Sacroiliac Joint PainNCT07370272
CMCT Versus CSE in Treatment of SIJ Pain
A study testing The conventional Physiotherpay Program (US & MET) and Core Stability Exercises (CSE) in people with Sacroiliac Joint Pain, run by Cairo University at 1 site in Egypt.
Trial summary
This study aims to investigate the difference between integrating lumbopelvic cognitive movement control training versus core stabilization exercises to the conventional physiotherapy program on pain, function, lumbopelvic stability, functional load transfer, and postural control in patients suffering from SIJ pain. Read more about this study
- Who is it for?
- Ages 18 to 45 years
- Conditions the study is for
- Sacroiliac Joint Pain
- What is being tested?
- The conventional Physiotherpay Program (US & MET) and Core Stability Exercises (CSE)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 1 siteEgypt
- Study dates
- Feb 2026to Aug 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 18 to 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age of the subjects will range between 18 - 45 years for young middle-aged adults.
- Unilateral SIJ pain lasting for at least 3 months, in lower back, buttock, groin, posterior superior iliac spine (PSIS) and with or without referral pain to the lower extremities.
- SIJ pain below L5 region.
- Non-centralized LBP i.e. has no directional preference.
- Score positive on 3 out of 5 SIJP provocation tests: compression, distraction, sacral thrust, thigh thrust, Gaenslen's.
Who cannot join
- Limb-length discrepancy,
- Clear signs of nerve root compression (radiating pain, motor and/or sensory deficits,
- Previous major back surgery or injury, fracture or arthritis of spine, pelvis, hip, knee or ankle joint,
- Seronegative spondyloarthropathies,
- Visual or vestibular deficit,
- Unable to follow command/ cognitive deficits,
- Postpartum women less than six months,
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Egypt1 site
Faculty of Physical Therapy, Cairo University
Giza
Marihan Z Aziz, +20 1201227971, marihan_aziz@cu.edu.eg
Mina M Morkos, Assistant Lecturer, PT. MSc
About this study
Official title: Lumbopelvic Cognitive Movement Control Training Versus Core Stability Exercises in Treatment of Sacroiliac Joint Pain
This study aims to investigate the difference between integrating lumbopelvic cognitive movement control training versus core stabilization exercises to the conventional physiotherapy program on pain, function, lumbopelvic stability, functional load transfer, and postural control in patients suffering from SIJ pain. The main question it aims to answer is:
What are the effects of adding lumbopelvic movement control training versus core stabilization exercises to the conventional physiotherapy program in treating patients with SIJ pain?
Read more
Researchers will compare adding lumbopelvic movement control training versus core stabilization exercises to the conventional physiotherapy program to investigate its effectiveness in treatment of SIJ pain
Participants will:
- receive the intervention as follows:
- Group (A) - Control Group: will receive conventional physiotherapy program (US and MET)
- Group (B) - Core Stability Exercises Group: will receive conventional US, MET, and core stability ex's
- Group (C) - Lumbopelvic cognitive movement control training Group: will receive conventional US, MET, and cognitive movement control training.
- receive the training protocol 3 times a week for 8 weeks according to the set schedules.
- perform a home exercise program in the same dose of repetitions and time as in the session.
- be assessed before and after the intervention and training period to address the outcome measures.
Read the detailed description
The sacroiliac joint (SIJ) pain is a significant contributor to LBP at any age, but it affects the elderly and young active people more frequently. Based on estimates from several studies, the SIJ causes pain in 10-38% of LBP patients. Altered lumbopelvic stability causes faulty movement of the spine during limb movement, and the faulty movement may cause mechanical irritation to the adjacent joint which when repeated and accumulated may cause LBP or SIJP. Additionally, it was revealed that patients with LBP have altered movement strategies in the form of uncontrolled movements which cause symptoms. This uncontrolled movement can be defined as 'an inability to cognitively control movement at a specific site and direction, while moving elsewhere to benchmark standards'.
Despite the need to identify the most effective treatment options for SIJ pain, controversy still remains with unclear definite conclusion regarding the use of physiotherapy interventions in those patients. Clinically, the diagnosis pathway has become more definite, but the treatment algorithm is less well-defined with conflicting evidence of the standard treatment either invasively or conservatively. For the management of SIJP, the conventional approach which includes ultrasound (US) application combined with muscle energy technique (MET) for the lumbopelvic region can be successfully used. Moreover, core stabilization exercises are considered a fundamental component of physiotherapy with the goal to improve the strength and coordination of deep core stabilizers such as the transversus abdominis, multifidus, and pelvic floor muscles, which are critical for maintaining lumbopelvic stability, reducing pain and disability and also, lowing the risk of recurrent injury. Among the conservative interventions, cognitive movement control training has begun to emerge as a promising management approach and garnered attention in recent years because it involves active cognitive participation and focuses on improving stability and neuromuscular control of the lumbosacral region.
Despite that stabilization and motor control exercises, in the context of the physiotherapy literature, are a well-established management method for LBP and SIJ region pain, there is still limited evidence on which stabilization or motor control training approach is more effective and leads to better outcomes in patients with LBP of sacroiliac origin. Unfortunately, within the available literature, various treatment plans for SIJ pain have been described but there are few published studies regarding postural lumbopelvic stability and SIJ and as a result, the assessment and management of SIJP subjects with potential balance or postural control deficits are valuable and needed.
Although the effectiveness of motor control training in reducing pain in the lumbar spine was confirmed, the need for the selection of exercises due to the occurrence of various forms of movement pattern disorders is still critical. This underlies the need to recognize individual differences in clinical presentation and/or which activities and functions are painful and difficult to do. Therefore, here is the importance of cognitive movement control training in targeting the patient's own complaint and also tailoring interventions based on assessment.
So, CMCT can be an effective form of treatment for lumbopelvic pain because this type of exercises restores normal muscle activation, proprioceptive reeducation, and retraining of movement patterns with a positive effect of on disability and pain severity in the short-term and long-term.
Despite it has been shown to have great clinical utility at the hip and groin and also, on the non-specific low back pain with positive effects on disability and pain severity in the short and long terms, there are no clear results about the effect of cognitive movement control retraining on patients with SIJP. Therefore, here is the significance of this study.
- Conditions
- Sacroiliac Joint Pain
- Being tested
- The conventional Physiotherpay Program (US & MET), Core Stability Exercises (CSE), Lumbopelvic cognitive movement control training (CMCT)
- Keywords
- cognitive movement control training, core stability exercises, sacroiliac joint pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
The conventional Physiotherpay Program (US & MET)Other
Also called control group, traditional program
The conventional approach includes ultrasound (US) application combined with muscle energy technique (MET) for the lumbopelvic region. The subjects will receive therapeutic ultrasound (for 5 mins, intensity of 1W/cm2). In addition, MET will be applied in prone for anterior and posterior innominate rotation around the pelvis. The subject will then be asked to apply 20% force against that applied by the therapist and hold that contraction for 10 seconds over 5 to 10 repetitions.
Core Stability Exercises (CSE)Other
In addition to the conventional protocol including US and MET stretching, subjects in this group will perform core stabilization exercises (CSE) to improve the activation and coordination of deep core stabilizers: transversus abdominis, multifidus, and pelvic floor muscles, which are essential for maintaining lumbopelvic stability and neuromuscular control.
The core stabilization exercises consist of 5 exercises: pelvic tilt, double knee to chest, bridging, bird-dog, and cat-camel, to be performed in the same order. Also, before each exercise, the physical therapist will give detailed verbal explanation and visual instructions (pictures) regarding the start and end positions. Each exercise will be done for two sets of 10 repetitions, 3 sessions per week (day after day), for 8 weeks.
Lumbopelvic cognitive movement control training (CMCT)Other
In addition to the traditional protocol including US and MET stretching, subjects in this group will undergo lumbopelvic cognitive movement control training (CMCT) that requires the lumbopelvic region to be positioned in a neutral alignment and the subject will be asked to consciously maintain the desired alignment and keep a pre-determined value of PBU whilst the lower limbs are actively moved to achieve a pre-determined benchmark.
This training will be in multi-directions to address the lumbopelvic uncontrolled movements into flexion, extension and rotation as follows:
- Into flexion, we will use double bent leg lift exercise
- Into extension, we will use double leg lower exercise and also, double knee bend exercise
- Into rotation, we will use single hip extension exercise and also, bent knee fallout exercise Each exercise will be done for 20-30 slow repetitions or up to two consecutive mins. of slow repetitions, with hold time (no pressure change) for at least 5 seconds inbetween.
| Study group | Role | What they receive |
|---|---|---|
| Group (A): Control Group | Active comparator | The subjects will receive therapeutic ultrasound (for 5 mins, intensity of 1W/cm2). In addition, MET will be applied in prone position for anterior and posterior innominate rotation around the pelvis. Receives: Other: The conventional Physiotherpay Program (US & MET) |
| Group (B): Core Stability Exercises Group | Experimental | In addition to the traditional protocol delivered in group (A) including US and stretching by MET, subjects in this group will perform core stabilization exercises (CSE) to improve the activation and coordination of deep core stabilizers: transversus abdominis, multifidus, and pelvic floor muscles.
The core stabilization exercises consist of 5 exercises: pelvic tilt, double knee to chest, bridging, bird-dog, and cat-camel to be performed in the same order. Receives: Other: The conventional Physiotherpay Program (US & MET); Other: Core Stability Exercises (CSE) |
| Group (C): Lumbopelvic cognitive movement control training Group | Experimental | In addition to the traditional protocol delivered in group (A) including US and stretching by MET, subjects in this group will undergo lumbopelvic cognitive movement control training (CMCT) that requires the lumbopelvic region to be positioned neutrally and the subject will be asked to consciously maintain the desired alignment and keep a pre-determined value of PBU whilst the lower limbs are actively moved to achieve a pre-determined benchmark.
This training will be in multi-directions to address the lumbopelvic uncontrolled movements into flexion, extension and rotation as follows:
* Into flexion, we will use double bent leg lift exercise.
* Into extension, we will use double leg lower exercise and also, double knee bend exercise
* Into rotation, we will use single hip extension exercise and also, bent knee fallout exercise Receives: Other: The conventional Physiotherpay Program (US & MET); Other: Lumbopelvic cognitive movement control training (CMCT) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Pain: using Numerical Pain Rating Scale (NPRS)
The Arabic Numeric Pain Rating Scale (ANPRS) measures pain intensity in Arabic-speaking patients. The patients will be asked to rate their pain on a 10-point pain scale with a 0 score means no pain and 10 score means maximum pain.
Measured: Baseline (pre-treatment) and after 8 weeks (post-treatment)
Functional disability: using Oswestry Disability Index (ODI)
The Arabic ODI is appropriate for use as a patient reported outcome measure with Arabic speaking individuals with low back pain and /or SIJ pain. The patients will be instructed to fill the ODI which is a self-report pencil and paper survey, where subjects indicate how their pain affects their abilities in 10 questions on domains such as pain intensity, personal care, lifting, walking, sitting, standing, sleeping, social life, travel, and sexual life.
Measured: Baseline (pre-treatment) and after 8 weeks (post-treatment)
Secondary outcomes (3)
Lumbopelvic motor control function: by Pressure Biofeedback Unit (PBU)
It will be used to indirectly monitor muscle activity by the change of pressure as a mean to estimate the muscle activation of the multifidus (MF) and transversus abdominis (TA) muscles that, in turn, helps patients undertake motor control exercise interventions.
While the subjects will be trying to keep the PBU value constant as possible (40 mm Hg in supine and 70 mm Hg in prone), they will be instructed to breathe normally to avoid a Valsalva maneuver and to consciously do certain lower limb movements (double bent leg lift and lowering in crook-lying, double knee bend in prone).
Measured: Baseline (pre-treatment) and after 8 weeks (post-treatment)
Functional Load transfer: by Active straight leg raise test (ASLR)
The ASLR test will be performed to detect failed load transfer across the lumbopelvic region in supine position with straight legs and feet apart. Patients will be asked to raise his/her lower limb above the bench for 20 cm or 20° hip flexion without bending the knee and return it to back after a 1-2 second hold. The test then will be repeated while a manual compressive force is applied through the ilia, or with a belt tightened around the pelvis or SIJ. A positive test is denoted by improved ability to raise the leg.
Measured: Baseline (pre-treatment) and after 8 weeks (post-treatment)
Balance and Postural control: by Single leg stance balance test with eyes closed (SLSBT-EC)
This test will be used for detecting balance impairments and postural control deficits in SIJP patients. While standing bare-footed on the weightbearing lower extremity on the floor with the contralateral hip flexed to 45° and the knee flexed to 90° so that the knee is in front of the standing leg and the foot behind the standing leg, the patients will be asked to balance for up to 30 s with eyes closed (EC).
Measured: Baseline (pre-treatment) and after 8 weeks (post-treatment)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Jan 2026
- Study startFeb 2026 (estimated)
- Primary completionJul 2026 (estimated)
- Study completionAug 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (38)Papers the sponsor has linked to this study.
- Other trials for Sacroiliac Joint PainStudies of the same condition, open and under way.
- More trials run by Cairo 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
- Masking
- None (open label)
- Enrolment
- 36 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Mina Maher Morkos, Cairo University
- Investigators
- Salwa F Abdelmajeed, Professor, PT. PhD., Study chair, Cairo UniversityMarihan Z Aziz, Lecturer, PT. PhD, Study director, Cairo UniversityIhab M Emran, Assistant Professor, MD. PhD, Study chair, Faculty of Medicine (Kasr Al-Aini), Cairo University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07370272
- Sponsor's protocol ID
- CMCT in SIJ Pain
- Status last verified
- Jan 2026
- First submitted
- 19 Jan 2026
- Last updated
- 27 Jan 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Zaworski K, Gawlik K, Kregiel-Rosiak A, Baj-Korpak J. The effect of motor control training according to the Kinetic Control concept on the back pain of female football players. J Back Musculoskelet Rehabil. 2021;34(5):757-765. doi: 10.3233/BMR-200226.
PubMed 33896810Yan H, Zhao P, Guo X, Zhou X. The effects of Core Stability Exercises and Mulligan's mobilization with movement techniques on sacroiliac joint dysfunction. Front Physiol. 2024 Apr 18;15:1337754. doi: 10.3389/fphys.2024.1337754. eCollection 2024.
PubMed 38699145Vleeming A, Schuenke MD, Masi AT, Carreiro JE, Danneels L, Willard FH. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. J Anat. 2012 Dec;221(6):537-67. doi: 10.1111/j.1469-7580.2012.01564.x. Epub 2012 Sep 19.
PubMed 22994881Stochkendahl MJ, Kjaer P, Hartvigsen J, Kongsted A, Aaboe J, Andersen M, Andersen MO, Fournier G, Hojgaard B, Jensen MB, Jensen LD, Karbo T, Kirkeskov L, Melbye M, Morsel-Carlsen L, Nordsteen J, Palsson TS, Rasti Z, Silbye PF, Steiness MZ, Tarp S, Vaagholt M. National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. Eur Spine J. 2018 Jan;27(1):60-75. doi: 10.1007/s00586-017-5099-2. Epub 2017 Apr 20.
PubMed 28429142Sarkar M, Goyal M, Samuel AJ. Comparing the Effectiveness of the Muscle Energy Technique and Kinesiotaping in Mechanical Sacroiliac Joint Dysfunction: A Non-blinded, Two-Group, Pretest-Posttest Randomized Clinical Trial Protocol. Asian Spine J. 2021 Feb;15(1):54-63. doi: 10.31616/asj.2019.0300. Epub 2020 Jan 30.
PubMed 31992024Santos GK, Goncalves de Oliveira R, Campos de Oliveira L, Ferreira C de Oliveira C, Andraus RA, Ngomo S, Fusco A, Cortis C, DA Silva RA. Effectiveness of muscle energy technique in patients with nonspecific low back pain: a systematic review with meta-analysis. Eur J Phys Rehabil Med. 2022 Dec;58(6):827-837. doi: 10.23736/S1973-9087.22.07424-X. Epub 2022 Sep 28.
PubMed 36169931Saner J, Kool J, Sieben JM, Luomajoki H, Bastiaenen CH, de Bie RA. A tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment: A randomised controlled trial with one-year follow-up. Man Ther. 2015 Oct;20(5):672-9. doi: 10.1016/j.math.2015.02.005. Epub 2015 Feb 26.
PubMed 25770419Saltychev M, Mattie R, McCormick Z, Barlund E, Laimi K. Psychometric properties of the Oswestry Disability Index. Int J Rehabil Res. 2017 Sep;40(3):202-208. doi: 10.1097/MRR.0000000000000226.
PubMed 28368870Mottram S, Warner M, Booysen N, Bahain-Steenman K, Stokes M. Retraining in a Female Elite Rower with Persistent Symptoms Post-Arthroscopy for Femoroacetabular Impingement Syndrome: A Proof-of-Concept Case Report. J Funct Morphol Kinesiol. 2019 May 7;4(2):24. doi: 10.3390/jfmk4020024.
PubMed 33467339Sahrmann S, Azevedo DC, Dillen LV. Diagnosis and treatment of movement system impairment syndromes. Braz J Phys Ther. 2017 Nov-Dec;21(6):391-399. doi: 10.1016/j.bjpt.2017.08.001. Epub 2017 Sep 27.
PubMed 29097026Prather H, Bonnette M, Hunt D. Nonoperative Treatment Options for Patients With Sacroiliac Joint Pain. Int J Spine Surg. 2020 Feb 10;14(Suppl 1):35-40. doi: 10.14444/6082. eCollection 2020 Feb.
PubMed 32123656Promsri A. Age and Visual Contribution Effects on Postural Control Assessed by Principal Component Analysis of Kinematic Marker Data. Sports (Basel). 2023 May 5;11(5):98. doi: 10.3390/sports11050098.
PubMed 37234054Owen PJ, Miller CT, Mundell NL, Verswijveren SJJM, Tagliaferri SD, Brisby H, Bowe SJ, Belavy DL. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. Br J Sports Med. 2020 Nov;54(21):1279-1287. doi: 10.1136/bjsports-2019-100886. Epub 2019 Oct 30.
PubMed 31666220O'Sullivan PB, Beales DJ, Beetham JA, Cripps J, Graf F, Lin IB, Tucker B, Avery A. Altered motor control strategies in subjects with sacroiliac joint pain during the active straight-leg-raise test. Spine (Phila Pa 1976). 2002 Jan 1;27(1):E1-8. doi: 10.1097/00007632-200201010-00015.
PubMed 11805650Mottram S, Blandford L. Assessment of movement coordination strategies to inform health of movement and guide retraining interventions. Musculoskelet Sci Pract. 2020 Feb;45:102100. doi: 10.1016/j.msksp.2019.102100. Epub 2019 Dec 9.
PubMed 32056825
Study at a glance
From the registry record, last updated by the sponsor on 27 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Lumbopelvic Cognitive Movement Control Training Versus Core Stability Exercises in Treatment of Sacroiliac Joint Pain
- ClinicalTrials.gov ID
- NCT07370272
- Acronym / sponsor ID
- CMCT in SIJ Pain
- Conditions
- Sacroiliac Joint Pain
- Keywords
- cognitive movement control training, core stability exercises, sacroiliac joint pain
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 36 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- Feb 2026 (estimated)
- Primary completion
- Jul 2026 (estimated)
- Study completion
- Aug 2026 (estimated)
- First posted
- 27 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.
This study aims to investigate the difference between integrating lumbopelvic cognitive movement control training versus core stabilization exercises to the conventional physiotherapy program on pain, function, lumbopelvic stability, functional load transfer, and postural control in patients suffering from SIJ pain. The main question it aims to answer is:
What are the effects of adding lumbopelvic movement control training versus core stabilization exercises to the conventional physiotherapy program in treating patients with SIJ pain?
Researchers will compare adding lumbopelvic movement control training versus core stabilization exercises to the conventional physiotherapy program to investigate its effectiveness in treatment of SIJ pain
Participants will:
- receive the intervention as follows:
- Group (A) - Control Group: will receive conventional physiotherapy program (US and MET)
- Group (B) - Core Stability Exercises Group: will receive conventional US, MET, and core stability ex's
- Group (C) - Lumbopelvic cognitive movement control training Group: will receive conventional US, MET, and cognitive movement control training.
- receive the training protocol 3 times a week for 8 weeks according to the set schedules.
- perform a home exercise program in the same dose of repetitions and time as in the session.
- be assessed before and after the intervention and training period to address the outcome measures.
Detailed description
The sacroiliac joint (SIJ) pain is a significant contributor to LBP at any age, but it affects the elderly and young active people more frequently. Based on estimates from several studies, the SIJ causes pain in 10-38% of LBP patients. Altered lumbopelvic stability causes faulty movement of the spine during limb movement, and the faulty movement may cause mechanical irritation to the adjacent joint which when repeated and accumulated may cause LBP or SIJP. Additionally, it was revealed that patients with LBP have altered movement strategies in the form of uncontrolled movements which cause symptoms. This uncontrolled movement can be defined as 'an inability to cognitively control movement at a specific site and direction, while moving elsewhere to benchmark standards'.
Despite the need to identify the most effective treatment options for SIJ pain, controversy still remains with unclear definite conclusion regarding the use of physiotherapy interventions in those patients. Clinically, the diagnosis pathway has become more definite, but the treatment algorithm is less well-defined with conflicting evidence of the standard treatment either invasively or conservatively. For the management of SIJP, the conventional approach which includes ultrasound (US) application combined with muscle energy technique (MET) for the lumbopelvic region can be successfully used. Moreover, core stabilization exercises are considered a fundamental component of physiotherapy with the goal to improve the strength and coordination of deep core stabilizers such as the transversus abdominis, multifidus, and pelvic floor muscles, which are critical for maintaining lumbopelvic stability, reducing pain and disability and also, lowing the risk of recurrent injury. Among the conservative interventions, cognitive movement control training has begun to emerge as a promising management approach and garnered attention in recent years because it involves active cognitive participation and focuses on improving stability and neuromuscular control of the lumbosacral region.
Despite that stabilization and motor control exercises, in the context of the physiotherapy literature, are a well-established management method for LBP and SIJ region pain, there is still limited evidence on which stabilization or motor control training approach is more effective and leads to better outcomes in patients with LBP of sacroiliac origin. Unfortunately, within the available literature, various treatment plans for SIJ pain have been described but there are few published studies regarding postural lumbopelvic stability and SIJ and as a result, the assessment and management of SIJP subjects with potential balance or postural control deficits are valuable and needed.
Although the effectiveness of motor control training in reducing pain in the lumbar spine was confirmed, the need for the selection of exercises due to the occurrence of various forms of movement pattern disorders is still critical. This underlies the need to recognize individual differences in clinical presentation and/or which activities and functions are painful and difficult to do. Therefore, here is the importance of cognitive movement control training in targeting the patient's own complaint and also tailoring interventions based on assessment.
So, CMCT can be an effective form of treatment for lumbopelvic pain because this type of exercises restores normal muscle activation, proprioceptive reeducation, and retraining of movement patterns with a positive effect of on disability and pain severity in the short-term and long-term.
Despite it has been shown to have great clinical utility at the hip and groin and also, on the non-specific low back pain with positive effects on disability and pain severity in the short and long terms, there are no clear results about the effect of cognitive movement control retraining on patients with SIJP. Therefore, here is the significance of this study.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Group (A): Control Group | Active comparator | Other: The conventional Physiotherpay Program (US & MET)The subjects will receive therapeutic ultrasound (for 5 mins, intensity of 1W/cm2). In addition, MET will be applied in prone position for anterior and posterior innominate rotation around the pelvis. |
| Group (B): Core Stability Exercises Group | Experimental | Other: The conventional Physiotherpay Program (US & MET), Other: Core Stability Exercises (CSE)In addition to the traditional protocol delivered in group (A) including US and stretching by MET, subjects in this group will perform core stabilization exercises (CSE) to improve the activation and coordination of deep core stabilizers: transversus abdominis, multifidus, and pelvic floor muscles. The core stabilization exercises consist of 5 exercises: pelvic tilt, double knee to chest, bridging, bird-dog, and cat-camel to be performed in the same order. |
| Group (C): Lumbopelvic cognitive movement control training Group | Experimental | Other: The conventional Physiotherpay Program (US & MET), Other: Lumbopelvic cognitive movement control training (CMCT)In addition to the traditional protocol delivered in group (A) including US and stretching by MET, subjects in this group will undergo lumbopelvic cognitive movement control training (CMCT) that requires the lumbopelvic region to be positioned neutrally and the subject will be asked to consciously maintain the desired alignment and keep a pre-determined value of PBU whilst the lower limbs are actively moved to achieve a pre-determined benchmark. This training will be in multi-directions to address the lumbopelvic uncontrolled movements into flexion, extension and rotation as follows: * Into flexion, we will use double bent leg lift exercise. * Into extension, we will use double leg lower exercise and also, double knee bend exercise * Into rotation, we will use single hip extension exercise and also, bent knee fallout exercise |
Who may qualify
- Ages
- 18 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Age of the subjects will range between 18 - 45 years for young middle-aged adults.
- Unilateral SIJ pain lasting for at least 3 months, in lower back, buttock, groin, posterior superior iliac spine (PSIS) and with or without referral pain to the lower extremities.
- SIJ pain below L5 region.
- Non-centralized LBP i.e. has no directional preference.
- Score positive on 3 out of 5 SIJP provocation tests: compression, distraction, sacral thrust, thigh thrust, Gaenslen's.
Key exclusion criteria (7 listed)
- Limb-length discrepancy,
- Clear signs of nerve root compression (radiating pain, motor and/or sensory deficits,
- Previous major back surgery or injury, fracture or arthritis of spine, pelvis, hip, knee or ankle joint,
- Seronegative spondyloarthropathies,
- Visual or vestibular deficit,
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 |
|---|---|---|
| The conventional Physiotherpay Program (US & MET)Also: control group, traditional programThe conventional approach includes ultrasound (US) application combined with muscle energy technique (MET) for the lumbopelvic region. The subjects will receive therapeutic ultrasound (for 5 mins, intensity of 1W/cm2). In addition, MET will be applied in prone for anterior and posterior innominate rotation around the pelvis. The subject will then be asked to apply 20% force against that applied by the therapist and hold that contraction for 10 seconds over 5 to 10 repetitions. | Other | Group (A): Control Group, Group (B): Core Stability Exercises Group, Group (C): Lumbopelvic cognitive movement control training Group |
| Core Stability Exercises (CSE)In addition to the conventional protocol including US and MET stretching, subjects in this group will perform core stabilization exercises (CSE) to improve the activation and coordination of deep core stabilizers: transversus abdominis, multifidus, and pelvic floor muscles, which are essential for maintaining lumbopelvic stability and neuromuscular control. The core stabilization exercises consist of 5 exercises: pelvic tilt, double knee to chest, bridging, bird-dog, and cat-camel, to be performed in the same order. Also, before each exercise, the physical therapist will give detailed verbal explanation and visual instructions (pictures) regarding the start and end positions. Each exercise will be done for two sets of 10 repetitions, 3 sessions per week (day after day), for 8 weeks. | Other | Group (B): Core Stability Exercises Group |
| Lumbopelvic cognitive movement control training (CMCT)In addition to the traditional protocol including US and MET stretching, subjects in this group will undergo lumbopelvic cognitive movement control training (CMCT) that requires the lumbopelvic region to be positioned in a neutral alignment and the subject will be asked to consciously maintain the desired alignment and keep a pre-determined value of PBU whilst the lower limbs are actively moved to achieve a pre-determined benchmark. This training will be in multi-directions to address the lumbopelvic uncontrolled movements into flexion, extension and rotation as follows: * Into flexion, we will use double bent leg lift exercise * Into extension, we will use double leg lower exercise and also, double knee bend exercise * Into rotation, we will use single hip extension exercise and also, bent knee fallout exercise Each exercise will be done for 20-30 slow repetitions or up to two consecutive mins. of slow repetitions, with hold time (no pressure change) for at least 5 seconds inbetween. | Other | Group (C): Lumbopelvic cognitive movement control training Group |
Primary outcome
Pain: using Numerical Pain Rating Scale (NPRS)
Time frame: Baseline (pre-treatment) and after 8 weeks (post-treatment)
The Arabic Numeric Pain Rating Scale (ANPRS) measures pain intensity in Arabic-speaking patients. The patients will be asked to rate their pain on a 10-point pain scale with a 0 score means no pain and 10 score means maximum pain.
Functional disability: using Oswestry Disability Index (ODI)
Time frame: Baseline (pre-treatment) and after 8 weeks (post-treatment)
The Arabic ODI is appropriate for use as a patient reported outcome measure with Arabic speaking individuals with low back pain and /or SIJ pain. The patients will be instructed to fill the ODI which is a self-report pencil and paper survey, where subjects indicate how their pain affects their abilities in 10 questions on domains such as pain intensity, personal care, lifting, walking, sitting, standing, sleeping, social life, travel, and sexual life.
3 secondary outcomes
Lumbopelvic motor control function: by Pressure Biofeedback Unit (PBU)
Time frame: Baseline (pre-treatment) and after 8 weeks (post-treatment)
Functional Load transfer: by Active straight leg raise test (ASLR)
Time frame: Baseline (pre-treatment) and after 8 weeks (post-treatment)
Balance and Postural control: by Single leg stance balance test with eyes closed (SLSBT-EC)
Time frame: Baseline (pre-treatment) and after 8 weeks (post-treatment)
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 27 Jan 2026.
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- Background: PubMed 38699145Yan H, Zhao P, Guo X, Zhou X. The effects of Core Stability Exercises and Mulligan's mobilization with movement techniques on sacroiliac joint dysfunction. Front Physiol. 2024 Apr 18;15:1337754. doi: 10.3389/fphys.2024.1337754. eCollection 2024.
- Background: PubMed 22994881Vleeming A, Schuenke MD, Masi AT, Carreiro JE, Danneels L, Willard FH. The sacroiliac joint: an overview of its anatomy, function and potential clinical implications. J Anat. 2012 Dec;221(6):537-67. doi: 10.1111/j.1469-7580.2012.01564.x. Epub 2012 Sep 19.
- Background: PubMed 28429142Stochkendahl MJ, Kjaer P, Hartvigsen J, Kongsted A, Aaboe J, Andersen M, Andersen MO, Fournier G, Hojgaard B, Jensen MB, Jensen LD, Karbo T, Kirkeskov L, Melbye M, Morsel-Carlsen L, Nordsteen J, Palsson TS, Rasti Z, Silbye PF, Steiness MZ, Tarp S, Vaagholt M. National Clinical Guidelines for non-surgical treatment of patients with recent onset low back pain or lumbar radiculopathy. Eur Spine J. 2018 Jan;27(1):60-75. doi: 10.1007/s00586-017-5099-2. Epub 2017 Apr 20.
- Background: PubMed 31992024Sarkar M, Goyal M, Samuel AJ. Comparing the Effectiveness of the Muscle Energy Technique and Kinesiotaping in Mechanical Sacroiliac Joint Dysfunction: A Non-blinded, Two-Group, Pretest-Posttest Randomized Clinical Trial Protocol. Asian Spine J. 2021 Feb;15(1):54-63. doi: 10.31616/asj.2019.0300. Epub 2020 Jan 30.
- Background: PubMed 36169931Santos GK, Goncalves de Oliveira R, Campos de Oliveira L, Ferreira C de Oliveira C, Andraus RA, Ngomo S, Fusco A, Cortis C, DA Silva RA. Effectiveness of muscle energy technique in patients with nonspecific low back pain: a systematic review with meta-analysis. Eur J Phys Rehabil Med. 2022 Dec;58(6):827-837. doi: 10.23736/S1973-9087.22.07424-X. Epub 2022 Sep 28.
- Background: PubMed 25770419Saner J, Kool J, Sieben JM, Luomajoki H, Bastiaenen CH, de Bie RA. A tailored exercise program versus general exercise for a subgroup of patients with low back pain and movement control impairment: A randomised controlled trial with one-year follow-up. Man Ther. 2015 Oct;20(5):672-9. doi: 10.1016/j.math.2015.02.005. Epub 2015 Feb 26.
- Background: PubMed 28368870Saltychev M, Mattie R, McCormick Z, Barlund E, Laimi K. Psychometric properties of the Oswestry Disability Index. Int J Rehabil Res. 2017 Sep;40(3):202-208. doi: 10.1097/MRR.0000000000000226.
- Background: PubMed 33467339Mottram S, Warner M, Booysen N, Bahain-Steenman K, Stokes M. Retraining in a Female Elite Rower with Persistent Symptoms Post-Arthroscopy for Femoroacetabular Impingement Syndrome: A Proof-of-Concept Case Report. J Funct Morphol Kinesiol. 2019 May 7;4(2):24. doi: 10.3390/jfmk4020024.
- Background: PubMed 29097026Sahrmann S, Azevedo DC, Dillen LV. Diagnosis and treatment of movement system impairment syndromes. Braz J Phys Ther. 2017 Nov-Dec;21(6):391-399. doi: 10.1016/j.bjpt.2017.08.001. Epub 2017 Sep 27.
- Background: PubMed 32123656Prather H, Bonnette M, Hunt D. Nonoperative Treatment Options for Patients With Sacroiliac Joint Pain. Int J Spine Surg. 2020 Feb 10;14(Suppl 1):35-40. doi: 10.14444/6082. eCollection 2020 Feb.
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- Individual participant dataSharing planned: Undecided
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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.
Salwa F Abdelmajeed, Professor, PT. PhD. study chair
Cairo University
Marihan Z Aziz, Lecturer, PT. PhD study director
Cairo University
Ihab M Emran, Assistant Professor, MD. PhD study chair
Faculty of Medicine (Kasr Al-Aini), Cairo 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 The conventional Physiotherpay Program (US & MET) and Core Stability Exercises (CSE) in people with Sacroiliac Joint Pain, run by Cairo University at 1 site in Egypt.
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 5 inclusion and 7 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: opening soon, as of the sponsor's last update on 27 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 Egypt. 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 Mina M Morkos, Assistant Lecturer, PT. MSc. (+20 1285061286, mina.maher.morkos@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Pain: using Numerical Pain Rating Scale (NPRS) (time frame: Baseline (pre-treatment) and after 8 weeks (post-treatment)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07370272, which also lists 38 linked publications.
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 Jan 2026.