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Sacroiliac Joint DysfunctionMWM KCT SIJDNCT07529093

Combined Effects of Mulligan's Mobilization With Movement and Kinetic Control Training on Pain, Range of Motion, Gait and Functional Disability Among Patients With Sacroiliac Joint Dysfunction

A study testing Mobilization with Movement in people with Sacroiliac Joint Dysfunction, run by Lahore University of Biological and Applied Sciences at 2 sites in Pakistan.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Sacroiliac joint dysfunction (SIJD) is a frequent source of low back and pelvic pain and contributes significantly to movement restriction, altered gait patterns, and functional disability in adults. Read more about this study

Who is it for?
Ages 45 to 64 years
Conditions the study is for
Sacroiliac Joint Dysfunction
What is being tested?
Mobilization with Movement
Could I receive a placebo?
No, everyone receives an active treatment
How many people
55 participants
Where
2 sitesPakistan
Study dates
15 Apr 2026to 15 Oct 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 45 to 64 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Both male and female patients
  • Age between 45- 64 years
  • Unilateral non-radiating pain
  • Confirmed diagnosis through at least 3/5 provocative tests Faber test Distraction test Thigh thrust test Gaenslen test Sacral thrust test
  • Pain rating from 4-6 on Numeric Pain Rating Scale
  • Symptoms of SIJD for more than 2 months

Who cannot join

  • Patients with history of any surgery at lumbo-sacral or pelvic region
  • Pregnancy, lactation
  • Congenital, postural deformities
  • Acute disc hernia and spinal stenosis that may cause pain in the lower back and hips, piriformis syndrome
  • Rheumatic diseases (fibromyalgia, ankylosing spondylitis, rheumatic arthritis)
  • Acute infections or malignancies
Show all 9Show fewer
  • Having received manual therapy for the sacroiliac joint in the past 3 months
  • Injection of corticosteroids or anesthesia in the SIJ during the previous 1 month
  • Psychological disorders affecting the subject's ability to follow the instructions

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Pakistan2 sites, 2 recruiting
  • Ali Hospital

    Lahore, Punjab Province

    Not yet recruiting
  • Physiotherapy Center

    Lahore, Punjab Province

    Recruiting

Other trials in Pakistan

About this study

Sacroiliac joint dysfunction (SIJD) is a frequent source of low back and pelvic pain and contributes significantly to movement restriction, altered gait patterns, and functional disability in adults. It is associated with impaired lumbopelvic motor control, weakness of key stabilizing muscles, and faulty load transfer across the pelvis. SIJD is prevalent in both physically active individuals and sedentary populations. In addition to its clinical impact, SIJD imposes a considerable socioeconomic burden due to reduced work productivity and long-term disability.

Contemporary management of SIJD emphasises on pain reduction, restoration of movement, functional independence, and participation in daily activities. Manual therapy techniques such as Mulligan's Mobilization with Movement (MWM) are widely used to correct positional faults and restore pain-free movement, while kinetic control training targets deficits in motor control of the lumbopelvic stabilizing muscles. Although both approaches are individually supported in the literature, evidence regarding their combined effectiveness on pain, range of motion, gait parameters, and functional disability remains limited. Therefore, this study aims to compare the effects of combined Mulligan's Mobilization with Movement and kinetic control training versus kinetic control training alone in patients with sacroiliac joint dysfunction using validated outcome measures.

Read the detailed description

Sacroiliac joint dysfunction (SIJD) refers to altered biomechanics of the sacroiliac joint, characterized by either excessive or restricted movement, or the presence of abnormal motion patterns. It is a recognized source of pain originating from the sacroiliac joint and occurs due to abnormal or increased movement of the ilium relative to the sacrum, leading to irritation of the surrounding joint structures. The prevalence of SIJD among individuals with low back pain has been reported to range from 15% to 30% in Asian populations, including Pakistan. In the Pakistani context, SIJD is frequently observed among healthcare professionals and individuals whose occupations involve prolonged standing or repetitive postural activities. In recent years, the incidence of SIJD appears to be increasing, possibly due to sedentary lifestyles, cumulative mechanical stress, and improved clinical recognition of the sacroiliac joint as a distinct contributor to low back pain.

The clinical diagnosis of SIJD is primarily based on a detailed patient history and focused physical examination, while its management involves a combination of therapeutic approaches. Current management strategies are consistent with the World Health Organization's International Classification of Functioning, Disability and Health (ICF) framework. Two therapeutic approaches of concern in this study are Mulligan's Mobilization with Movement (MWM) and KInetic Control (KC) training.

Mulligan's Mobilization with Movement (MWM) is a manual therapy technique that applies sustained accessory glides during active movement to correct positional faults and alleviate pain. This approach is intended to produce immediate functional improvement by combining pain-free accessory glides with physiological movement. Mobilization of the sacroiliac joint through physiotherapy aims to restore normal joint mechanics, enabling patients to maintain optimal sacroiliac joint function throughout daily activities.

Kinetic Control, as proposed by Comerford and Mottram, focuses on retraining faulty movement patterns to address uncontrolled movement and enhance joint stability. Movement is fundamental to functional performance and participation in daily life, and restoring controlled movement enables individuals to regain the functional choices that are often lost in the presence of pain and movement impairment. This study therefore seeks to compare the effects of Mulligan's MWM combined with kinetic control training targeting the gluteus maximus and multifidus muscles.

Being tested
Kinetic Control + Mobilization with Movement, Mobilization with Movement
Keywords
Sacroiliac Joint Dysfunction, Mulligan's Mobilization with Movement, Kinetic Control Training, Uncontrolled Movement

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Kinetic Control + Mobilization with MovementOther

    Participants will receive baseline therapy consisting of superficial heating therapy followed by structured stretching and strengthening exercises for the sacroiliac joint and lumbar region on mat. Then Mulligan's MWM will be applied to the sacroiliac joint using sustained accessory glides combined with pain-free active movement. This will be followed by kinetic control training targeting the gluteus maximus and multifidus muscles. Gluteus maximus retraining will be performed in supported positions emphasising controlled hip extension with the knee flexed while maintaining lumbo-pelvic neutrality.

    Multifidus retraining will target the deep segmental lumbar extensors with contribution from the deep thoracic extensors. Training will begin in crook lying with a pillow or thick folded towel under the sacrum to elevate the pelvis and allow the lumbar spine to relax while thoracic spine remians neutral. Each session lasts 45 minutes. The intervention will be delivered for 8 weeks.

  • Mobilization with MovementOther

    Participants will receive baseline therapy consisting of superficial heating therapy followed by structured stretching and strengthening exercises for the sacroiliac joint and lumbar region on mat. Mulligan's MWM will be applied according to standard Mulligan principles. Participants will be classified as having anterior or posterior ilial rotation based on physical examination findings. For anterior rotation, a sustained posterior glide to the affected ilium with sacral stabilization will be applied during prone press-up. For posterior rotation, an anterolateral glide will be delivered over the posterior superior iliac spine with counter-pressure to the opposite ilium. Mobilization will be performed in non-weight-bearing for 3 sets of 10 repetitions per session, within a pain-free range, over 8 weeks (3 sessions/week).

Study groups in NCT07529093
Study groupRoleWhat they receive
KC + MWM GroupExperimentalGroup A will receive routine physical therapy along with kinetic control training of multifidus and glutues maximus with mulliogan's mobilization with movement.
Receives: Other: Kinetic Control + Mobilization with Movement
MWMGroupActive comparatorGroup B will receive routine physical therapy along with Mulligan's mobilization with movement.
Receives: Other: Mobilization with Movement

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Numeric Pain Rating Scale (NPRS)

    The intensity of pain was measured by using the NPRS, a scale of 11 points starting from 0 to 10, where 0 represents no pain and 10 represents the worst possible pain. The NPRS has been found to possess good construct validity by showing strong correlation with other pain intensity measurement tools. This scale has also been found to possess consistent reliability (ICC: 0.58 to 0.88), especially in patients experiencing neck pain. The application of this scale has also been found to extend beyond patients experiencing musculoskeletal disorders.

    Measured: 8 weeks

  2. Inclinometer

    ROM was measured by using an inclinometer to measure joint movement quantitatively. Inclinometer has been found to possess superior reliability over a goniometer for measuring ROM. High intrarater reliability values (ICC>0.90) has been observed for inclinometers, indicating excellent consistency of measurement by a tester. High reliability has also been found for medical and digital types of inclinometers (ICC ≈ 0.91-0.95). For measuring ROM two inclinometers were fixed, with one placed over the T12 spinous process and the other over the S1 spinous process. This helped to measure the ROM of lumbar spine, keeping the effects of hip and sacral joints at a minimum. The ROM of lumbar spine was measured by using a dual inclinometer technique, keeping one over the superior aspect of T12 and the other over the inferior aspect of S1. The subjects were asked to perform various types of lumbar spine movements by keeping their knees straight.

    Measured: 8 weeks

  3. Observational Gait Analysis (OGA)

    Gait assessment was carried out by using observational gait analysis (OGA), which is a structured assessment of gait using standardized gait assessment scales. It helps to assess and quantify abnormalities of gait through visual observation. The basic framework of OGA is a 5-point scale, where each gait parameter is scored during the stance and swing phases. The clinician first observes the gait cycle of the patient, focusing on the kinematic gait patterns including pelvic alignment during initial contact of the foot and knee flexion during the mid-swing phase. The OGA form provides a connection between qualitative and quantitative assessment of gait. This heps in the development of a rehabilitation program for each patient.

    Measured: 8 weeks

  4. Modified Oswestry Disability Index (MODI)

    Functional disability was measured using MODI, a self reported questionnaire that was designed to measure disability related to low back and lumbopelvic disorders. MODI follows the same scoring system and disability interpretation criteria as the original ODI. It consists of 10 sections that include pain intensity, personal care (e.g., washing and dressing etc), lifting, walking, sitting, standing, sleeping, social life, travelling and eployment/home making. Each scored from 0 to 5, yielding a maximum total score of 50 points (or 45 points if 1 section is omitted). The final score is calculated by formula:

    Patient's total score / total possible score × 100

    The percentage score is interpreted as follows:

    • 0-20% : minimal disbability
    • 21-40% : moderate disability
    • 41-60% : severe disability
    • 61-80% : crippling disability where pain impinges on all aspects of patient's life
    • 81-100%: patients are bed bound a minimum change of 10% is necessary to reflect reliable change in disability

    Measured: 8 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Apr 2026
  2. Study start15 Apr 2026
  3. Primary completion15 Oct 2026 (estimated)
  4. Study completion15 Oct 2026 (estimated)

Resources

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
Other
Allocation
Randomised
Intervention model
Parallel groups
Model description
Interventional Study Model: Randomized Clinical Trial (Parallel-Group Design): This study will adopt a randomized clinical trial (RCT) model, employing a parallel-group design to evaluate and compare the combined effects of two physiotherapeutic interventions-Muligan's Mobilization with Movement (MWM) and Kinetic Control (KC) training-on pain, range of Motion, gait and Functional disability among patients with Sacroiliac Joint Dysfunction (SIJD). Participants who meet the inclusion criteria will be randomly assigned into two groups: One group i.e. MWM Group will receive treatment on Mulligan's concept of MWM . Second group i.e. MWM + KC group will receive Mulligan's MWM followed by kinetic control training of gluteus maximus and multifidus muscles. Baseline treatment will be given to both groups which includes heat therapy, stretches and strengthening exercises. Pre- and post-intervention assessments will be conducted using validated functional outcome measures to ensure objectivity.
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
55 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07529093
Sponsor's protocol ID
UBAS/ERB/FoRS/25/019
Acronym
MWM KCT SIJD
Status last verified
May 2026
First submitted
13 Jan 2026
Last updated
26 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Mobilization with Movement in people with Sacroiliac Joint Dysfunction, run by Lahore University of Biological and Applied Sciences at 2 sites 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 6 inclusion and 9 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 26 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites 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 Misha Zahid (+923277866777, misha15zahid@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Numeric Pain Rating Scale (NPRS) (time frame: 8 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 26 May 2026.

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