Ignite Creation Date:
2024-10-25 @ 8:04 PM
Last Modification Date:
2024-10-26 @ 3:43 PM
Study NCT ID:
NCT06656195
Status:
RECRUITING
Last Update Posted:
None
First Post:
2024-10-23
Brief Title:
Comparison of Gluteus Maximus Strengthening and Hamstring Flexibility in Sacroiliac Joint Dysfinction
Sponsor:
None
Organization:
None
Study Overview
Official Title:
Comparison of Effect of Gluteus Maximus Strengthening and Hamstring Flexibility in Patients With Sacroiliac Joint
Status:
RECRUITING
Status Verified Date:
2024-10
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
No
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The aim of this research is to compare effect of strengthening of gluteus maximus and hamstring flexibility on hamstring tightness in sacroiliac joint dysfunction
Detailed Description:
The sacroiliac joints SIJ are the largest diarthrodial auricular shape axial joints in the human body that connect the iliac bones to the sacrum SIJ dysfunction is mostly caused by abnormal motion and misalignment of the joint Worldwide the prevalence of sacroiliac joint dysfunction SIJD lies within a range of 13 to 30In approximately 10 to 25 of patients SIJD is a cause of mechanical low back and leg pain Hamstrings muscle tightness is one of the major problems associated with SIJ dysfunction Over- activation of the hip flexors and inhibition of the gluteus maximus are common in the hamstring tendinopathy patient population With decreased gluteal activation the hamstrings are dominant for hip extension and can lead to a repetitive stress on the fibers which would lead to its tendinopathy GM contraction produces compression of the SI joint and also contributes to the force transmission mechanism from the lower extremity to the pelvis through the SI joint during functional activities such as ambulation Inappropriate timing of GM activation during gait is thought to be one of the causes of SIJ dysfunction because it decreases shock absorption mechanism at the sacroiliac joint Earlier onset of hamstrings activation has been noted in patients with SIJ dysfunction as compensation for delayed firing of the GM Weakness of the GM also leads to slouched posture makes walking extremely difficult and necessitates substitution by hamstrings Therefore neuromuscular specific GM strengthening exercises reduce the forces going directly through the hamstring muscle and tendon and therefore protects it Jennifer Saunders et al provides a linkage between mechanical dysfunction of the sacroiliac joint and alterations in muscle function around the pelvis which has the potential to lead to recurrent injuries of the hamstring muscles Any injury that leads to abnormal movement of the sacroiliac joint can alter the information sent from mechanoreceptors receptors at the articular surface and this may explain the pattern of inhibition of the transversus abdominis multifidus and ipsilateral gluteus maximus which is commonly reported with SIJ dysfunction There is some evidence that hamstring spasm may accompany the dysfunction in a reflex attempt to stiffen the joint force closure
Conditions
Conditions SIJ dysfunction
Keywords hamstring tightness strengthening of gluteus maximus SIJ dysfunction Study Design Study Type Interventional
Primary Purpose Treatment
Study Phase NA
Interventional Study Model NA
Allocation Randomize Enrollment 44 Actual
Intervention After obtaining informed consent from participants demographics will be recorded Screening will be performed to assess health status Participants will be educated about the procedure and significance of the test Patients fulfilling the inclusion criteria will be randomized into 2 groups ie Group A Group B and with the help of sealed envelope method Patients in Group A will receive strength of Gluteus maximus Group B will receive hamstring flexibility exercises
Group A Group B Week 1 2
SIJ Mobilization
Week 1
Single leg bridge
alternating leg lifts
clam Exercise
Prone hip extension with knee flexion Week 2
Side-squats
Star excursion exercise
Forward step-down
TENS
SIJ mobilization
Soft tissue mobilization 17
Static Hamstrings stretching 3 sets 15 repetitions with a holding time of 15 seconds 3 times a week for 4 week
Dynamic hamstrings stretching 3 set 15 repetitions with a holding time of 1 second 3 times a week for 4 weeks 18
Week 3 and 4 SIJ Mobilization
Week 3
bilateral squat
single leg squat
split squatlunge
frontal step up
lateral step up
Week 4
bilateral squat with a band
hip extension against resistance
Three times a week for 4 weeks In each session a total of two sets of 12 repetitions each were carried out with a 1 min rest time between sets 16
Outcome Measures
Active knee extension test The patient is positioned supine with the hip flexed 90 degrees either actively or passively The knee is then actively extended from a starting position of 90-degree flexion toward full extension The test is positive for hamstring tightness if the angle of knee extension is greater than 20 degrees
Dynamometer It is a small device that the examiner holds against the patients limb as the patient exerts a maximal force Dynamometers measure the amount of force and shows on its screen
NPRS The NPRS is frequently employed to measure pain intensity in which patients are asked to select a number from 0 to 10 to represent their pain severity
Cluster of Laslett for Sacroiliac joint assessment
The Cluster of Laslett is a tool used in SI joint assessment Laslett proposes an algorithm comprising 4 provocative tests to identify the SI joint as the source of pain as the other two tests didnt have additional diagnostic value
Denver SI Joint Questionnaire Denver SI Joint Questionnaire is a brief 10-question survey that assesses the impact of pain on daily life activities such as sitting walking getting up from chair walking up and down the stairs getting in and out of car bending at the waist kneeling or squatting lifting sleeping work recreation social life sex life or familyhome activities Joint Stability For each question there is a possible 5 points Total score is calculated as total scored50 X 100 Scores range from 0-100 with higher scores representing more disability
Eligibility
Inclusion Criteria
Both genders
Patient with pain over the posterior aspect of SI joint
Age between 25-45 years
Positive Active knee extension test angle of knee extension greater than 20 degrees
Two of four test of Laslett cluster of Sacro-iliac dysfunction is positive
Exclusion Criteria
Herniated disc
Skin infection
Any contraindications for affected lower limb exercises eg venous thrombosis lymphedema
Patients with any post operative history of Hip joint fracture subluxation dislocation diabetes arthritis
Conditions
Conditions SIJ dysfunction
Keywords hamstring tightness strengthening of gluteus maximus SIJ dysfunction Study Design Study Type Interventional
Primary Purpose Treatment
Study Phase NA
Interventional Study Model NA
Allocation Randomize Enrollment 44 Actual
Intervention After obtaining informed consent from participants demographics will be recorded Screening will be performed to assess health status Participants will be educated about the procedure and significance of the test Patients fulfilling the inclusion criteria will be randomized into 2 groups ie Group A Group B and with the help of sealed envelope method Patients in Group A will receive strength of Gluteus maximus Group B will receive hamstring flexibility exercises
Group A Group B Week 1 2
SIJ Mobilization
Week 1
Single leg bridge
alternating leg lifts
clam Exercise
Prone hip extension with knee flexion Week 2
Side-squats
Star excursion exercise
Forward step-down
TENS
SIJ mobilization
Soft tissue mobilization 17
Static Hamstrings stretching 3 sets 15 repetitions with a holding time of 15 seconds 3 times a week for 4 week
Dynamic hamstrings stretching 3 set 15 repetitions with a holding time of 1 second 3 times a week for 4 weeks 18
Week 3 and 4 SIJ Mobilization
Week 3
bilateral squat
single leg squat
split squatlunge
frontal step up
lateral step up
Week 4
bilateral squat with a band
hip extension against resistance
Three times a week for 4 weeks In each session a total of two sets of 12 repetitions each were carried out with a 1 min rest time between sets 16
Outcome Measures
Active knee extension test The patient is positioned supine with the hip flexed 90 degrees either actively or passively The knee is then actively extended from a starting position of 90-degree flexion toward full extension The test is positive for hamstring tightness if the angle of knee extension is greater than 20 degrees
Dynamometer It is a small device that the examiner holds against the patients limb as the patient exerts a maximal force Dynamometers measure the amount of force and shows on its screen
NPRS The NPRS is frequently employed to measure pain intensity in which patients are asked to select a number from 0 to 10 to represent their pain severity
Cluster of Laslett for Sacroiliac joint assessment
The Cluster of Laslett is a tool used in SI joint assessment Laslett proposes an algorithm comprising 4 provocative tests to identify the SI joint as the source of pain as the other two tests didnt have additional diagnostic value
Denver SI Joint Questionnaire Denver SI Joint Questionnaire is a brief 10-question survey that assesses the impact of pain on daily life activities such as sitting walking getting up from chair walking up and down the stairs getting in and out of car bending at the waist kneeling or squatting lifting sleeping work recreation social life sex life or familyhome activities Joint Stability For each question there is a possible 5 points Total score is calculated as total scored50 X 100 Scores range from 0-100 with higher scores representing more disability
Eligibility
Inclusion Criteria
Both genders
Patient with pain over the posterior aspect of SI joint
Age between 25-45 years
Positive Active knee extension test angle of knee extension greater than 20 degrees
Two of four test of Laslett cluster of Sacro-iliac dysfunction is positive
Exclusion Criteria
Herniated disc
Skin infection
Any contraindications for affected lower limb exercises eg venous thrombosis lymphedema
Patients with any post operative history of Hip joint fracture subluxation dislocation diabetes arthritis
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None