Chronic sacroiliac joint and pelvic girdle dysfunction in a 35-year-old nulliparous woman successfully managed with multimodal and multidisciplinary approach

K, A. P. K, J. P, B. A. Effect of Mulligan’s mobilization combined with motor control exercises on pain functional ability and muscle activity in sacroiliac joint dysfunction

Introduction and Aim: Sacroiliac joint dysfunction accounts 15% to 30% 0f low back ache conditions, If the SIJ is hypomobile, it cannot be effectively absorbed forces causing other body parts may be overstressed causing musculoskeletal dysfunction. This study’s aim is to identify the effect of mulligan’s joint mobilization techniques, motor control exercises and, aerobic exercises on pain functional ability and muscle activity in patients with SI joint dysfunction.   Methodology: Randomized controlled study was done by selecting patients with SI joint dysfunction. 185 participants with low back pain were evaluated and out of them 116 had positive SI joint dysfunction and 95 were selected based on selection criteria.  Computer- assisted randomization was done to divide the participants into three groups. Based on that group I has got 30, group II has 33, and group III has 32. Group I participants underwent Mulligan’s mobilisation for SI joint and followed by motor control exercises, Group II participants underwent motor control exercises and Group III participants underwent Aerobic exercises. All the treatment was given for 45 minutes 5 days per week for 6 weeks of duration. This study uses functional disability, Transverses abdominis muscle endurance, and pain measured using the Oswestry disability index, pressure biofeedback and numerical pain scale respectively.   Results:  On comparing group I and group II, the group I shows a significant improvement in all the outcomes. The ANOVA results show that the p-value is < .00001. The result is significant at p <0.05.   Conclusion: This study concludes that mulligans mobilization with motor control exercises would significantly improve pain, functional disability, and transverses abdominis muscle endurance.

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

STUDY DESIGN

Two-group, pretest-posttest randomized clinical trial.

PURPOSE

To evaluate the efficacy of the muscle energy technique (MET) and Kinesiotaping (KT) in addition to conventional physiotherapy among patients with mechanical sacroiliac joint dysfunction (SIJD).

OVERVIEW OF LITERATURE

Patients with SIJD suffer from lower back and gluteal pain, as well as stiffness, due to restricted pelvic joint movement. To restore function and reduce pain among individuals with mechanical SIJD, the MET and KT may be helpful. However, a limited number of studies have compared MET and KT in mechanical SIJD.

METHODS

A total of 40 male and female participants aging between 30 and 50 years experiencing unilateral pain around the gluteal area, groin area, and lower limbs for more than 4 weeks but less than 1 year will be selected. Patients will then be randomized into two groups: METCp (n=20) and KTCp groups (n=20). The METCp group will receive MET along with conventional physiotherapy, while the KTCp group will receive conventional physiotherapy with KT. Both groups will receive three alternating days of treatment per week that will continue for 4 weeks. The modified Oswestry Disability Index, a digital pressure algometer, and sacroiliac joint motion testing will be used for evaluation. Between- and within-group pre- and post-intervention results for mechanical SIJD were compared using the Wilcoxon signed-rank test/paired t-test and Mann-Whitney U -test/independent t -test.

RESULTS

Modified Oswestry Disability Index, digital pressure algometer, and sacroiliac joint motion will be measured at baseline, 2nd week during intervention, and 4th week at the end of intervention.

CONCLUSIONS

The present study will provide data regarding the effects of MET and KT among patients with mechanical SIJD.

High-velocity, low-amplitude manipulation (HVLA) does not alter three-dimensional position of sacroiliac joint in healthy men: A quasi-experimental study

The impact of high-velocity, low-amplitude (HVLA) manipulations on the behavior of sacroiliac joint (SIJ) mobility in individuals submitted to an osteopathic intervention has not been sufficiently investigated. Furthermore, there is no standard agreement on the description of the acute effects of HLVA with regards to the mobility of the SIJ through three-dimensional motion analysis. The purpose of this study was to analyse possible alterations in the mobility of the SIJ pre- and post-manipulation of the ilium bone in healthy men. Thirty healthy male patients aged between 18 and 35 years were examined and divided into two groups: manipulation (MN) and placebo (PL) groups. SIJ movement was assessed through a three-dimensional motion analysis system before and after osteopathic manipulation of the anterior ilium bone, during hip flexion. Statistical analysis was performed using the Kolmogorov-Smirnov normality test, and Fisher's exact test was used to observe associations of interest in the mobility of the SIJ. Finally, the t-test was used to analyse values of mobility of the SIJ pre- and post-manipulation (p < 0.05). Non-significant differences were observed in SIJ mobility. In MN the means were pre-manipulation right SIJ 39.98 mm ± 10.82 [CI - 29.16-50.8] and post- 42.85 mm ± 27.17 [CI - 15.68-70.02] with p = 0.61. Pre-manipulation left SIJ 41.73 mm ± 15.34 [CI 10.89-82.99] and post- 39.97 mm ± 14.70 [CI - 24.67-54.07] with p = 0.39. HVLA does not alter the mobility of SIJ under these conditions. Further studies under different conditions, with patients that report pain, are required to fully understand the behavior of the SIJ after HVLA manipulation.

The impact of progressive pelvic floor muscle exercise and manual therapy in a patient postpartum who met the criteria for sacroiliac joint pain based on Laslett's cluster of provocation signs

Sacroiliac joint (SIJ) pain has been identified as a primary or contributing source of pain in patients with low back pain. The Laslett cluster of SIJ pain provocation tests has the strongest evidence for noninvasive clinical testing. The purpose of this report was to describe the impact of physical therapy treatments for a patient postpartum with SIJ pain who satisfied the Laslett cluster. Specifically, the goal was to assess the impact of progressive pelvic floor muscle exercise and manual therapy. The Modified Oswestry Low Back Pain Disability Questionnaire (MODI) was the primary outcome measure used in this case. In addition, the Numeric Pain Rating Scale (NRPS) and Global Rating of Change (GROC) were used as secondary outcome measures. In this case report, the patient responded to the combined interventions with decreases in MODI, NRPS and GROC. Further research is warranted to develop stronger evidence to identify specific interventions for the treatment of SIJ pain.