This research compares two rehabilitation strategies for people with sacroiliac joint dysfunction (SIJD): Dynamic Neuromuscular Stabilization (DNS) and Core Stability Exercises (CSE). SIJD is presented as a biomechanical source of low-back, buttock and leg pain caused by altered joint mechanics, muscle control problems, or asymmetric pelvic alignment; diagnosis relies on clinical provocation tests and exclusion of other causes. The study aims to determine which of the two exercise-based approaches better reduces pain and improves lumbopelvic control. The trial is a single-blinded, parallel randomized controlled trial conducted in an outpatient physiotherapy setting with supervised sessions over four weeks. Adults aged 20-50 with at least three positive SIJ provocation tests and moderate, chronic pain were included; important exclusions were prior spinal/pelvic surgery, systemic inflammatory disease, pregnancy, cardiopulmonary limitation or poor session attendance. Each participant received a baseline conventional physiotherapy package; one arm received a DNS program (breathing-based and developmental movement patterns) and the other performed progressive core-stability training emphasizing transversus abdominis and multifidus activation. Primary outcomes are pain (Numeric Pain Rating Scale) and lumbopelvic stability measured with a pressure biofeedback unit (PBU). Data were collected at baseline and after four weeks; the analysis plan uses SPSS with paired and independent t-tests, ANCOVA to adjust for baseline differences, and effect sizes/confidence intervals to interpret clinical relevance. Safety, informed consent, assessor blinding and standard ethical safeguards are described. The synopsis notes a gap in direct RCT evidence comparing DNS and CSE for SIJD and positions this trial to address that gap with clinical and mechanistic outcomes.
Age between 30 and 45 years
Confirmed diagnosis by at least three positive provocation tests
FABER
Gaenslen's, Thigh Thrust
Other spinal conditions such as, spinal stenosis or tumors
Prior history of spinal or pelvic surgery
Patients with neurological disorders or systemic diseases such as rheumatoid arthritis
Pregnant women
Parallel
Dynamic Neuromuscular Stabilization
Other interventionDynamic Neuromuscular Stabilization (DNS) is a motor control-based rehabilitation approach using human developmental movement patterns to restore optimal motor programs and improve lumbopelvic stability. In this study, participants receive supervised DNS sessions three times per week for four weeks, 45 minutes per session, including conventional physiotherapy followed by DNS exercises. Exercises progress from supine diaphragmatic breathing, abdominal bracing, quadruped rocking, and side-lying reaches to half-kneel, standing weight shifts, step-ups, split-squats and get-ups. Emphasis is on coordinated activation of diaphragm, pelvic floor, deep trunk, and spinal stabilizers, intra-abdominal pressure regulation, postural alignment, and sensorimotor control, with continuous verbal and tactile feedback. Unlike conventional core programs, DNS targets motor control, functional integration, and neuromuscular coordination rather than only strength or endurance.
Core stabilization Exercise Program
Other interventionCore Stability Exercises (CSE) focus on improving segmental spinal and lumbopelvic stability by targeting the transversus abdominis (TrA) and lumbar multifidus (LM). In this study, participants receive supervised CSE sessions three times per week for four weeks, 45 minutes per session, beginning with low-load activation in supine, prone, and seated positions using abdominal drawing-in maneuver (ADIM), LM activation with contralateral arm raise, and TrA-LM co-contraction with bridging. Progression includes endurance training with controlled extremity movements, quadruped bird-dog, bridge marching, mini-squats, step-ups, wall push-ups, and self-palpation for awareness. Exercises emphasize isolated muscle activation, segmental control, and functional strength, guided by therapist supervision and biofeedback
Lumbopelvic stability
Lumbopelvic Stability was measured with two validated instruments: Pressure Biofeedback Unit (PBU). The PBU is an inflatable pressure cuff that is attached to a pressure gauge that was positioned under the lumbar spine. Test was performed in hook lying abdominal drawing-in test by inflating the cuff approximately 40 mmHg. The patient was instructed to contract the TrA by draw-in maneuver. Normal functioning involves sustaining pressure within ±5-10 mmHg of the baseline value. A decrease or rise above this level signifies compromised stability
Pain Intensity
Pain Intensity was measured with the Numeric Pain Rating Scale (NPRS), an 11-point self-report scale from 0 (no pain) to 10 (worst pain possible). Participants were asked to indicate their average pain during the past 24 hours. The NPRS is a reliable and valid instrument to quantify musculoskeletal pain and can detect clinically significant change in pain.
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