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

Not yet recruiting

Conditions

Intervention / Treatment

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

Interventional

Enrollment (Estimated)

40

Phase

  • 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

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
Intervention / Treatment
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

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

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

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)

December 1, 2026

Primary Completion (Estimated)

December 1, 2027

Study Completion (Estimated)

March 1, 2028

Study Registration Dates

First Submitted

October 30, 2026

First Submitted That Met QC Criteria

October 30, 2026

First Posted (Actual)

November 4, 2026

Study Record Updates

Last Update Posted (Actual)

November 4, 2026

Last Update Submitted That Met QC Criteria

October 30, 2026

Last Verified

October 1, 2026

More Information

Terms related to this study

Other Study ID 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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