Effect of Retro Walking in Patients With Sacroiliac Joint Dysfunction

October 30, 2026 updated by: Hasnaa Hamdy Abd-allah Salama, Cairo University

Effect of Retro Walking on Isokinetic Peak Torque of Lower Limb Muscles in Patients With Sacroiliac Joint Dysfunction

The goal of this clinical trial is to investigate the effect of adding retro-walking (RW) to core stabilization exercises (CSE) on isokinetic peak torque of lower limb muscles, pain severity, and disability level in patients with sacroiliac joint dysfunction(SIJD).The main questions it aims to answer are:

Will there be any effect for the combined application of RW training and CSE on isokinetic peak torques of, hip extensors and abductors, knee extensors, and ankle planter-flexors, pain severity, and disability level in patients with SIJD? Will there be any difference between the combined application of RW training and CSE and the solo application of CSE on isokinetic peak torques hip extensors and abductors, knee extensors, and ankle planter-flexors, pain severity, and disability level in patients with SIJD?

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

One of the most overlooked sources of low back pain (LBP) is the sacroiliac joint dysfunction (SIJD). The reported prevalence of chronic mechanical LBP originating from the sacroiliac joint (SIJ) ranges from 15% to 30% with females being affected more than males. SIJ is the largest axial joint in the body that connects the spine to the pelvis and thus transfers load from the lumbar spine to lower extremities and vice versa. During weight bearing activities, the ankle, knee and hip act as a linked system minimizing the transmission of force to the pelvis and spine.

Some studies investigated electromyographic activity of gluteus maximus, gluteus medius and other lumbo-pelvic muscles in patients with SIJD. They found reduced activity of these muscles and delayed onset of activation in SIJD compared with the controls. Also, recent studies found there was a relation between pelvic, and lower limb injuries and SIJD.

Treatment of SIJ pain is variable, and there are no guidelines or an appropriate management plan for this dysfunction. Core Stabilization Exercises (CSE) are a common form of exercise therapy used to treat LBP and SIJD. Backward walking (BW) or retro-walking (RW) is a recently emerging exercise that helps enhance the balance, muscle strength of the lower limbs and hamstring flexibility. Reviewing the literature revealed that there was no study investigated the effect of BW training on lower limb muscles' strength, pain, and disability in patients with SIJD. Yet, there is a gap in literature regarding the effect of RW training on hip, knee, and ankle muscles' strength in such patients. Furthermore, the effect of adding RW training to CSE on such variables wasn't previously investigated. So, the current study will be conducted to fill this gap, by investigating the effect of adding RW to CSE on isokinetic peak torques of hip extensors and abductors, knee extensors, ankle planter-flexors, pain severity, and disability level in patients with SIJD. Additionally, this study aims to compare the changes in the selected parameters after applying RW in addition to CSE versus applying CSE only in patients with SIJD.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
40

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

20 years to 40 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • Age ranging from 20-40 years.
  • pain lasting for more than 3 months
  • ≥ 4 in diagnostic scoring system (Kurosawa et al., 2017).
  • 3 or more positive provocative test of SIJ tests (distraction test, compression test, sacral trust, thigh trust test, gaenslen test).
  • Pain in or around the sacroiliac region with or without leg pain.

Exclusion Criteria:

  • Midline or symmetrical pain above the level of L5 or radicular pain with neurological deficits (sensory or motor deficit).
  • A history of spinal surgery, infection, tumors fracture of the spine, pelvis or lower extremities.
  • Hospitalization for severe trauma or car accident.
  • Pregnancy or lactation.
  • Any systemic disease such as arthritis, tuberculosis.
  • Leg length discrepancy and scoliosis.
  • Injection of corticosteroids or anesthetics in the SIJ during the previous month.
  • Participating in physical therapy for 3 months prior the study.
  • Taking non-steroidal anti-inflammatory drugs during the therapy.
  • Participating in any regular exercise.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Experimental group

Patients will perform core stabilization exercises combined with backward walking training. The intervention will be administered for 3 times per week for 6 weeks. Each session lasts for approximately 40-50 minutes.
Behavioral: core stabilization exercises with backward walking

core stabilization exercises will be performed followed by backward walking three times per week for six weeks.

Behavioral: core stabilization exercises

core stabilization exercises will be performed three times per week for six weeks. Each exercise will be repeated 15 times, with a brief rest interval of 3s between repetitions and 1-min between exercises.
Active Comparator: Control group

Patients will perform core stabilization exercises only. The intervention will be administered for 3 times per week for 6 weeks. Each session lasts for approximately 20-30 minutes.
Behavioral: core stabilization exercises with backward walking

core stabilization exercises will be performed followed by backward walking three times per week for six weeks.

Behavioral: core stabilization exercises

core stabilization exercises will be performed three times per week for six weeks. Each exercise will be repeated 15 times, with a brief rest interval of 3s between repetitions and 1-min between exercises.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Isokinetic peak torque of lower limb muscles
Time Frame: The isokinetic peak torques of the four tested muscles will be measured at the beginning and after six weeks for the two tested groups

Biodex System 3 Multi-Joint system testing and rehabilitation (Biodex Medical system, Shirley, NY, USA) will be used to measure peak torques of hip extensors and abductors, in addition to knee extensors and ankle planter flexors at an angular velocity of 60°/sec.
The isokinetic peak torques of the four tested muscles will be measured at the beginning and after six weeks for the two tested groups
Pain intensity
Time Frame: VAS pain score will be measured at the beginning and after six weeks for the two tested groups

Visual analog scale (VAS) will be used for measuring the pain intensity.
VAS pain score will be measured at the beginning and after six weeks for the two tested groups

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Functional disability
Time Frame: ODI score will be measured at the beginning and after six weeks for the two tested groups

Oswestry disability index (ODI) will be used for assessing pain related disability and quality of life
ODI score will be measured at the beginning and after six weeks for the two tested groups

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Cairo University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
December 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 1, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
March 1, 2028

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
October 30, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 30, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
November 4, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
November 4, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 30, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
October 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • P.T.REC/012/005650

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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