Comparison of the Effectiveness of Mobilization and Myofascial Release Techniques in Patients With Sacroiliac Joint Dysfunction
Comparison of the Effectiveness of Mobilization and Myofascial Release Techniques on Pain, Postural Control, and Spinal Mobility in Patients With Sacroiliac Joint Dysfunction
Kirsehir Ahi Evran Universitesi
42 participants
Jan 19, 2026
INTERVENTIONAL
Conditions
Summary
Sacroiliac joint dysfunction (SIED) is one of the major causes of chronic mechanical low back pain and is associated with pain, postural control impairment, and functional limitations. While manual therapy approaches are commonly used in the treatment of sacroiliac joint pain, evidence regarding the clinical superiority of different manual techniques is limited. This study was designed as a prospective, randomized controlled trial to compare the effects of myofascial release techniques and sacroiliac joint mobilizations, applied in addition to a traditional physical therapy program, on pain intensity, spinal mobility, postural control, and functional status in women diagnosed with sacroiliac joint dysfunction. The study plans to include female individuals aged 18-65 years with a Visual Analog Scale (VAS) score ≥3 who have been diagnosed with sacroiliac joint dysfunction according to international diagnostic criteria. Participants will be randomly assigned to two groups: one group will receive traditional treatment combined with myofascial release techniques, while the other group will receive traditional treatment combined with sacroiliac joint mobilizations. Interventions will be performed three days per week for six weeks. Primary and secondary outcome measures will include pain intensity (VAS), postural control (Biodex Balance System), spinal mobility, and postural endurance (Spinal Mouse) assessments. Participants will be randomly assigned to two groups: one group will receive traditional treatment combined with myofascial release techniques, while the other group will receive traditional treatment combined with sacroiliac joint mobilizations. Interventions will be performed three days a week for six weeks. Primary and secondary outcome measures will include pain intensity (VAS), postural control (Biodex Balance System), spinal mobility, and postural endurance (Spinal Mouse) assessments. All assessments will be conducted before treatment and at the end of the six-week intervention period. This study aims to provide clinical evidence regarding the comparative effectiveness of manual therapy approaches in the conservative treatment of sacroiliac joint dysfunction and to contribute to clinical decision-making processes.
Eligibility
Inclusion Criteria6
- Being a female individual between the ages of 18 and 65.
- Having been diagnosed with sacroiliac joint dysfunction (according to the International Association for the Study of Pain criteria).
- Having localized pain in the sacroiliac joint region and pain that may radiate to the hip, groin, or lower extremities.
- Positivity in at least 3 out of 5 sacroiliac joint-specific provocation tests (Vorlauf, Gillet, irritation point positivity, posterior shear test, compression test).
- Pain intensity of ≥3 as assessed by the Visual Analog Scale (VAS).
- Volunteering to participate in the study and providing written informed consent.
Exclusion Criteria6
- History of surgery involving the spine, pelvis, or lower extremities.
- Presence of lumbar disc herniation, spinal stenosis, or acute pathologies of the hip joint.
- Diagnosis of piriformis syndrome or low back/hip pain originating from sources other than the sacroiliac joint.
- Known central or peripheral nervous system disease or progressive neurological deficit.
- History of rheumatological disease (rheumatoid arthritis, ankylosing spondylitis, etc.).
- Pregnancy or the presence of a serious systemic disease that could prevent participation in the study.
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Interventions
Bridge exercises, back extension exercises, and sit-up exercises as strengthening exercises. These exercises will be preferred to strengthen the abdominal and back muscles. Ultrasound will be applied to the sacroiliac region in the prone position. The practitioner will rotate the ultrasound head in a circular motion at a 90-degree angle to apply ultrasound to the right and left sacroiliac joints. A 4 cm wide probe will be used to apply continuous ultrasound at 1 MHz and 1.5 watts/cm2 for 8 minutes.
The myofascial release time for each muscle was 90 to 120 seconds, applied twice per session. 1. Myofascial release of the erector spinae muscles: the patient assumed a prone position; and the therapist stood at the patient's pelvis level on the treatment side, applying the cross-hand technique. 2. To increase muscle tension, the patient's lower extremity was placed in hip flexion and adduction at the highest point. The therapist stood behind the patient, at the level of the patient's pelvis, and applied the transverse tapping technique using the knuckles. 4. Myofascial release of the gluteus medius muscle: The patient assumed a lateral recumbent position on the untreated side. The therapist stood behind the patient, at the level of the patient's pelvis, and applied the vertical tapping technique using the knuckles.
Patients lay on their side with the sacroiliac joint restricted at the top, and sacroiliac manipulation was performed. Then, the physiotherapist flexed the lumbar spine by moving toward the upper part of the thigh, applying an impulse using the intermittent stretching technique in the direction of the major thoracanthus from the iliac crest. In the prone position, caudal traction, traction of the sacrum relative to the ilium, and traction stretches from the iliac crests will be applied.
Locations(1)
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NCT07310368