The goal of this clinical trial is to evaluate the effectiveness of the Kinetic control on pain, endurance, Gait and postural stability in patients suffering from chronic sacroiliac joint dysfunction.

The main question it aims to answer is:

• Does kinetic control training work on pain in SIJ dysfunction?
• Does kinetic control therapy work on functional outcomes, including gait metrics, postural sway, and lumbar endurance?

The treatment arm will receive the Kinetic control training, and the comparison arm will undergo standard physical therapy care. Participants will be asked to perform movement control exercises based on the principle of kinetic control training core muscles and hip muscles after routine physical therapy. The participants in the control/comparison group will only receive routine physical therapy that includes a heating pad, TENS, joint mobilizations, and stretching and strengthening exercises.

The sacroiliac joint connects the lower part of the spine (sacrum) to the pelvic bones (ilium) and helps transfer body weight between the upper body and legs. It plays an important role in providing stability while allowing limited movement during walking or bending.

Sacroiliac joint dysfunction (SIJD) occurs when the joint becomes inflamed, stiff, or moves abnormally. This may cause pain in the lower back, buttocks, or thighs, sometimes spreading to the groin or legs. People with SIJD often experience difficulty standing for long periods, walking, or bending. The condition is commonly mistaken for lumbar spine or hip problems because of overlapping symptoms. Research shows that 15-30% of people with long-term lower back pain may actually have SIJ dysfunction, but many cases go undiagnosed due to the absence of a single definitive test.

Kinetic control is a movement-based physiotherapy method that focuses on retraining how muscles coordinate to stabilize and move joints. It aims to correct poor movement control, improve muscle endurance, and restore healthy patterns of motion, particularly in the core and hip muscles. By improving control and alignment, kinetic control training may reduce pain and enhance posture, walking ability, and overall function.

In this 8-week randomized controlled trial, participants with chronic SIJ dysfunction will be assigned to one of two groups. The intervention group will receive kinetic control-based exercises in addition to routine physiotherapy, while the control group will receive standard physiotherapy treatments such as heat therapy, TENS, joint mobilizations, stretching, and strengthening exercises.

Assessments will be conducted at the beginning, after 4 weeks, and after 8 weeks, measuring pain, balance, gait, and lumbar muscle endurance using validated tools. The study aims to determine whether kinetic control provides greater improvements in pain relief, postural control, walking performance, and endurance compared to routine care in individuals with chronic sacroiliac joint dysfunction.

Inclusion Criteria:

• Symptoms of sacroiliac joint dysfunction lasting more than 2 months
• Male and female participants aged 20-60 years
• Positive lumbopelvic motor control tests
• Pain intensity of ≥4 on a 0-10 Numeric pain rating scale (NPRS)
• Positive results in three or more of the following provocative tests: FABER test, Distraction test, Thigh Thrust test, Gaenslen test, or Sacral Thrust test
• Diagnosis consistent with International Association for the Study of Pain (IASP) criteria, indicating pain localized to the sacroiliac joint region (hips/groins or radiating to the lower extremity)

Exclusion Criteria:

• History of malignancy
• Neurological disease affecting the central nervous system (e.g., multiple sclerosis, dementia)
• Rheumatic disease (e.g., fibromyalgia, ankylosing spondylitis, rheumatoid arthritis)
• Disc herniation or lumbar radiculopathy due to systemic disease
• Spinal surgery within the last 12 months
• Pregnancy
• Signs or symptoms of lumbar nerve root pathology identified during neurological examination