Core StabilityNCT07441018
Mulligan Mobilization With Movement in Patients With Unilateral Anterior Sacral Nutation.
A study testing Mulligan mobilization with movement. and Conservative Physical Therapy. in people with Core Stability and Exercise Therapy, run by Riphah International University at 1 site in Pakistan.
Trial summary
Somatic Dysfunction of the SIJ is defined as hypo or hyper-mobility of the joint in addition to a malalignment or change of positioning of the sacrum and ilium bones (e.g. Forward sacral torsion, backward sacral torsion, bilateral anterior or posterior sacral nutation, Unilateral anterior and posterior sacral… Read more about this study
- Who is it for?
- Ages 20 to 30 yearsHealthy volunteers can take part
- Conditions the study is for
- Core Stability, Exercise Therapy, Low Back Pain
- What is being tested?
- Mulligan mobilization with movement. and Conservative Physical Therapy.
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 41 participants
- Where
- 1 sitePakistan
- Study dates
- 15 Feb 2025to 15 Jan 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
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 20 to 30 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Numeric pain rating score from 3 to 7 (Pain around or close to the sacral sulcus)
- Patients with a minimum of 3 positive results from among the 5 provocation tests that show sacroiliac joint dysfunction.
- Fuctional Leg length discrepancy.
- Using no other nonsteroidal anti-inflammatory drugs during the therapy.
Who cannot join
- Prolapsed intervertebral disc (PIVD)
- Lumbar canal stenosis
- Tumors or any traumatic condition to pelvis and lower limb.
- Lumbar surgery within a year prior to the study or reported vertebral fracture,
- Pregnancy
- Ankylosing spondylitis
Trial locations and contacts
1 site in 1 country.
Pakistan1 site
Gosh-e-Shifa Hospital and Al Raheem Physiotherapy Centre, Lahore.
Lahore, 56700
About this study
Official title: Effect of Mulligan Mobilization With Movement on Pain, Range of Motion and Disability in Patients With Unilateral Anterior Sacral Nutation.
Somatic Dysfunction of the SIJ is defined as hypo or hyper-mobility of the joint in addition to a malalignment or change of positioning of the sacrum and ilium bones (e.g. Forward sacral torsion, backward sacral torsion, bilateral anterior or posterior sacral nutation, Unilateral anterior and posterior sacral nutation). The classic physical signs for a dysfunction of the sacroiliac joint in which a unilateral anterior nutation of the sacrum or ilium has occurred in the sagittal plane about a transverse axis are: Sacral sulcus seen deeper, PSIS seen Caudad, Inferior lateral angle (ILA) seen Posterior, Pubic tubercle seen as Cephalad, ASIS as Cephalad, Sacroiliac joint seen upper pole and tender, Sacrospinous and Sacrotuberous ligament are under tension and gait abnormality seen due to leg length discrepancy.
Read the detailed description
A randomized control trial will be conducted to determine the effects of mulligan mobilization with movement in order to improve pain, lumbar range of motion and functional disability in patients with unilateral anterior sacral nutation. A sample size of 41 subjects will be taken, Data will be collected from Gosh-e-Shifa Medical Rehabilitation Centre and Al-Raheem Physiotherapy Centre of Lahore. Outcome measures will be taken using Numeric pain rating scale (NPRS) for pain, Lumbar flexion by Goniometer and Modified Oswestry Disability Index (MODI) for functional Disability. A written consent form will be taken from participants meeting inclusion criteria and will be randomly allocated in two groups (Group A and Group B) of equal members. Group A (Experimental group) will receive mulligan mobilization with movement along with standardized physiotherapy intervention. While Group B will receive only standardized physiotherapy intervention. Over the course of 6 weeks, all participants in the control group and the experimental group will attend a total of 18 intervention sessions (three times per week). All participants in both groups will be evaluated before and after the treatment programs.
- Being tested
- Mulligan mobilization with movement., Conservative Physical Therapy.
- Keywords
- Core Stability, Exercise Therapy, Low back pain, Mulligan mobilization, Sacroiliac joint
- Medical subject headings
- Low Back Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Mulligan mobilization with movement.Other
Participants receive Mulligan mobilization (10 Repetitions of 3 sets with 5 minutes rest period between each set) and baseline physical therapy intervention.Joint mobilization will be accomplished by using the posterior innominate (on affected side) and anterior innominate (on unaffected side) techniques (Mobilization with Movement).
Conservative Physical Therapy.Other
- Hot pack for 10 minutes (32). (Electric Medicare Heating pad)
- TENS with frequency of 120Hz at low intensity below the local painful sensory threshold with pulse of width 50-200 μs for 10 minutes (33).
- SIJ Stretching Exercises (hamstring stretches, hip adductor stretch, piriformis stretch, quadriceps stretch, one knee to chest stretch, both knees to chest stretch, lower trunk rotation, and pelvic rotation stretch) (1).
- Core Strengthening Exercises (Isometric hip abduction/adduction strengthening)
| Study group | Role | What they receive |
|---|---|---|
| Mulligan Mobilization with conservative treatment. | Experimental | Participants receive Mulligan mobilization and baseline physical therapy. Receives: Other: Mulligan mobilization with movement. |
| Only conservative treatment. | Active comparator | Participants receive baseline physical therapy intervention. Receives: Other: Conservative Physical Therapy. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mitchell Model for Unilateral Anterior Sacral Nutation
Osteopathic authors have adopted several models to assess and diagnose the presence of sacroiliac dysfunction. The Mitchell model recommends static bony palpatory findings combined with motion tests as a basis for determining the presence and nature of SIJD (25). Physiotherapists employed diagnostic techniques congruent with Mitchell's model, but they also frequently added additional motion tests, measured tenderness, and used pain provocation techniques
Measured: 8 weeks
Numerical Pain Rating Scale (NPRS)
Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10.
0 indicates "no pain" and 10 indicates "worst pain". Clinicians can be confident that a 2point change on the NPRS represents clinically meaningful change that exceeds the bounds of measurement error. NPRS shave shown high test-retest reliability(r=0.96)
Measured: 8 weeks
Modified Oswestry Disability Index (MODI)
MODQ is a valid and reliable tool for the assessment of the disability following low back pain. The thorough questionnaire demonstrated good reliability, good internal consistency, and confirmed convergent validity. The physical component domain of the SF-36 (r=-0.55, p<0.001) showing that MODI is measuring what it is supposed to measure in terms of disability and physical function.
Measured: 8 weeks
Secondary outcomes (1)
Goniometer
It is recommended in clinical practice that the instruments for measuring spinal ROM should be valid and reliable, should have low cost and are easy to use. Study recommend the use of instruments with lower costs and easier handling, as the goniometer
Measured: 8 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Feb 2026
- Study start15 Feb 2025
- Primary completion15 Jan 2026
- Study completion15 Jan 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Core StabilityStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe 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
- Model description
- Patients receive mulligan mobilization with movement along with standardized physiotherapy intervention.
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 41 participants (actual)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Faiza Taufiq, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07441018
- Sponsor's protocol ID
- S24C14G30003
- Status last verified
- Feb 2026
- First submitted
- 23 Feb 2026
- Last updated
- 27 Feb 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 27 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Mulligan Mobilization With Movement on Pain, Range of Motion and Disability in Patients With Unilateral Anterior Sacral Nutation.
- ClinicalTrials.gov ID
- NCT07441018
- Acronym / sponsor ID
- S24C14G30003
- Keywords
- Core Stability, Exercise Therapy, Low back pain, Mulligan mobilization, Sacroiliac joint
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 41 participants (actual)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 15 Feb 2025 (actual)
- Primary completion
- 15 Jan 2026 (actual)
- Study completion
- 15 Jan 2026 (actual)
- First posted
- 27 Feb 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.
Somatic Dysfunction of the SIJ is defined as hypo or hyper-mobility of the joint in addition to a malalignment or change of positioning of the sacrum and ilium bones (e.g. Forward sacral torsion, backward sacral torsion, bilateral anterior or posterior sacral nutation, Unilateral anterior and posterior sacral nutation). The classic physical signs for a dysfunction of the sacroiliac joint in which a unilateral anterior nutation of the sacrum or ilium has occurred in the sagittal plane about a transverse axis are: Sacral sulcus seen deeper, PSIS seen Caudad, Inferior lateral angle (ILA) seen Posterior, Pubic tubercle seen as Cephalad, ASIS as Cephalad, Sacroiliac joint seen upper pole and tender, Sacrospinous and Sacrotuberous ligament are under tension and gait abnormality seen due to leg length discrepancy.
Detailed description
A randomized control trial will be conducted to determine the effects of mulligan mobilization with movement in order to improve pain, lumbar range of motion and functional disability in patients with unilateral anterior sacral nutation. A sample size of 41 subjects will be taken, Data will be collected from Gosh-e-Shifa Medical Rehabilitation Centre and Al-Raheem Physiotherapy Centre of Lahore. Outcome measures will be taken using Numeric pain rating scale (NPRS) for pain, Lumbar flexion by Goniometer and Modified Oswestry Disability Index (MODI) for functional Disability. A written consent form will be taken from participants meeting inclusion criteria and will be randomly allocated in two groups (Group A and Group B) of equal members. Group A (Experimental group) will receive mulligan mobilization with movement along with standardized physiotherapy intervention. While Group B will receive only standardized physiotherapy intervention. Over the course of 6 weeks, all participants in the control group and the experimental group will attend a total of 18 intervention sessions (three times per week). All participants in both groups will be evaluated before and after the treatment programs.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- Patients receive mulligan mobilization with movement along with standardized physiotherapy intervention.
| Arm | Type | Receives |
|---|---|---|
| Mulligan Mobilization with conservative treatment. | Experimental | Other: Mulligan mobilization with movement.Participants receive Mulligan mobilization and baseline physical therapy. |
| Only conservative treatment. | Active comparator | Other: Conservative Physical Therapy.Participants receive baseline physical therapy intervention. |
Who may qualify
- Ages
- 20 to 30 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (4 listed)
- Numeric pain rating score from 3 to 7 (Pain around or close to the sacral sulcus)
- Patients with a minimum of 3 positive results from among the 5 provocation tests that show sacroiliac joint dysfunction.
- Fuctional Leg length discrepancy.
- Using no other nonsteroidal anti-inflammatory drugs during the therapy.
Key exclusion criteria (6 listed)
- Prolapsed intervertebral disc (PIVD)
- Lumbar canal stenosis
- Tumors or any traumatic condition to pelvis and lower limb.
- Lumbar surgery within a year prior to the study or reported vertebral fracture,
- Pregnancy
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 |
|---|---|---|
| Mulligan mobilization with movement.Participants receive Mulligan mobilization (10 Repetitions of 3 sets with 5 minutes rest period between each set) and baseline physical therapy intervention.Joint mobilization will be accomplished by using the posterior innominate (on affected side) and anterior innominate (on unaffected side) techniques (Mobilization with Movement). | Other | Mulligan Mobilization with conservative treatment. |
| Conservative Physical Therapy.* Hot pack for 10 minutes (32). (Electric Medicare Heating pad) * TENS with frequency of 120Hz at low intensity below the local painful sensory threshold with pulse of width 50-200 μs for 10 minutes (33). * SIJ Stretching Exercises (hamstring stretches, hip adductor stretch, piriformis stretch, quadriceps stretch, one knee to chest stretch, both knees to chest stretch, lower trunk rotation, and pelvic rotation stretch) (1). * Core Strengthening Exercises (Isometric hip abduction/adduction strengthening) | Other | Only conservative treatment. |
Primary outcome
Mitchell Model for Unilateral Anterior Sacral Nutation
Time frame: 8 weeks
Osteopathic authors have adopted several models to assess and diagnose the presence of sacroiliac dysfunction. The Mitchell model recommends static bony palpatory findings combined with motion tests as a basis for determining the presence and nature of SIJD (25). Physiotherapists employed diagnostic techniques congruent with Mitchell's model, but they also frequently added additional motion tests, measured tenderness, and used pain provocation techniques
Numerical Pain Rating Scale (NPRS)
Time frame: 8 weeks
Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates "no pain" and 10 indicates "worst pain". Clinicians can be confident that a 2point change on the NPRS represents clinically meaningful change that exceeds the bounds of measurement error. NPRS shave shown high test-retest reliability(r=0.96)
Modified Oswestry Disability Index (MODI)
Time frame: 8 weeks
MODQ is a valid and reliable tool for the assessment of the disability following low back pain. The thorough questionnaire demonstrated good reliability, good internal consistency, and confirmed convergent validity. The physical component domain of the SF-36 (r=-0.55, p<0.001) showing that MODI is measuring what it is supposed to measure in terms of disability and physical function.
1 secondary outcome
Goniometer
Time frame: 8 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Feb 2026.
- Individual participant dataSharing planned: No
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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. This study is not recruiting at the moment.
Faiza Taufiq principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Mulligan mobilization with movement. and Conservative Physical Therapy. in people with Core Stability and Exercise Therapy, run by Riphah International University 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 4 inclusion and 6 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: finished, as of the sponsor's last update on 27 Feb 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Mitchell Model for Unilateral Anterior Sacral Nutation (time frame: 8 weeks). The study lists 3 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 27 Feb 2026.