PIR of Quadratus Lumborum With and Without Gluteus Maximus Activation in Innominate Upslip Suprapubic Dysfunction

NCT ID: NCT05347589

Last Updated: 2022-06-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-04-25

Study Completion Date

2023-01-10

Brief Summary

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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. .

Detailed Description

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Conditions

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Innominate Upslip Suprapubic Dysfunction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Post isometric relaxation of quadratus lumborum and gluteus Gluteus maximus activation exercises

Group Type EXPERIMENTAL

Post isometric relaxation of quadratus lumborum and gluteus Gluteus maximus activation exercises

Intervention Type OTHER

Post Isometric Relaxation: The patient will be in a left recumbent position with his leg in a fully flexed position close to his chest and fixed by his left hand. The patient is asked to hold the treatment table with a right hand in an overhead position to support the body in applying the technique. The patient fully extended left will be taken away from the treatment table. At this point, the patient will be asked to press the leg down until the range where the patient feels discomfort to the point of torsion of Quadratus lumborum. This is the point that is the barrier range. Smaller than this range the patient will be asked to lift his left against the counterforce by the therapist and hold it for five to seven seconds which will be followed by five to seven seconds of relaxation. The technique will be repeated by five times in the pain-free range.

post isometric relaxation of the Quadratus lumborum

Intervention Type OTHER

Post Isometric Relaxation: The patient will be in a left recumbent position with his leg in a fully flexed position close to his chest and fixed by his left hand. The patient is asked to hold the treatment table with a right hand in an overhead position to support the body in applying the technique. The patient fully extended left will be taken away from the treatment table. At this point, the patient will be asked to press the leg down until the range where the patient feels discomfort to the point of torsion of Quadratus lumborum. This is the point that is the barrier range. Smaller than this range the patient will be asked to lift his left against the counterforce by the therapist and hold it for five to seven seconds which will be followed by five to seven seconds of relaxation. The technique will be repeated by five times in the pain-free range

post isometric relaxation of the Quadratus lumborum

Group Type ACTIVE_COMPARATOR

post isometric relaxation of the Quadratus lumborum

Intervention Type OTHER

Post Isometric Relaxation: The patient will be in a left recumbent position with his leg in a fully flexed position close to his chest and fixed by his left hand. The patient is asked to hold the treatment table with a right hand in an overhead position to support the body in applying the technique. The patient fully extended left will be taken away from the treatment table. At this point, the patient will be asked to press the leg down until the range where the patient feels discomfort to the point of torsion of Quadratus lumborum. This is the point that is the barrier range. Smaller than this range the patient will be asked to lift his left against the counterforce by the therapist and hold it for five to seven seconds which will be followed by five to seven seconds of relaxation. The technique will be repeated by five times in the pain-free range

Interventions

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Post isometric relaxation of quadratus lumborum and gluteus Gluteus maximus activation exercises

Post Isometric Relaxation: The patient will be in a left recumbent position with his leg in a fully flexed position close to his chest and fixed by his left hand. The patient is asked to hold the treatment table with a right hand in an overhead position to support the body in applying the technique. The patient fully extended left will be taken away from the treatment table. At this point, the patient will be asked to press the leg down until the range where the patient feels discomfort to the point of torsion of Quadratus lumborum. This is the point that is the barrier range. Smaller than this range the patient will be asked to lift his left against the counterforce by the therapist and hold it for five to seven seconds which will be followed by five to seven seconds of relaxation. The technique will be repeated by five times in the pain-free range.

Intervention Type OTHER

post isometric relaxation of the Quadratus lumborum

Post Isometric Relaxation: The patient will be in a left recumbent position with his leg in a fully flexed position close to his chest and fixed by his left hand. The patient is asked to hold the treatment table with a right hand in an overhead position to support the body in applying the technique. The patient fully extended left will be taken away from the treatment table. At this point, the patient will be asked to press the leg down until the range where the patient feels discomfort to the point of torsion of Quadratus lumborum. This is the point that is the barrier range. Smaller than this range the patient will be asked to lift his left against the counterforce by the therapist and hold it for five to seven seconds which will be followed by five to seven seconds of relaxation. The technique will be repeated by five times in the pain-free range

Intervention Type OTHER

Eligibility Criteria

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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
Minimum Eligible Age

20 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Riphah International University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Saima Zahid, PhD*

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

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Ghurki Trust Teaching Hospital

Lahore, Punjab Province, Pakistan

Site Status RECRUITING

Countries

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Pakistan

Central Contacts

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Saima Zahid, PhD*

Role: CONTACT

03334349520

Facility Contacts

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Saima Zahid, PhD*

Role: primary

03334349520

References

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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.

Reference Type BACKGROUND
PMID: 32580480 (View on PubMed)

Sarkar M, Goyal M, Samuel AJ. Comparing the Effectiveness of the Muscle Energy Technique and Kinesiotaping in Mechanical Sacroiliac Joint Dysfunction: A Non-blinded, Two-Group, Pretest-Posttest Randomized Clinical Trial Protocol. Asian Spine J. 2021 Feb;15(1):54-63. doi: 10.31616/asj.2019.0300. Epub 2020 Jan 30.

Reference Type BACKGROUND
PMID: 31992024 (View on PubMed)

Patel VD, Eapen C, Ceepee Z, Kamath R. Effect of muscle energy technique with and without strain-counterstrain technique in acute low back pain - A randomized clinical trial. Hong Kong Physiother J. 2018 Jun;38(1):41-51. doi: 10.1142/S1013702518500051. Epub 2018 Apr 4.

Reference Type BACKGROUND
PMID: 30930578 (View on PubMed)

Kamali F, Zamanlou M, Ghanbari A, Alipour A, Bervis S. Comparison of manipulation and stabilization exercises in patients with sacroiliac joint dysfunction patients: A randomized clinical trial. J Bodyw Mov Ther. 2019 Jan;23(1):177-182. doi: 10.1016/j.jbmt.2018.01.014. Epub 2018 Jan 31.

Reference Type BACKGROUND
PMID: 30691749 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 32318454 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 33654504 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 26245709 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 33802528 (View on PubMed)

Other Identifiers

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REC/Lhr/22/0129 Uzair

Identifier Type: -

Identifier Source: org_study_id

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