Comparison of the Effectiveness of Mobilization and Myofascial Release Techniques on Pain, Postural Control, and Spinal Mobility in Patients With Sacroiliac Joint Dysfunction
Overview
- Phase
- Not Applicable
- Status
- Not yet recruiting
- Sponsor
- Kirsehir Ahi Evran Universitesi
- Enrollment
- 42
- Primary Endpoint
- Postural control assessment
Overview
Brief Summary
Sacroiliac joint dysfunction (SIED) is one of the major causes of chronic mechanical low back pain and is associated with pain, postural control impairment, and functional limitations. While manual therapy approaches are commonly used in the treatment of sacroiliac joint pain, evidence regarding the clinical superiority of different manual techniques is limited.
This study was designed as a prospective, randomized controlled trial to compare the effects of myofascial release techniques and sacroiliac joint mobilizations, applied in addition to a traditional physical therapy program, on pain intensity, spinal mobility, postural control, and functional status in women diagnosed with sacroiliac joint dysfunction.
The study plans to include female individuals aged 18-65 years with a Visual Analog Scale (VAS) score ≥3 who have been diagnosed with sacroiliac joint dysfunction according to international diagnostic criteria. Participants will be randomly assigned to two groups: one group will receive traditional treatment combined with myofascial release techniques, while the other group will receive traditional treatment combined with sacroiliac joint mobilizations. Interventions will be performed three days per week for six weeks.
Primary and secondary outcome measures will include pain intensity (VAS), postural control (Biodex Balance System), spinal mobility, and postural endurance (Spinal Mouse) assessments. Participants will be randomly assigned to two groups: one group will receive traditional treatment combined with myofascial release techniques, while the other group will receive traditional treatment combined with sacroiliac joint mobilizations. Interventions will be performed three days a week for six weeks.
Primary and secondary outcome measures will include pain intensity (VAS), postural control (Biodex Balance System), spinal mobility, and postural endurance (Spinal Mouse) assessments. All assessments will be conducted before treatment and at the end of the six-week intervention period.
This study aims to provide clinical evidence regarding the comparative effectiveness of manual therapy approaches in the conservative treatment of sacroiliac joint dysfunction and to contribute to clinical decision-making processes.
Detailed Description
This study is a clinical prospective, randomized controlled trial evaluating two different manual therapy approaches added to a traditional physical therapy program in women diagnosed with sacroiliac joint dysfunction (SIED). The primary objective of the study is to comparatively evaluate the effects of myofascial release techniques and sacroiliac joint mobilizations on pain, spinal mobility, postural control, and postural endurance.
Eligible participants included in the study will be randomly assigned to two intervention groups using a computer-based randomization method. Both groups will receive the same traditional physical therapy program three days a week for six weeks. This approach aims to ensure that any differences between the groups are solely attributable to the manual therapy technique applied.
The traditional physical therapy program will include stabilization and strengthening exercises targeting the abdominal and back muscles (bridge, back extension, and sit-up exercises) and therapeutic ultrasound application to the sacroiliac region. This program will be applied to all participants for the same duration and intensity.
Myofascial release techniques will be used in addition to the traditional physical therapy program. The myofascial release techniques applied in this group will be planned to target the erector spinae, quadratus lumborum, thoracolumbar fascia, piriformis, and gluteus medius muscles. The applications will be performed in accordance with the principles of soft tissue mobilization and fascial release.
Mobilization will be treated with sacroiliac joint mobilization techniques in addition to the traditional physical therapy program. In this group, posterior-anterior and inferior mobilization techniques will be applied to regulate the biomechanics of the sacroiliac joint and increase joint mobility. Mobilizations will be graded according to the patient's tolerance and performed within safe limits.
All interventions will be performed by physical therapists experienced in manual therapy. Participants will not be allowed to receive any other manual therapy or alternative treatment during the treatment period.
Outcome assessments will be conducted before the treatment program (baseline) and at the end of the six-week intervention period. Pain intensity will be assessed using the Visual Analog Scale (VAS) as the primary outcome measure. Secondary outcome measures will include postural control (Biodex Balance System), spinal mobility, and postural endurance (Spinal Mouse system). All measurements will be performed by the same evaluator under standardized conditions.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Investigator)
Eligibility Criteria
- Ages
- 18 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Being a female individual between the ages of 18 and
- •Having been diagnosed with sacroiliac joint dysfunction (according to the International Association for the Study of Pain criteria).
- •Having localized pain in the sacroiliac joint region and pain that may radiate to the hip, groin, or lower extremities.
- •Positivity in at least 3 out of 5 sacroiliac joint-specific provocation tests (Vorlauf, Gillet, irritation point positivity, posterior shear test, compression test).
- •Pain intensity of ≥3 as assessed by the Visual Analog Scale (VAS).
- •Volunteering to participate in the study and providing written informed consent.
Exclusion Criteria
- •History of surgery involving the spine, pelvis, or lower extremities.
- •Presence of lumbar disc herniation, spinal stenosis, or acute pathologies of the hip joint.
- •Diagnosis of piriformis syndrome or low back/hip pain originating from sources other than the sacroiliac joint.
- •Known central or peripheral nervous system disease or progressive neurological deficit.
- •History of rheumatological disease (rheumatoid arthritis, ankylosing spondylitis, etc.).
- •Pregnancy or the presence of a serious systemic disease that could prevent participation in the study.
Outcomes
Primary Outcomes
Postural control assessment
Time Frame: 6 week
Postural control will be assessed statically and dynamically. The Biodex balance system (Biodex Medical System Inc., NY, USA, SW45 30D E6N Model, SD 950 304) will be used. This device creates stability indices by evaluating movements in the overall, anterior-posterior, and medial-lateral directions. For static balance assessment, the subject is asked to hold a small circle containing a black dot representing their center of gravity without moving it for 20 seconds, repeated 3 times. For dynamic assessment, the floor movement level is set to 12 at the start and gradually reduced to 9 throughout the test. At these levels, the subject attempts to keep their center of gravity balanced within the small circle. Total, anterior-posterior (A-P), and medial-lateral (M-L) values are recorded. Increased values indicate worsening balance activity
Posture and spinal mobility
Time Frame: 6 week
It was measured using the computer-assisted wireless Spinal Mouse device (the Spinal Mouse System, Idiag, Fehraltorf, Switzerland). The Spinal Mouse device is moved over the spine using its wheel, measuring the length of the spine, posture, and joint movements, and transferring this sequence to a computer environment. It is a reliable method that can noninvasively measure the physical characteristics and movement of the spine in a practical way. Measurements are taken from the spinous process of the seventh cervical vertebra to the third sacral vertebra. For spinal mobility, the trunk flexion posture is recorded. For postural competence values, an upright posture measurement is performed, and then a weight equal to 5% of the person's body weight is held parallel between the shoulders for 30 seconds. After the weight is still in the person's hands, the upright posture is measured again
Secondary Outcomes
- Pain level(6 week)
- Disability(6 week)
Investigators
Safak Kuzu
Assist. Prof.
Kirsehir Ahi Evran Universitesi