Sacro-iliac joint act as the shock absorber of the body. It is responsible for transferring vertical load of the whole body to lower limb hence contributing to stability of pelvic girdle. However, SI joint dysfunction is one of the most common causes of low back pain among the patients suffering from non-radicular low back pain. There can be a mechanical source which is due to muscle insufficiency or instability or a non-mechanical source which is osteoarthritis, infection or any trauma. It is thought to affect females more commonly with prevalence of about 46.71% in females and with the prevalence of about 15 to 30% in general. This poses great threat to bio mechanics of the body which can significantly lead to disability that can affect mobility, daily activities and quality of life of the individual. According to a study the pain caused by SIJD caused activity limitation and participation restriction of about 25% of the individuals. Hence making it difficult for them to continue their jobs. increased pain leads to worsening of the ability to perform ADLs which ultimately effects the quality of life. Altered biomechanics also leads to alteration in spatio temporal gait parameters.This study aims to compare the effects of autogenic inhibition technique and reciprocal inhibition technique in addition with conventional therapy in reliving low back pain, improving functional disability and alteration in spatio-temporal gait parameters in patients with sacroiliac joint dysfunction. Patients with SIJD will be recruited and will be randomly divided into two groups 20 in each group. Group 1 will receive autogenic inhibition technique of iliopsas, hamstrings, erector spinae and piriformis muscles along with standard core stabilization exercises and group 2 will receive reciprocal inhibition technique on iliopsas, hamstrings, erector spinae and piriformis muscles along with standard core stabilization exercises. The treatment will be continued for 3 weeks with 4 sessions of 25 minutes per week.
Patients having low back pain greater than 4 weeks
Patients with positive gaenslen's test, thigh thurst test, standing flexion test, sacral compression and distraction test.
Patients not having any other condition that can affect gait
25-45 years
Patients having nonspecific low back
Patients with lumbosacral fusion
Patients with any neurological condition
Patients with history of trauma of spine
Parallel
Autogenic Inhibition
Procedure/SurgeryDuring week 1, group 1 will receive TENS + hot pack ⇢10 mins Drawing in maneuver in quadruped position Bridiging PIR of illiopsoas,Piriformis, hamstrings,erector spinae During week 2, group 1 will receive TENS + hot pack ⇢10 mins Drawing in manuver in quadruped position Bridiging Clam shell exercises PIR of illiopsoas, PIRiformis, hamstrings, erector spinae During week 3, group 1 will receive TENS + hot pack ⇢10 mins Drawing in manuver in quadruped position Supine Bridiging, Clam shell exercises, PIR of illiopsoas PIR of Piriformis, hamstrings and erector spinae
Reciprocal Inhibition
Procedure/SurgeryDuring week 1, group 2 will receive TENS + hot pack ⇢10 mins Drawing in maneuver in quadruped position ⇢7 reps ⇢3 sec hold Bridiging ⇢5 reps ⇢no hold RI-MET of illiopsoas, PIRiformis, hamstrings, erector spinae ⇢5 reps ⇢10 sec hold During week 2, group 2 will receive TENS + hot pack ⇢10 mins Drawing in manuver in quadruped position ⇢7 reps ⇢6 sec hold Bridiging ⇢5reps ⇢3 sec hold Clam shell exercises ⇢6 reps RI-MET of illiopsoas, PIRiformis, hamstrings, erector spinae ⇢7 reps ⇢10 sec hold During week 3, group 2 will receive TENS + hot pack ⇢10 mins drawing in manuver in quadruped position ⇢8 reps ⇢8 sec hold Supine Bridiging, Clam shell exercises ⇢10 reps ⇢6 sec hold RI-MET of illiopsoas, Piriformis, erector spinae ⇢10 reps ⇢10 sec hold
Functional disability
It will be measured by using Denver SI joint disability questionnaire which 10 questions questionnaire consisting of scoring range from 0-5 in each item answered. 0 means no disability and 5 means maximum disability. And total score is calculated in the form of percentage. Higher the percentage greater is the disability.
Pain intensity
Pain will be measured by NPRS. A line of 10 centimeters containing numbers from 0 to 10 marked. The starting point of the scale indicates 0 or no pain whereas the ending point marks the pain as 10 which means the pain is as worse as it could be.
Gait Speed
Gait speed will be measured by calculating the distance covered in meters divided by the time taken in seconds during walking assessment. Formula: Gait Speed (m/s) = Distance (m) × Time (s)
Cadance
Cadence will be measured as the number of steps taken per minute during walking assessment. Formula: Cadence (steps/min) = Steps Counted × 60 / Time (s)
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