Sanika Vaidya, Prem Venkatesan, Karvannan Harikesan
Department of Physiotherapy, Manipal Academy Of Higher Education, School of Allied Health Sciences, Bangalore, India.
Int J Ther Massage Bodywork. 2021 Mar 1;14(1):30-38. eCollection 2021 Mar.
Sacroiliac joint dysfunction (SIJD) is the primary source of low-back pain. Main muscles forming the force closure of sacroiliac joint are the biceps femoris and gluteus maximus which increase the stability through massive attachments via sacrotuberous ligament. However, there is a dearth of literature of the importance of activation of gluteus maximus in SIJD.
To study the effect of gluteus maximus activation on Oswestry Disability Index (ODI), visual analog scale (VAS), and pelvic tilt angle in subjects with anterior rotated sacrolilac joint dysfunction.
The study was conducted in outpatient Physiotherapy Department, Manipal Hospital, Bangalore, India.
Anterior rotated SIJD subjects were recruited in the study. They were divided into two groups (experimental and control groups) by block randomisation.
This is a randomised control trial.
Treatment order was determined by block randomisation. The subjects of both experimental and control group received Muscle Energy Technique (MET) technique on 1 session to correct the anterior rotated SIJD. The experimental group received gluteus maximus activation protocol, whereas the control group received flexion bias exercises. The groups received the treatment of 20 mins per session. There were two supervised sessions per week for four weeks.
The primary outcome measure in the study is Oswestry Disability Index (ODI). The secondary outcome measures included visual analog scale (VAS) and Palpation Meter (PALM).
48 subjects (26 females, 22 males) were randomised into experimental and control groups having anterior rotation SIJD, and average age in groups was 38.83 ± 11.4 years and 34.96 ± 9.5 years, respectively. The within-group analysis showed significant improvements in only ODI outcome of both the groups ( = .001). The between-group analysis in both groups did not show any statistical significant difference in ODI, VAS, or PALM.
The flexion bias exercise and the gluteus maximus activation exercises used in this study were equally effective in improving physical function and reduction in pain, and maintaining the normal pelvic angle in subjects with anterior rotated SIJD.
骶髂关节功能障碍（SIJD）是下腰痛的主要来源。构成骶髂关节力闭合的主要肌肉是股二头肌和臀大肌，它们通过骶结节韧带的大量附着增加稳定性。然而，关于臀大肌激活在SIJD中的重要性的文献匮乏。
研究臀大肌激活对骶髂关节前旋功能障碍患者的Oswestry功能障碍指数（ODI）、视觉模拟评分（VAS）和骨盆倾斜角度的影响。
该研究在印度班加罗尔马尼帕尔医院的门诊物理治疗科进行。
招募骶髂关节前旋SIJD患者参与研究。通过区组随机化将他们分为两组（实验组和对照组）。
这是一项随机对照试验。
治疗顺序由区组随机化确定。实验组和对照组的受试者均接受1次肌肉能量技术（MET）治疗以纠正骶髂关节前旋。实验组接受臀大肌激活方案，而对照组接受屈曲偏向练习。每组每次治疗20分钟。每周进行两次监督治疗，共四周。
该研究的主要观察指标是Oswestry功能障碍指数（ODI）。次要观察指标包括视觉模拟评分（VAS）和触诊仪（PALM）。
48名受试者（26名女性，22名男性）被随机分为骶髂关节前旋SIJD的实验组和对照组，两组的平均年龄分别为38.83±11.4岁和34.96±9.5岁。组内分析显示两组仅ODI结果有显著改善（P = .001）。两组间分析在ODI、VAS或PALM方面均未显示任何统计学显著差异。
本研究中使用的屈曲偏向练习和臀大肌激活练习在改善骶髂关节前旋SIJD患者的身体功能、减轻疼痛以及维持正常骨盆角度方面同样有效。
