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Sacroiliac joint as a potential source of low back pain is an overlooked problem. Yet, in the existing years there has been an increasing interest in sacroiliac joint as a pain originator and more attention is being paid into its assessment and treatment in the current literature. Muscle imbalance due to postural dysfunction involves mainly gluteus medius and hamstring; however the role of quadratus lumborum working on compensatory mechanism and its treatment effect in the management of sacroiliac joint dysfunction is yet not discovered.
Going through current literature, it is evident that sacroiliac joint dysfunction as a postural dysfunction is highly prevalent among adult population. This dysfunction due to major muscle imbalances if not treated timely can result in serious consequences later in life where it becomes the permanent dysfunction involving the major changes in the joint itself. Muscle imbalance due to postural dysfunction involves mainly gluteus medius and hamstring; however the role of quadratus lumborum working on compensatory mechanism and its treatment effect in the management of sacroiliac joint dysfunction is yet not discovered. All patients will be assessed and screened by consultants as indicated and will refer to physiotherapy with diagnosed non- specific chronic back pain.Patients will further be screened for SIJ dysfunction by physiotherapist.Only those patients who fulfill the criteria of Quadratus lumborum tightness & Gulteus medius weakness will randomly be selected and the sample of 70 will finally be selected for intervention.Written consent form will be taken from all study participants.Simple randomization technique will be used through "Randomization Main" software and randomization sheet will be generated. Patients will be further be assigned equally into two groups as per randomization sheet.Treatment will be performed three sessions per week for 4 weeks with postural advice and home exercise program with daily record of home diary. The selected outcome measures will be taken on initial visit (pre intervention), session 6 and final session 12 (post intervention).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental | Experimental | Following physiotherapy treatment will be given to the participants in this group for 4 weeks and each session last for 30 minutes. i. MET Quadratus lumborum ii. Ultrasound iii. Gluteus medius exercises iv. Hamstring stretch Posture advice and home exercise program |
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| Comparator | Active Comparator | Following physiotherapy treatment will be given to the participants in this group for 4 weeks and each session last for 30 minutes. i. Ultrasound ii.Gluteus medius exercises iii.Hamstring stretch |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| physiotherapy | Other |
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| Measure | Description | Time Frame |
|---|---|---|
| visual analog scale to measure the change in level of Pain intensity | A Visual Analogue ScalE is usually a horizontal line, 100 mm in length, anchored by word descriptors at each end ranging from no pain to severe pain. | Total duration of treatment is 4 weeks and 12 sessions, 3 sessions per week on alternate days. Patients will be assessed at baseline, at 6th session at the end of 2nd week and 12th session at the end of 4th week. |
| Oswestry Disability Index to measure change in level of disability | Change in level of disability as evaluated by means of Oswestry Disability Index 2.0 (ODI) | Total duration of treatment is 4 weeks and 12 sessions, 3 sessions per week on alternate days. Patients will be assessed at baseline, at 6th session at the end of 2nd week and 12th session at the end of 4th week. |
| SF-36 QUALITY OF LIFE to measure change in general health | SF-36 measure 8 different health concepts including general health, physical functioning, role functioning, bodily pain, mental health, emotional functioning, vitality, and social functioning. | Total duration of treatment is 4 weeks and 12 sessions, 3 sessions per week on alternate days. Patients will be assessed at baseline and 12th session at the end of 4th week. |
| Measure | Description | Time Frame |
|---|---|---|
| Hand Held Dynamometer to check gluteus medius muscle strength | The strength of the gluteus medius muscle was assessed on the dominant side using the Microfet2 hand-held dynamometer (MicroFET 2, Hoogan Health Industries, West Jordan, UT, USA). | Total duration of treatment is 4 weeks and 12 sessions, 3 sessions per week on alternate days. Patients will be assessed at baseline, at 6th session at the end of 2nd week and 12th session at the end of 4th week. |
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Inclusion Criteria:
• Subjects with unilateral non-specific LBP
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Rabail Soomro | University of Lahore | Principal Investigator |
| Hussain Kari mi | University of Lahore | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institute of physical medicine and rehabilitation, Dow University of health sciences | Karachi | Sindh | 74200 | Pakistan |
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| ID | Term |
|---|---|
| D026741 | Physical Therapy Modalities |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D012046 | Rehabilitation |
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Double blinding will be used as the subjects and the assessor both will be blinded for the treatment used.
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