Effects of Innominate Rotation Correction Compared With Sacral Torsion Correction in Patients With Sacroiliac Joint Dysfunction

Foundation University Islamabad

Status: Not yet enrolling

Conditions: Sacroiliac Joint Dysfunction

Treatments: Procedure: Muscle Energy Technique for Innominate rotation; Procedure: Muscle Energy Technique for Sacral torsion

Study type: Interventional

Funder types: Other

Identifiers

NCT07176169

FUI/CTR/2025/01

Details and patient eligibility

About

The purpose of this study is to evaluate the comparative effects of Innominate Rotation Correction and Sacral Torsion Correction using Muscle Energy Techniques (METs) in patients with Sacroiliac Joint Dysfunction (SIJD). A total of 50 participants will be recruited, aged 18-50 yrs, with confirmed SIJD based on atleast 3 positive provocation tests. Participants will be randomized into two equal groups. Group A (Innominate Rotation Correction) and Group B (Sacral Torsion Correction). Both groups will receive Conventional Therapy (Thermotherapy, Electrotherapy and Core stabilization exercises).

Study variables include:

• Independent Variable: Type of MET applied (Innominate vs Sacral Torsion)
• Dependent Variables: Pain (measured by Visual Analog Scale), Functional Disability (assessed via Denver SIJ Disability Questionnaire)
• Control Variables: Age, Gender, BMI, Baseline Pain/ Disability Scores

The intervention will last 4 weeks with 8 sessions (2 sessions per week). Assessments will be conducted at baseline (Week 1, Pre-treatment) and Post every second session. Data will be analyzed to compare immediate and short-term effects of the two interventions.

This study aims to provide evidence for targeted manual therapy approaches in SIJD, potentially guiding clinicians toward the most effective technique for pain reduction and functional improvement.

Full description

This Randomized Controlled Trial aims to compare the effects of Innominate Rotation Correction versus Sacral Torsion Correction using Muscle Energy Techniques (METs) in patients with Sacroiliac Joint Dysfunction (SIJD).

A Total of 50 participants will be recruited and randomized equally into two groups.

• Group A: Sacral Torsion Correction via METs
• Group B: Innominate Rotation Correction via METs

Both groups will additionally receive conventional management (TENs, Heating, Core Stabilization Exercises).

INTERVENTION SCHEDULE:

• Duration: 4 weeks
• Frequency: 2 Sessions/week
• Total Sessions: 8 Sessions per participant

Group A - Sacral Torsion Correction

• Patient Position: Side lying - depending on the torsion type
• Therapist applies downward force or guided contraction to correct torsion, with isometric contraction (3-5 sec hold), relaxation and then passive stretch.
• Each correction repeated 3-5 times.

Group B - Innominate Rotation Correction

• Patient Position: Supine
• Therapist brings limb to restrictive barrier, patient performs isometric contraction (3-5 sec) against resistance, followed by relaxation and stretch to new barrier.
• Each correction repeated 3-5 times.

ASSESSMENTS:

• Conducted at Baseline (Pre-Intervention), after every 2nd session (progress monitoring), and post-intervention (end of week 4)
• Outcomes: Pain Intensity (VAS), Functional Disability (Denver SIJD Questionnaire)

DATA ANALYSIS:

Intra-group comparisons (Pre vs Post) and Inter-group comparisons (Innominate Rotation vs Sacral Torsion) will be performed at the end of the 4-week intervention.

Enrollment: 50 estimated patients

Sex: All

Ages: 18 to 50 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Dysfunction based on at least 3 of the following tests

  • Distraction Test

  • Compression Test

  • Gaenslen's Test

  • Thigh Thrust Test

  • Sacral Thrust Test

    • Presence of Pain in Buttock, Posterior Pelvis, or Lower Lumbar Region for more than 2 weeks
    • Confirmed Pelvic Asymmetry through Palpation (i.e., ASIS/PSIS Landmarks, Gillet's Test)

Exclusion criteria

• • History of Lumbar or Pelvic Fracture, Recent Surgery, or Hip/Knee Pathology affecting Gait/Posture.

  • Pregnancy or Post-partum less than 6 months - due to Hormonal Laxity & Altered Biomechanics
  • Systemic Inflammatory conditions - Rheumatoid Arthritis, Ankylosing Spondylitis
  • Neurological Deficits - Cauda Equina Syndrome, Radiculopathy with Motor Loss
  • Ongoing Physiotherapy treatment for Low Back Pain in past 4 weeks
  • Inability/Contraindications to tolerate Manual Therapy - Osteoporosis
  • Leg Length Discrepancy - >1.5 cm or Structural Scoliosis
  • BMI > 35 (ASIA) - it may affect assessment validity due to obesity

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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50 participants in 2 patient groups

Group A: Sacral Torsion Correction

Active Comparator group

Description:

Participants allocated to this arm will receive Muscle Energy Techniques (METs) for Sacral Torsion Correction. Covering Patterns: * Left-on-Left Torsion * Right-on-Right Torsion * Left-on-Right Torsion * Right-on-Left Torsion * Bilateral Nutation * Bilateral Counternutation Each participant will undergo 8 sessions over 4 weeks (2 Sessions/week), and receive Conventional Physiotherapy

Treatment:

Procedure: Muscle Energy Technique for Sacral torsion

Group B: Innominate Rotation Correction

Experimental group

Description:

Participants allocated to this arm will receive Muscle Energy Techniques (METs) for Innominate Rotation Correction along with Conventional Treatment. * Anterior Rotation * Posterior Rotation Each participant will undergo 8 Sessions over a period of 4 weeks (2 Sessions/week).

Treatment:

Procedure: Muscle Energy Technique for Innominate rotation