Additional Effects of Mulligan Mobilization With Movement Along With Core Strengthening Exercises in Postpartum Females With Sacroiliac Joint Dysfunction

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexFemale
Age20-40
SponsorFoundation University Islamabad

About this trial

This study aims to evaluate the combined effectiveness of Mulligan mobilization and core strengthening exercises in managing postpartum sacroiliac joint dysfunction (SIJD). Postpartum SIJD is a common condition resulting from biomechanical and hormonal changes during pregnancy, often leading to pelvic instability and pain. Mulligan mobilization, a manual therapy technique, aims to correct joint alignment and restore pain-free movement. For the SIJ, Mulligan MWM aims to correct subtle positional faults or movement restrictions that may cause pain and dysfunction-especially common postpartum due to ligamentous laxity, hormonal changes, and altered biomechanics.The core muscles provide stability to the pelvis and lumbar spine. When these muscles are weak or imbalanced, it can lead to increased strain on the SIJ, contributing to pain and dysfunction. Strengthening the core improves load transfer through the pelvis and enhances neuromuscular control, thereby reducing SIJ stress and symptoms. Core strengthening exercises enhances outcomes by targeting both mechanical alignment and muscular stability. Core strengthening exercises target muscles that support pelvic stability, including the transverse abdominis and pelvic floor. The study hypothesizes that integrating Mulligan mobilization with core strengthening may provide superior outcomes in pain reduction, joint function, and overall quality of life compared to core exercises alone.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Postpartum females(both normal delivery & C-section) aged 20-40 years

Parity level: Multiparous

Duration: 6 weeks to 6 months postpartum

At least three Positive SIJ provocation tests (e.g., stork test, compression, distraction, thigh thrust, Ganslen's and sacral thrust)

Disqualifiers

Pelvic fractures or recent surgery

Neurological or rheumatologic disorders

Inability to participate in active exercise or manual therapy due to medical or psychological reasons

Trial design

Design model

Parallel

Treatments tested in this trial

  • Mulligan Mobilization with Movement along with core strengthening exercises

    Procedure/Surgery

    Week 1 Pain relief \& gentle activation- SIJ belt-assisted MWM (supine/standing)- Therapist-applied posterior glide with pain-free hip flexion Week 2 Core re-engagement \& stability- Standing hip flexion with MWM (with belt)- Low step-up + MWM Week 3 Functional integration- Sit-to-stand + MWM- Lateral step-down with therapist-assisted MWM Week 4 Load, endurance \& return to function - Self-mobilization (belt or resistance band)- Light weighted lunges/step-ups (if cleared)

  • Core & Pelvic Floor Exercises

    Procedure/Surgery

    Week 1- Diaphragmatic breathing- Pelvic floor contraction + TA co-activation- Supine pelvic tilts- Week 2- Dead bug (with pelvic floor engagement)- Bridge with pelvic floor cue- Clamshells (side-lying, glute med targeting)- Modified side plank (knees down) Week 3- Bird-dog- Full bridge (add band if ready)- Side plank (full or modified)- Functional pelvic floor: squat with exhale/lift Week 4- Single-leg bridge- (core + pelvic floor engaged)- Wall sits or squats

Treatment groups

48 Participants
are divided into 2 treatment groups
Group A: Movement with mobilization with core strengthening exerciseExperimental treatment 1 intervention
Group B: Core strengthening exercisesActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Pain Intensity

It will be measured using numeric pain rating scale. '0' shows no pain whereas '10' represents worst pain.

Time frame
Baseline, and 4th week
2

Sacroilaic Joint Disability

It will be measured using Denver SI Joint Questionnaire (DSIJQ). It is a 10 item questionnaire with 6 options to choose from.

Time frame
Baseline, and 4th week
3

Lumbar Range of Motion

Lumbar ROM will be assessed using a dual inclinometer.

Time frame
Baseline, and 4th week

Secondary outcomes

Other outcomes

Sponsors and contacts

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