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 volunteersQualifiers
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
Parallel
Treatments tested in this trial
Mulligan Mobilization with Movement along with core strengthening exercises
Procedure/SurgeryWeek 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/SurgeryWeek 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
Trial outcomes
Primary outcomes
Pain Intensity
It will be measured using numeric pain rating scale. '0' shows no pain whereas '10' represents worst pain.
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.
Lumbar Range of Motion
Lumbar ROM will be assessed using a dual inclinometer.
Sponsors and contacts
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