The effect of pelvic proprioceptive neuromuscular facilitation techniques in patients with sacroiliac joint dysfunction: A randomized controlled study

BackgroundDespite the widespread presence of sacroiliac joint dysfunction (SIJD) among causes of low back pain, SIJD is still overlooked.ObjectiveThis study aimed to investigate the effect of pelvic proprioceptive neuromuscular facilitation techniques (PNF) in patients with SIJD. MethodsThis prospective, single-blinded, randomized controlled study was conducted between December 2023 and March 2024. Fourty patients diagnosed with SIJD, with pain for at least 4 weeks initially, aged between 18 and 40, were randomly allocated into experimental group (EG, n = 20) and control group (CG, n = 20) using a computer-based randomised numbered list. The CG received patient education consisting of basic lumbar stabilization exercises (LSE); the EG received exercise training consisting of pelvic PNF techniques in addition to patient education. The interventions of both groups were applied 3 days a week for 6 weeks. Pain, mobility, flexibility, lumbar range of motion, posture, trunk flexor muscle endurance, and trunk extensor muscle endurance were assessed by VAS, Modified Schober's test, sit-and-reach test, goniometer, New York Posture Rating Chart, flexor endurance test, ve Biering-Sørensen test, respectively, before and after interventions. The Shapiro-Wilk test was used to assess normality, while intra-group and inter-group comparisons were conducted using either the Paired sample T-test or the Independent samples T-test.ResultsOf the EG (n = 20, 30,88 ± 14,23 years), 82.35% (n = 14) were female, while the CG (n = 20, 27,18 ± 7,58 years) comprised 76.47% (n = 13) females. The mean body mass index for the EG was 23.71 ± 3.68 kg/m², compared to 23.51 ± 3.68 kg/m² in the CG. Baseline values of pain (p = 0.152, 95% CI [-0.342-2.107]), mobility (p = 0.407, 95% CI [-12.699-5.405]), flexibility (p = 0.758, 95% CI [-2.293-3.116]), posture (p = 0.913, [-2.422-3.613]), trunk flexor muscle endurance (p = 0.336, 95% CI [-3.213-5.955]), and trunk extensor muscle endurance (p = 0.405, 95% CI [-2.927-4.842]) of the groups were similar. Both the EG and CG achieved significant improvements in reducing pain (p < 0.001). The improvement in the pain was significantly higher in the EG compared to the CG (p < 0.001, dcohen = -1.030). There were significantly change in the scores of mobility, flexibility, and lumbar range of motion only in the EG. All changes had a medium or high effect size (p < 0.001, dcohen = 0.631; p = 0.011, dcohen = 0.417; p < 0.05, dcohen = 0.649, respectively).ConclusionIncorporating the pelvic proprioceptive neuromuscular facilitation techniques into the rehabilitation protocols for patients with sacroiliac joint dysfunction may prove beneficial, potentially enhancing pain relief while also improving mobility, flexibility, and lumbar range of motion.