scale, and functional disability assessed using the Modified Oswestry Disability Index. The intervention will occur three times per week for six weeks, with each session lasting approximately 40-45 minutes. Both groups will receive standard physiotherapy consisting of a hot pack and Transcutaneous Electrical Nerve Stimulation for pain modulation, followed by muscle energy techniques directed at the hamstrings, gluteus medius, piriformis, and iliopsoas to improve muscle balance and sacroiliac joint mobility. The experimental group will additionally participate in a structured pelvic floor exercise program designed to enhance pelvic stability and reinforce load transfer across the sacroiliac joint. Participants will be advised to avoid any external treatments during the study period. Post-intervention assessments will be conducted immediately, after three weeks of treatment and again at six weeks post-treatment to determine both immediate and short-term follow-up effects. This study aims to clarify whether the integration of pelvic floor exercises with traditional muscle energy techniques results in superior clinical outcomes compared to muscle energy techniques alone in the management of sacroiliac joint dysfunction.

Interventions

• Other Muscle Energy Techniques with Hot pack and Transcutaneous Electrical Nerve Stimulation
  There will be an application of a hot pack for 10minutes and TENS for 10minutes. After that Muscle Energy Techniques (METs) will be performed as isometric relaxation technique targeting iliopsoas, piriformis, hamstring and gluteus medius muscles. The protocol will involve isometric contraction in which patients will perform a contraction at \~30% effort against the therapist's resistance for 7-10 seconds. A 5-second relaxation phase followed by a stretch to the new range barrier, held for 10-60
• Other Muscle Energy Techniques with Hot pack, Transcutaneous Electrical Nerve Stimulation and Pelvic floor Exercises
  There will be an application of a hot pack for 10minutes and TENS for 10minutes. After that Muscle Energy Techniques (METs) will be performed as isometric relaxation technique targeting iliopsoas, piriformis, hamstring and gluteus medius muscles. The protocol will involve isometric contraction in which patients will perform a contraction at \~30% effort against the therapist's resistance for 7-10 seconds. A 5-second relaxation phase followed by a stretch to the new range barrier, held for 10-60

Primary outcome measures

• Pain for SIJD provocation tests [Time frame: From enrollment to the end of treatment at 6 weeks]

Secondary outcome measures (1)

• Functional Disability [Time frame: From enrollment to the end of treatment at 6 weeks]

Eligibility criteria

Inclusion criteria

• Unilateral sacroiliac joint dysfunction pre diagnosed patients
• Both male and female
• Age 30 to 50 years
• Positive on at-least 3/5 provocation tests (Compression, Distraction, Gaenslen, Thigh Thrust, Sacral Thrust and FABER (Flexion, Abduction, External Rotation) test)
• Pain at Fortin area
• Symptoms >3 weeks

Exclusion criteria

• Pregnant females
• Any other neurological, orthopedic, or musculoskeletal disorder
• Recent history of pelvic surgery or any history of malignancy
• Lumbar pathologies (scoliosis, spondylosis, spondylolisthesis)
• Sacroiliitis

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Triple blind

Primary purpose

Treatment

Study locations

Center list to be confirmed — check the primary protocol.

Identifiers

NCT: NCT07275294 · UBAS/ERB/FoRS/25/027

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗