Gluteus Maximus Versus Gluteus Medius Strength On Back Muscles Performance In Patients With Sacroiliac Dysfunction

This study will be conducted to compare between the effect of glutes maximus and glutes medius muscles strength on back muscle performance in patients with Sacroiliac joint dysfunction.

Study Overview

• Status: Not yet recruiting
• Conditions: Sacroiliac Joint Dysfunction
• Intervention / Treatment: Other: Glutes maximus strength protocol; Other: Corrective Exercises; Device: Ultrasound; Other: Gluteus medius strength program

Detailed Description

The purposes of this study are:

1. To investigate the effect of Gluteus maximus strengthening exercises and Gluteus medius strengthening exercises on back pain in patient with Sacroiliac joint dysfunction
2. To investigate the effect of Gluteus maximus strengthening exercises and Gluteus medius strengthening exercises on back muscle performance in patients with Sacroiliac joint dysfunction
3. To investigate the effects of Gluteus maximus strengthening exercises and Gluteus medius strengthening exercises on function in patient with Sacroiliac joint Dysfunction

• Study Type: Interventional
• Enrollment (Anticipated): 60
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Reham Abd El-Moneim; Phone Number: +201006722789; Email: Rehamgomma.88@gmail.com

Study Locations

• Egypt
  • Dokki, Egypt
    • Outpatient clinic faculty of physica therapy cairo university

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Age from 25-40 years.
• Patients with chronic lumbopelvic pain (more than 12 weeks) and clinical test positive for SIJD.
• The pain distribution and tenderness on palpation under the posterior superior iliac spine (PSIS) are reliable signs that the SIJ is the source of pain.
• Complaint of unilateral pain rather than bilateral pain is also considered more likely to be coming from an SIJ.
• Patients willing and able to participate in an exercise program safely and without cognitive impairments that would limit their participation.

Exclusion Criteria:

• Neurological disorder, psychosomatic disorder
• Tumor.
• Infection condition.
• Recent surgeries.
• Pregnancy.
• Back pain referred from organic cause.
• Osteoporosis and bone disease (induced or idiopathic).

Study Plan

How is the study designed?

Design Details

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

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Glutes maximus Strengthening group; Twenty patients received Strengthening exercises for Glutes maximus muscle and conventional physical therapy (corrective exercises and ultrasound).	Other: Glutes maximus strength protocol; The subjects attended physical therapy two times. Per week for a total of 10 visits. Each session lasted approximately 30 minutes. In the first five sessions, subjects performed the following exercises to strengthen the gluteus maximus: bilateral bridge, unilateral bridge, and non-weight-bearing hip extension in prone with the knee flexed at 90 degrees. In the next five sessions, abduction and external rotation in a quadruped ("fire hydrant" exercise) and weight-bearing hip extension (known as "deadlift" exercise) were added. Each exercise was performed for 10 repetitions. Elastic resistance was added to the fire hydrant, hip extension in prone and dead lift exercises to allow each subject to perform at a 10-repetition maximum. The resistance for each subject was adjusted weekly as needed. The exercise program was performed under direct supervision only during the physical therapy sessions.; Other: Corrective Exercises; The following low back corrective exercises were given: To stretch the tight lower back muscles: Seated Forward Bend and Full Squat held for 5 sec and Repeated for 3 times, once a day. To strengthen the weak lower abdomen: Draw in and Reverse Crunch 3 seconds, repeated 5 times, once a day. To stretch the tight hip flexors: held for 10-15 seconds repeated 5 times on both legs, once a day. To stretch the tight quadriceps: held for 3 seconds, repeated 5 times on each side, once a day. To strengthen weak hamstrings: Kick Butts 2 sec, repeated 8 times, once a day.; Device: Ultrasound; US was administered in continuous mode at PSIS with patient in prone lying position, with a frequency of 1 MHz and intensity of 0.8 W/cm2 for 5 minutes every alternating day
Experimental: Glutes Medius Strengthening group; Twenty patients received Strengthening exercises for Glutes medius muscle and conventional physical therapy (corrective Exercises and therapeutic ultrasound (US).	Other: Corrective Exercises; The following low back corrective exercises were given: To stretch the tight lower back muscles: Seated Forward Bend and Full Squat held for 5 sec and Repeated for 3 times, once a day. To strengthen the weak lower abdomen: Draw in and Reverse Crunch 3 seconds, repeated 5 times, once a day. To stretch the tight hip flexors: held for 10-15 seconds repeated 5 times on both legs, once a day. To stretch the tight quadriceps: held for 3 seconds, repeated 5 times on each side, once a day. To strengthen weak hamstrings: Kick Butts 2 sec, repeated 8 times, once a day.; Device: Ultrasound; US was administered in continuous mode at PSIS with patient in prone lying position, with a frequency of 1 MHz and intensity of 0.8 W/cm2 for 5 minutes every alternating day; Other: Gluteus medius strength program; Strengthening exercises for Gluteus Medius subdivisions: The anterior GMED exercise: side lying abduction exercise The middle GMED exercise: wall press Exercise The posterior GMED exercise: was the pelvic drop exercise
Active Comparator: Conventional treatment group; Twenty Patients received conventional therapy (corrective exercises and ultrasound).	Other: Corrective Exercises; The following low back corrective exercises were given: To stretch the tight lower back muscles: Seated Forward Bend and Full Squat held for 5 sec and Repeated for 3 times, once a day. To strengthen the weak lower abdomen: Draw in and Reverse Crunch 3 seconds, repeated 5 times, once a day. To stretch the tight hip flexors: held for 10-15 seconds repeated 5 times on both legs, once a day. To stretch the tight quadriceps: held for 3 seconds, repeated 5 times on each side, once a day. To strengthen weak hamstrings: Kick Butts 2 sec, repeated 8 times, once a day.; Device: Ultrasound; US was administered in continuous mode at PSIS with patient in prone lying position, with a frequency of 1 MHz and intensity of 0.8 W/cm2 for 5 minutes every alternating day

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessing the change in the peak torque of back muscles	By using isokinetic dynamometer, and the unit of of measurement will be (Kg).	at baseline and after 5 weeks of intervention
Assessing the change in pain threshold	by using Traditional pressure algometers are ideal for measuring pressure pain threshold (PPTs) of superficial muscles and bony landmarks. Pressure pain threshold has been defined as the lowest stimulus intensity at which a subject perceives mechanical pain	at baseline and after 5 weeks of intervention
Assessing the change in Functional ability level	By using Modified Oswestry Disability Questionnaire (MODQ). The Oswestry Low Back Pain Disability Questionnaire Arabic version will be used to measure disability caused by low back pain in the general population. It consists of 10 questions each consisting of six alternatives. Every question is scored from 0-5 and a percentage are formulated as a result of the sum of the scores.	at baseline and after 5 weeks of intervention
Assessing the change in pain intensity	By using visual analogue scale (VAS). This scale will be used to measure the intensity of pain. It has been graded as a 10-cm line, which was used for measuring the intensity of perceived pain. In this scale, zero represents the absence of pain, 1-3 shows mild pain, 4-6 denotes moderate pain, and 7-10 indicates severe pain	at baseline and after 5 weeks of intervention

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Principal Investigator: Reham Abd El-Moneim, Cairo University

Study record dates

Study Major Dates

• Study Start (Anticipated): April 10, 2023
• Primary Completion (Anticipated): June 15, 2023
• Study Completion (Anticipated): August 15, 2023

Study Registration Dates

• First Submitted: March 17, 2023
• First Submitted That Met QC Criteria: March 30, 2023
• First Posted (Actual): April 12, 2023

Study Record Updates

• Last Update Posted (Actual): April 12, 2023
• Last Update Submitted That Met QC Criteria: March 30, 2023
• Last Verified: March 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Joint Diseases
• Other Study ID Numbers: Reham_Gomma_PhD

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No