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

NCT ID: NCT07275294

Last Updated: 2025-12-10

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 46 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-12-31
• Study Completion Date: 2026-02-28

Brief Summary

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.

Conditions

Sacroiliac Joint Dysfunction

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: TRIPLE

Study Groups

Control group

Muscle Energy Techniques with Hot pack and Transcutaneous Electrical Nerve Stimulation

Group Type: ACTIVE_COMPARATOR

Muscle Energy Techniques with Hot pack and Transcutaneous Electrical Nerve Stimulation

Intervention Type: OTHER

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 seconds. Each stretch will be repeated 3-5 in each session. This will be performed 3 times per session 3 times per week for 6 weeks.

Experimental Group

Muscle Energy Techniques with Hot pack, Transcutaneous Electrical Nerve Stimulation and Pelvic Floor Exercises

Group Type: EXPERIMENTAL

Muscle Energy Techniques with Hot pack, Transcutaneous Electrical Nerve Stimulation and Pelvic floor Exercises

Intervention Type: OTHER

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 seconds. Each stretch will be repeated 3-5 in each session. This will be performed 3 times per session 3 times per week for 6 weeks.

Participants in the experimental group will be instructed to perform the Pelvic Floor Exercises (Kegel exercises, Pelvic Tilts and Bridge with pelvic floor engagement) according to the defined protocol.

Interventions

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 seconds. Each stretch will be repeated 3-5 in each session. This will be performed 3 times per session 3 times per week for 6 weeks.

Intervention Type: 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 seconds. Each stretch will be repeated 3-5 in each session. This will be performed 3 times per session 3 times per week for 6 weeks.

Participants in the experimental group will be instructed to perform the Pelvic Floor Exercises (Kegel exercises, Pelvic Tilts and Bridge with pelvic floor engagement) according to the defined protocol.

Intervention Type: OTHER

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

• Minimum Eligible Age: 30 Years
• Maximum Eligible Age: 50 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Lahore University of Biological and Applied Sciences

OTHER

Sponsor Role: lead

Responsible Party

Dr. Muhammad Tariq Rafiq

Associate Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

MUHAMMAD TARIQ RAFIQ, PhD

Role: PRINCIPAL_INVESTIGATOR

Lahore University of Biological & Applied Sciences

Central Contacts

Aneela Bajwa, DPT

Role: CONTACT

ubs24lmspt021@ubas.edu.pk

+923304295020

MUHAMMAD TARIQ RAFIQ, PhD

Role: CONTACT

rafiqmuhammadtariq149@gmail.com

Other Identifiers

UBAS/ERB/FoRS/25/027

Identifier Type: -

Identifier Source: org_study_id