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Effect of Retro Walking in Patients With Sacroiliac Joint Dysfunction

30. oktober 2026 opdateret af: 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?

Studieoversigt

Detaljeret beskrivelse

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.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

40

Fase

  • Ikke anvendelig

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

20 år til 40 år (Voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Kvinde

Beskrivelse

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.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: 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.

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

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.

Aktiv komparator: 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.

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

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.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Isokinetic peak torque of lower limb muscles
Tidsramme: 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
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Functional disability
Tidsramme: 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

Samarbejdspartnere og efterforskere

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Datoer for undersøgelser

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Studer store datoer

Studiestart (Anslået)

1. december 2026

Primær færdiggørelse (Anslået)

1. december 2027

Studieafslutning (Anslået)

1. marts 2028

Datoer for studieregistrering

Først indsendt

30. oktober 2026

Først indsendt, der opfyldte QC-kriterier

30. oktober 2026

Først opslået (Faktiske)

4. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

4. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

30. oktober 2026

Sidst verificeret

1. oktober 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • P.T.REC/012/005650

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