Effect of Retro Walking in Patients With Sacroiliac Joint Dysfunction
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?
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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.
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Critérios de elegibilidade
Idades elegíveis para estudo
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Descrição
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.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Solteiro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
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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. |
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. |
|
Comparador Ativo: 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. |
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Isokinetic peak torque of lower limb muscles
Prazo: The isokinetic peak torques of the four tested muscles will be measured at the beginning and after six weeks for the two tested groups
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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
|
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Pain intensity
Prazo: VAS pain score will be measured at the beginning and after six weeks for the two tested groups
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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
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Functional disability
Prazo: ODI score will be measured at the beginning and after six weeks for the two tested groups
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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
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Colaboradores e Investigadores
Patrocinador
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Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
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Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
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Atualizações de registro de estudo
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Mais Informações
Termos relacionados a este estudo
Outros números de identificação do estudo
- P.T.REC/012/005650
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