The purpose of this study is to evaluate the comparative effects of Innominate Rotation Correction and Sacral Torsion Correction using Muscle Energy Techniques (METs) in patients with Sacroiliac Joint Dysfunction (SIJD). A total of 50 participants will be recruited, aged 18-50 yrs, with confirmed SIJD based on atleast 3 positive provocation tests. Participants will be randomized into two equal groups. Group A (Innominate Rotation Correction) and Group B (Sacral Torsion Correction). Both groups will receive Conventional Therapy (Thermotherapy, Electrotherapy and Core stabilization exercises).
Study variables include:
* Independent Variable: Type of MET applied (Innominate vs Sacral Torsion) * Dependent Variables: Pain (measured by Visual Analog Scale), Functional Disability (assessed via Denver SIJ Disability Questionnaire) * Control Variables: Age, Gender, BMI, Baseline Pain/ Disability Scores
The intervention will last 4 weeks with 8 sessions (2 sessions per week). Assessments will be conducted at baseline (Week 1, Pre-treatment) and Post every second session. Data will be analyzed to compare immediate and short-term effects of the two interventions.
This study aims to provide evidence for targeted manual therapy approaches in SIJD, potentially guiding clinicians toward the most effective technique for pain reduction and functional improvement.
Dysfunction based on at least 3 of the following tests
Distraction Test
Compression Test
Gaenslen's Test
• History of Lumbar or Pelvic Fracture, Recent Surgery, or Hip/Knee Pathology affecting Gait/Posture.
Pregnancy or Post-partum less than 6 months - due to Hormonal Laxity & Altered Biomechanics
Systemic Inflammatory conditions - Rheumatoid Arthritis, Ankylosing Spondylitis
Neurological Deficits - Cauda Equina Syndrome, Radiculopathy with Motor Loss
Parallel
Muscle Energy Technique for Sacral torsion
Procedure/SurgeryConventional management including Electrotherapy by application of Thermotherapy or Cryotherapy, Transcutaneous Electrical Nerve Stimulation (TENS) for 20 minutes, Core-stabilization Exercises, * Clamshells * Four Point Kneeling * Bridging/Side Bridges * Bird-Dog Pose * Dead Bugs * Dynamic Core Stability (Unstable Surfaces) For Sacral Torsions, Six MET protocols address Forward and Backward torsions on Left and Right Oblique axis using patient generated force in Prone or Side-lying positions. Left-on-Left (LOL) Forward Torsion, Right -on-Right (ROR) Forward Torsion, Right-On-Left (ROL) Backward Torsion, Left-on-Right (LOR) Backward Torsion, Bilateral Sacral Nutation, Bilateral Sacral Counternutation
Muscle Energy Technique for Innominate rotation
Procedure/SurgeryConventional management including Electrotherapy by application of Thermotherapy or Cryotherapy, Transcutaneous Electrical Nerve Stimulation (TENS) for 20 minutes, Core-stabilization Exercises, • Clamshells • Four Point Kneeling • Bridging/Side Bridges • Bird-Dog Pose • Dead Bugs • Dynamic Core Stability (Unstable Surfaces). Anterior Innominate Rotation and Posterior Innominate Rotation.
JOINT DISABILITY
The Denver Sacroiliac Joint Disability Questionnaire (DSIJQ) comprises 10 items that assess various aspects of SIJ-related disability, including pain intensity, mobility, self-care, and social participation. Each item is scored on a 6-point Likert scale ranging from 0 to 5. (0 - No Disability; 5 - Unable to perform activity). To calculate the total percentage, the obtained score is divided by 50 and multiplied by 100 to calculate total percentage. Then it is compared with an Ordinal Scale grading, shown as follows: * 0-20% = Minimal Disability * 21-40% = Moderate Disability * 41-60% = Severe Disability * 61-80% = Crippled * 81-100% = Bed-bound or Exaggerating symptoms
JOINT PAIN
The Visual Analog Scale (VAS) is a simple patient-reported measure of current Pain Intensity. Scoring - Patients mark their pain on a 10-cm horizontal line, anchored by "No Pain" (0-cm) and "Worst Possible Pain" (10-cm), and the distance between 0-cm to the Point of Pain perception is marked as the recorded score (in millimeters or centimeters). High Value means Severe Pain and vice versa.
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