Comparison of Effect of Gluteus Maximus Strengthening and Hamstring Flexibility in Patients With Sacroiliac Joint
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 44
- Locations
- 2
- Primary Endpoint
- Active knee extension test
Study Overview
Brief Summary
The aim of this research is to compare effect of strengthening of gluteus maximus and hamstring flexibility on hamstring tightness in sacroiliac joint dysfunction.
Detailed Description
The sacroiliac joints (SIJ) are the largest diarthrodial auricular shape axial joints in the human body that connect the iliac bones to the sacrum. SIJ dysfunction is mostly caused by abnormal motion and misalignment of the joint. Worldwide, the prevalence of sacroiliac joint dysfunction (SIJD) lies within a range of 13% to 30%.In approximately 10% to 25% of patients; SIJD is a cause of mechanical low back and leg pain. Hamstrings muscle tightness is one of the major problems associated with SIJ dysfunction. Over- activation of the hip flexors and inhibition of the gluteus maximus are common in the hamstring tendinopathy patient population. With decreased gluteal activation, the hamstrings are dominant for hip extension and can lead to a repetitive stress on the fibers which would lead to its tendinopathy. GM contraction produces compression of the SI joint, and also contributes to the force transmission mechanism from the lower extremity to the pelvis through the SI joint during functional activities such as ambulation. Inappropriate timing of GM activation during gait is thought to be one of the causes of SIJ dysfunction, because it decreases shock absorption mechanism at the sacroiliac joint. Earlier onset of hamstrings activation has been noted in patients with SIJ dysfunction as compensation for delayed firing of the GM. Weakness of the GM also leads to slouched posture, makes walking extremely difficult, and necessitates substitution by hamstrings. Therefore, neuromuscular specific GM strengthening exercises reduce the forces going directly through the hamstring muscle and tendon and therefore protects it. Jennifer Saunders et al provides a linkage between mechanical dysfunction of the sacroiliac joint and alterations in muscle function around the pelvis which has the potential to lead to recurrent injuries of the hamstring muscles. Any injury that leads to abnormal movement of the sacroiliac joint can alter the information sent from mechanoreceptors receptors at the articular surface and this may explain the pattern of inhibition of the transversus abdominis, multifidus and ipsilateral gluteus maximus which is commonly reported with SIJ dysfunction. There is some evidence that hamstring spasm may accompany the dysfunction in a reflex attempt to stiffen the joint (force closure).
Conditions
Conditions: SIJ dysfunction
Keywords: hamstring tightness, strengthening of gluteus maximus, SIJ dysfunction Study Design Study Type: Interventional
Primary Purpose: Treatment
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Participant)
Eligibility Criteria
- Ages
- 25 Years to 45 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Both genders
- •Patient with pain over the posterior aspect of SI joint
- •Age between 25-45 years.
- •Positive Active knee extension test (angle of knee extension greater than 20 degrees)
- •Two of four test of Laslett cluster of Sacro-iliac dysfunction is positive.
Exclusion Criteria
- •Herniated disc.
- •Skin infection.
- •Any contraindications for affected lower limb exercises (e.g., venous thrombosis, lymphedema).
- •Patients with any post operative history of Hip joint fracture, subluxation, dislocation, diabetes, arthritis.
Outcomes
Primary Outcomes
Active knee extension test
Time Frame: baseline to 4th week
It is use to measure hamstring flexibility.The patient is positioned supine with the hip flexed 90 degrees (either actively or passively). The knee is then actively extended from a starting position of 90-degree flexion toward full extension. The test is positive for hamstring tightness if the angle of knee extension is greater than 20 degrees.
Dynamometer
Time Frame: baseline to 4th week
It. is used to measure strength .It is a small device that the examiner holds against the patient's limb as the patient exerts a maximal force. Dynamometers measure the amount of force and shows on its screen.
Secondary Outcomes
- NPRS(baseline to 4th week)
- Denver SI Joint Questionnaire(baseline to 4th week)