Sacral TorsionNCT07329426
Effects of Muscle Energy Technique Combined With Mobilization in Patients With Sacral Torsion
A study testing Muscle Energy Technique + Maitland Mobilization and Maitland Mobilization in people with Sacral Torsion, run by Foundation University Islamabad at 1 site in Pakistan.
Trial summary
Project Summary Low Back Pain is one of the most prevalent musculoskeletal conditions worldwide. More than 70% of the people experience low back pain at some time in their life. The sacroiliac joint has been found to be the source of pain in 30% of mechanical low back pain sufferers. Read more about this study
- Who is it for?
- Ages 22 to 44 years
- Conditions the study is for
- Sacral Torsion
- What is being tested?
- Muscle Energy Technique + Maitland Mobilization and Maitland Mobilization
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 46 participants
- Where
- 1 sitePakistan
- Study dates
- 15 Jan 2025to 15 Jan 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 22 to 44 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age between 22- 44 years (18)
- Both males and females
- Clinically diagnosed sacral torsion. (Annexure E)
- Patients with pain intensity of at least 5 on NPRS
- Positive standing flexion test
- Positive seated flexion test
- Positive Gillet test
- Uneven anatomical landmarks (Sacral Sulcus, Inferior Lateral Angle, Lumbar Lordosis, Lumbar scoliosis, L5 position)
Who cannot join
- 1. Neurological deficits (hemiparesis, paralysis) 2. Pregnancy 3. Spinal surgery of any kind 4. Antero-Retro Spondylolisthesis diagnosed through radiological findings 5. Degenerative disc disease diagnosed through radiological findings 6. Spinal stenosis 7. Infection, tumors, osteoporosis, spinal fracture
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site, 1 recruiting
- Recruiting
Foundation University Islamabad
Islamabad, Punjab Province, 46000
Hafiza Noor ul Huda, DPT, 03245475950, hafiza.huda94@gmail.com
About this study
Project Summary Low Back Pain is one of the most prevalent musculoskeletal conditions worldwide. More than 70% of the people experience low back pain at some time in their life. The sacroiliac joint has been found to be the source of pain in 30% of mechanical low back pain sufferers. Sacral torsion is one of the types of SIJ dysfunction. This randomized controlled trial, conducted at Fauji Foundation Hospital and Foundation University College of Physical Therapy will assess the effects of combining muscle energy technique with mobilization on pain, lumbar range of motion, disability and active straight leg raise. Participants will be randomly assigned to either mobilization alone or mobilization with muscle energy technique, performed three times per week for two weeks. Data will be collected at baseline and at end of study (week 2) using the Numeric pain rating scale, goniometer, inclinometer and oswestry disability index. This study addresses a research gap by exploring combined effects of muscle energy technique (PFS) and Maitland mobilization for sacral torsion in improving pain, lumbar mobility, disability and active straight leg raise.
Read the detailed description
Low back pain (LBP) is one of the most common musculoskeletal conditions globally, with over 70% of individuals experiencing it at some point in their lifetime. It is the leading cause of disability worldwide and remains the primary global contributor to years lived with disability. A significant source of mechanical low back pain is the sacroiliac joint (SIJ), which accounts for 15% to 30% of cases, making it a key area of interest in both diagnosis and treatment.
SIJ dysfunction typically presents with localized pain and stiffness and can be difficult to differentiate from other causes of LBP such as lumbar spine or hip pathology. The dysfunction usually results from abnormal joint motion or malalignment, often linked to repetitive stress or minor subluxation that damages the joint capsule or posterior ligamentous structures. SIJ dysfunction can be categorized into five main types: anterior rotation, posterior rotation, up slip, down slip, and sacral torsions.
Sacral torsions are a specific type of SIJ dysfunction involving asymmetrical movement of the sacrum along a physiologic oblique axis, leading to joint fixation. These torsions are commonly described in osteopathic literature and include four types: Left-on-Left, Right-on-Right (forward torsions), and Right-on-Left, Left-on-Right (backward torsions). Such dysfunctions are frequently associated with asymmetries in lumbo-pelvic rhythm, leg length discrepancies, scoliosis, and muscular imbalances, particularly involving the hamstrings, piriformis, and quadratus lumborum. These biomechanical and muscular irregularities contribute to pelvic asymmetry during functional movements like forward flexion.
Muscle imbalances play a crucial role in the development and persistence of SIJ dysfunction. These may arise from adaptive responses or underlying biomechanical issues, leading to altered motor control and impaired movement quality. Balance in muscle strength and length, especially between corresponding groups on the left and right sides, is essential for maintaining proper pelvic alignment. Studies such as Jacobs et al. (2005) have shown significant asymmetries in hip abductor strength, highlighting the importance of bilateral symmetry in functional movement.
Conservative management of chronic SIJ dysfunction commonly includes physical therapy, manual therapy, activity modification, and pharmacological interventions such as analgesics and anti-inflammatory medications. Among manual therapy techniques, Muscle Energy Technique (MET) is widely used to address muscle imbalances by utilizing voluntary isometric contractions to engage autogenic or reciprocal inhibition mechanisms. This process activates the Golgi tendon organs, reducing muscle tension and facilitating improved joint mobility. A variation of MET, known as Post-Facilitation Stretch (PFS), involves a maximal isometric contraction followed by a rapid stretch, and has been shown to effectively increase flexibility and range of motion.
- Conditions
- Sacral Torsion
- Being tested
- Muscle Energy Technique + Maitland Mobilization, Maitland Mobilization
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Muscle Energy Technique + Maitland MobilizationProcedure or surgery
Group A will receive Muscle energy technique with Maitland mobilization. Treatment protocol given to both groups will be carried out for 3 sessions per week for 2 weeks.
Post Facilitation Muscle Energy Technique. WEEK 1:
- Hot pack (10 minutes)
- Post-Facilitation MET for piriformis, Quadratus Lumborum and Hamstrings.
WEEK 2:
- Hot pack (10 minutes)
- Post-Facilitation MET for piriformis, Quadratus Lumborum and Hamstrings.
Maitland MobilizationProcedure or surgery
Group B will not receive any form of Muscle Energy Technique (MET). Instead, the intervention will consist exclusively of a joint mobilization technique directed at Sacrum.
| Study group | Role | What they receive |
|---|---|---|
| Maitland Mobilization With Muscle Energy Technique (PFS) | Experimental | Participants in this group will receive Maitland mobilization technique, two sets of 60 oscillations for 30 seconds, directed at sacrum according to standard graded oscillatory movements, grade 1 or 2 in week 1 and grade 3 or 4 in week 2. Muscle Energy Technique (MET) will also be applied to this group targeting specific muscles contributing to sacral torsion (e.g., piriformis, hamstrings, quadratus lumborum), with the purpose of correcting asymmetry, improving joint alignment, and enhancing the overall effectiveness of mobilization. The contract time will be 6-10 seconds and Hold time will be 15 seconds. Receives: Procedure: Muscle Energy Technique + Maitland Mobilization |
| Maitland Mobilization | Experimental | Participants in this group will receive Maitland mobilization technique, two sets of 60 oscillations for 30 seconds, directed at the sacrum. Mobilization will be applied according to the standard graded oscillatory movements grade 1 or 2 in week 1 and grade 3 or 4 in week 2, aiming to restore joint mobility, reduce pain, and improve function. No additional interventions will be provided. Receives: Procedure: Maitland Mobilization |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain intensity
n=Numeric Pain Rating Scale (NPRS) will be used, 0 means no pain and 10 means worst pain.
Measured: 2 weeks
Functional Disability
Oswestry Disability Index
Measured: 2 weeks
Lumbar Mobility
Inclinometer will be used for checking the lumbar mobility
Measured: 2 weeks
Active Straight Leg Raise
Goniometer will measure Active Straight Leg Raise
Measured: 2 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Jan 2026
- Study start15 Jan 2025
- Primary completion30 Dec 2025 (estimated)
- Study completion15 Jan 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Sacral TorsionStudies of the same condition, open and under way.
- More trials run by Foundation University IslamabadThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 46 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Foundation University Islamabad
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07329426
- Sponsor's protocol ID
- FUI/CTR/2025/24
- Status last verified
- Dec 2025
- First submitted
- 29 Dec 2025
- Last updated
- 9 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 9 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Muscle Energy Technique Combined With Mobilization in Patients With Sacral Torsion
- ClinicalTrials.gov ID
- NCT07329426
- Acronym / sponsor ID
- FUI/CTR/2025/24
- Conditions
- Sacral Torsion
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 46 participants (estimated)
- Lead sponsor
- Foundation University IslamabadUniversity, hospital or other
- Study start
- 15 Jan 2025 (actual)
- Primary completion
- 30 Dec 2025 (estimated)
- Study completion
- 15 Jan 2026 (estimated)
- First posted
- 9 Jan 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Project Summary Low Back Pain is one of the most prevalent musculoskeletal conditions worldwide. More than 70% of the people experience low back pain at some time in their life. The sacroiliac joint has been found to be the source of pain in 30% of mechanical low back pain sufferers. Sacral torsion is one of the types of SIJ dysfunction. This randomized controlled trial, conducted at Fauji Foundation Hospital and Foundation University College of Physical Therapy will assess the effects of combining muscle energy technique with mobilization on pain, lumbar range of motion, disability and active straight leg raise. Participants will be randomly assigned to either mobilization alone or mobilization with muscle energy technique, performed three times per week for two weeks. Data will be collected at baseline and at end of study (week 2) using the Numeric pain rating scale, goniometer, inclinometer and oswestry disability index. This study addresses a research gap by exploring combined effects of muscle energy technique (PFS) and Maitland mobilization for sacral torsion in improving pain, lumbar mobility, disability and active straight leg raise.
Detailed description
Low back pain (LBP) is one of the most common musculoskeletal conditions globally, with over 70% of individuals experiencing it at some point in their lifetime. It is the leading cause of disability worldwide and remains the primary global contributor to years lived with disability. A significant source of mechanical low back pain is the sacroiliac joint (SIJ), which accounts for 15% to 30% of cases, making it a key area of interest in both diagnosis and treatment.
SIJ dysfunction typically presents with localized pain and stiffness and can be difficult to differentiate from other causes of LBP such as lumbar spine or hip pathology. The dysfunction usually results from abnormal joint motion or malalignment, often linked to repetitive stress or minor subluxation that damages the joint capsule or posterior ligamentous structures. SIJ dysfunction can be categorized into five main types: anterior rotation, posterior rotation, up slip, down slip, and sacral torsions.
Sacral torsions are a specific type of SIJ dysfunction involving asymmetrical movement of the sacrum along a physiologic oblique axis, leading to joint fixation. These torsions are commonly described in osteopathic literature and include four types: Left-on-Left, Right-on-Right (forward torsions), and Right-on-Left, Left-on-Right (backward torsions). Such dysfunctions are frequently associated with asymmetries in lumbo-pelvic rhythm, leg length discrepancies, scoliosis, and muscular imbalances, particularly involving the hamstrings, piriformis, and quadratus lumborum. These biomechanical and muscular irregularities contribute to pelvic asymmetry during functional movements like forward flexion.
Muscle imbalances play a crucial role in the development and persistence of SIJ dysfunction. These may arise from adaptive responses or underlying biomechanical issues, leading to altered motor control and impaired movement quality. Balance in muscle strength and length, especially between corresponding groups on the left and right sides, is essential for maintaining proper pelvic alignment. Studies such as Jacobs et al. (2005) have shown significant asymmetries in hip abductor strength, highlighting the importance of bilateral symmetry in functional movement.
Conservative management of chronic SIJ dysfunction commonly includes physical therapy, manual therapy, activity modification, and pharmacological interventions such as analgesics and anti-inflammatory medications. Among manual therapy techniques, Muscle Energy Technique (MET) is widely used to address muscle imbalances by utilizing voluntary isometric contractions to engage autogenic or reciprocal inhibition mechanisms. This process activates the Golgi tendon organs, reducing muscle tension and facilitating improved joint mobility. A variation of MET, known as Post-Facilitation Stretch (PFS), involves a maximal isometric contraction followed by a rapid stretch, and has been shown to effectively increase flexibility and range of motion.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Maitland Mobilization With Muscle Energy Technique (PFS) | Experimental | Procedure: Muscle Energy Technique + Maitland MobilizationParticipants in this group will receive Maitland mobilization technique, two sets of 60 oscillations for 30 seconds, directed at sacrum according to standard graded oscillatory movements, grade 1 or 2 in week 1 and grade 3 or 4 in week 2. Muscle Energy Technique (MET) will also be applied to this group targeting specific muscles contributing to sacral torsion (e.g., piriformis, hamstrings, quadratus lumborum), with the purpose of correcting asymmetry, improving joint alignment, and enhancing the overall effectiveness of mobilization. The contract time will be 6-10 seconds and Hold time will be 15 seconds. |
| Maitland Mobilization | Experimental | Procedure: Maitland MobilizationParticipants in this group will receive Maitland mobilization technique, two sets of 60 oscillations for 30 seconds, directed at the sacrum. Mobilization will be applied according to the standard graded oscillatory movements grade 1 or 2 in week 1 and grade 3 or 4 in week 2, aiming to restore joint mobility, reduce pain, and improve function. No additional interventions will be provided. |
Who may qualify
- Ages
- 22 to 44 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (8 listed)
- Age between 22- 44 years (18)
- Both males and females
- Clinically diagnosed sacral torsion. (Annexure E)
- Patients with pain intensity of at least 5 on NPRS
- Positive standing flexion test
Key exclusion criteria (1 listed)
- 1. Neurological deficits (hemiparesis, paralysis) 2. Pregnancy 3. Spinal surgery of any kind 4. Antero-Retro Spondylolisthesis diagnosed through radiological findings 5. Degenerative disc disease diagnosed through radiological findings 6. Spinal stenosis 7. Infection, tumors, osteoporosis, spinal fracture
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Muscle Energy Technique + Maitland MobilizationGroup A will receive Muscle energy technique with Maitland mobilization. Treatment protocol given to both groups will be carried out for 3 sessions per week for 2 weeks. Post Facilitation Muscle Energy Technique. WEEK 1: * Hot pack (10 minutes) * Post-Facilitation MET for piriformis, Quadratus Lumborum and Hamstrings. WEEK 2: * Hot pack (10 minutes) * Post-Facilitation MET for piriformis, Quadratus Lumborum and Hamstrings. | Procedure or surgery | Maitland Mobilization With Muscle Energy Technique (PFS) |
| Maitland MobilizationGroup B will not receive any form of Muscle Energy Technique (MET). Instead, the intervention will consist exclusively of a joint mobilization technique directed at Sacrum. | Procedure or surgery | Maitland Mobilization |
Primary outcome
Pain intensity
Time frame: 2 weeks
n=Numeric Pain Rating Scale (NPRS) will be used, 0 means no pain and 10 means worst pain.
Functional Disability
Time frame: 2 weeks
Oswestry Disability Index
Lumbar Mobility
Time frame: 2 weeks
Inclinometer will be used for checking the lumbar mobility
Active Straight Leg Raise
Time frame: 2 weeks
Goniometer will measure Active Straight Leg Raise
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Jan 2026.
Related trials for Sacral Torsion
Active, not recruiting
Comparative Effects of METs and Core Strengthening on Anterior Sacral Torsion Dysfunction
Anterior Sacral Torsion Dysfunction
Not yet recruiting
Effects of Innominate Rotation Correction Compared With Sacral Torsion Correction in Patients With Sacroiliac Joint Dysfunction
Sacroiliac Joint Dysfunction
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Muscle Energy Technique + Maitland Mobilization and Maitland Mobilization in people with Sacral Torsion, run by Foundation University Islamabad at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 9 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Hafiza Noor ul Huda, DPT (03245475950, hafiza.huda94@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain intensity (time frame: 2 weeks). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Jan 2026.