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NCT Number: NCT07176169

Effects of Innominate Rotation Correction Compared With Sacral Torsion Correction in Patients With Sacroiliac Joint Dysfunction

The purpose of this study is to evaluate the comparative effects of Innominate Rotation Correction and Sacral Torsion Correction using Muscle Energy Techniques (METs) in patients with Sacroiliac Joint Dysfunction (SIJD). A total of 50 participants will be recruited, aged 18-50 yrs, with confirmed SIJD based on atleast 3 positive provocation tests. Participants will be randomized into two equal groups. Group A (Innominate Rotation Correction) and Group B (Sacral Torsion Correction). Both groups will receive Conventional Therapy (Thermotherapy, Electrotherapy and Core stabilization exercises).

Study variables include:

* Independent Variable: Type of MET applied (Innominate vs Sacral Torsion) * Dependent Variables: Pain (measured by Visual Analog Scale), Functional Disability (assessed via Denver SIJ Disability Questionnaire) * Control Variables: Age, Gender, BMI, Baseline Pain/ Disability Scores

The intervention will last 4 weeks with 8 sessions (2 sessions per week). Assessments will be conducted at baseline (Week 1, Pre-treatment) and Post every second session. Data will be analyzed to compare immediate and short-term effects of the two interventions.

This study aims to provide evidence for targeted manual therapy approaches in SIJD, potentially guiding clinicians toward the most effective technique for pain reduction and functional improvement.

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Key information

Conditions

Sacroiliac Joint Dysfunction

Age range

18 year–50 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

This Randomized Controlled Trial aims to compare the effects of Innominate Rotation Correction versus Sacral Torsion Correction using Muscle Energy Techniques (METs) in patients with Sacroiliac Joint Dysfunction (SIJD).

A Total of 50 participants will be recruited and randomized equally into two groups.

  • Group A: Sacral Torsion Correction via METs
  • Group B: Innominate Rotation Correction via METs

Both groups will additionally receive conventional management (TENs, Heating, Core Stabilization Exercises).

INTERVENTION SCHEDULE:

  • Duration: 4 weeks
  • Frequency: 2 Sessions/week
  • Total Sessions: 8 Sessions per participant

Group A - Sacral Torsion Correction

  • Patient Position: Side lying - depending on the torsion type
  • Therapist applies downward force or guided contraction to correct torsion, with isometric contraction (3-5 sec hold), relaxation and then passive stretch.
  • Each correction repeated 3-5 times.

Group B - Innominate Rotation Correction

  • Patient Position: Supine
  • Therapist brings limb to restrictive barrier, patient performs isometric contraction (3-5 sec) against resistance, followed by relaxation and stretch to new barrier.
  • Each correction repeated 3-5 times.

ASSESSMENTS:

  • Conducted at Baseline (Pre-Intervention), after every 2nd session (progress monitoring), and post-intervention (end of week 4)
  • Outcomes: Pain Intensity (VAS), Functional Disability (Denver SIJD Questionnaire)

DATA ANALYSIS:

Intra-group comparisons (Pre vs Post) and Inter-group comparisons (Innominate Rotation vs Sacral Torsion) will be performed at the end of the 4-week intervention.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Dysfunction based on at least 3 of the following tests
  • Distraction Test
  • Compression Test
  • Gaenslen's Test
  • Thigh Thrust Test
  • Sacral Thrust Test
  • Presence of Pain in Buttock, Posterior Pelvis, or Lower Lumbar Region for more than 2 weeks
  • Confirmed Pelvic Asymmetry through Palpation (i.e., ASIS/PSIS Landmarks, Gillet's Test)

Exclusion criteria

  • • History of Lumbar or Pelvic Fracture, Recent Surgery, or Hip/Knee Pathology affecting Gait/Posture.
  • Pregnancy or Post-partum less than 6 months - due to Hormonal Laxity & Altered Biomechanics
  • Systemic Inflammatory conditions - Rheumatoid Arthritis, Ankylosing Spondylitis
  • Neurological Deficits - Cauda Equina Syndrome, Radiculopathy with Motor Loss
  • Ongoing Physiotherapy treatment for Low Back Pain in past 4 weeks
  • Inability/Contraindications to tolerate Manual Therapy - Osteoporosis
  • Leg Length Discrepancy - >1.5 cm or Structural Scoliosis
  • BMI > 35 (ASIA) - it may affect assessment validity due to obesity

Treatment and study plan

Muscle Energy Technique for Sacral torsion

Procedure

Conventional management including Electrotherapy by application of Thermotherapy or Cryotherapy, Transcutaneous Electrical Nerve Stimulation (TENS) for 20 minutes, Core-stabilization Exercises,

  • Clamshells
  • Four Point Kneeling
  • Bridging/Side Bridges
  • Bird-Dog Pose
  • Dead Bugs
  • Dynamic Core Stability (Unstable Surfaces) For Sacral Torsions, Six MET protocols address Forward and Backward torsions on Left and Right Oblique axis using patient generated force in Prone or Side-lying positions. Left-on-Left (LOL) Forward Torsion, Right -on-Right (ROR) Forward Torsion, Right-On-Left (ROL) Backward Torsion, Left-on-Right (LOR) Backward Torsion, Bilateral Sacral Nutation, Bilateral Sacral Counternutation

Muscle Energy Technique for Innominate rotation

Procedure

Conventional management including Electrotherapy by application of Thermotherapy or Cryotherapy, Transcutaneous Electrical Nerve Stimulation (TENS) for 20 minutes, Core-stabilization Exercises, • Clamshells • Four Point Kneeling • Bridging/Side Bridges • Bird-Dog Pose • Dead Bugs • Dynamic Core Stability (Unstable Surfaces). Anterior Innominate Rotation and Posterior Innominate Rotation.

Primary outcomes

  1. JOINT DISABILITY

    Time frame: Before and After 4 weeks.

    The Denver Sacroiliac Joint Disability Questionnaire (DSIJQ) comprises 10 items that assess various aspects of SIJ-related disability, including pain intensity, mobility, self-care, and social participation. Each item is scored on a 6-point Likert scale ranging from 0 to 5. (0 - No Disability; 5 - Unable to perform activity). To calculate the total percentage, the obtained score is divided by 50 and multiplied by 100 to calculate total percentage. Then it is compared with an Ordinal Scale grading, shown as follows:

    • 0-20% = Minimal Disability
    • 21-40% = Moderate Disability
    • 41-60% = Severe Disability
    • 61-80% = Crippled
    • 81-100% = Bed-bound or Exaggerating symptoms

  2. JOINT PAIN

    Time frame: Before Treatment and After 4 weeks

    The Visual Analog Scale (VAS) is a simple patient-reported measure of current Pain Intensity.

    Scoring - Patients mark their pain on a 10-cm horizontal line, anchored by "No Pain" (0-cm) and "Worst Possible Pain" (10-cm), and the distance between 0-cm to the Point of Pain perception is marked as the recorded score (in millimeters or centimeters). High Value means Severe Pain and vice versa.

Study contacts

Contact information is provided by the study sponsor or research team.

Muhammad Furqan Yaqoob, MS MSK-PT

CONTACT

[email protected]

+923465333101

Muhammad Shafay Ali, DPT

CONTACT

[email protected]

+923064259537

Sponsors and collaborators

Lead sponsor

Foundation University Islamabad

Other

Registry information

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Sep 16, 2025
Registry last updated
Jan 2, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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