CClinicalTrials.gg
CompletedNCT07441018Updated Feb 27, 2026

Mulligan Mobilization With Movement in Patients With Unilateral Anterior Sacral Nutation.

An interventional study of Mulligan mobilization with movement. and Conservative Physical Therapy. in Core Stability, Exercise Therapy and Low Back Pain, sponsored by Riphah International University. Completed at 1 site in Pakistan. Open to participants aged 20 Years to 30 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-02-27.

Sponsored by Riphah International University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 1 year after the study started (first participant enrolled Feb 2025, registered Feb 2026).
Phase
Not applicable
Study type
Interventional
Enrollment
41
Allocation
Randomized
Ages
20 Years to 30 Years
Sex
All
01

Study 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 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.

02

Conditions studied

  • Core Stability
  • Exercise Therapy
  • Low Back Pain
  • Mulligan Mobilization
  • Sacroiliac Joint

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Keywords

  • Core Stability
  • Exercise Therapy
  • Low back pain
  • Mulligan mobilization
  • Sacroiliac joint
03

In context

Low Back Pain

2,818 studies on the registry are indexed under Low Back Pain; 482 are open to participants now.

This study's enrollment of 41 is below the median of 60 across 2,268 interventional studies indexed under Low Back Pain.

Browse Low Back Pain studies →

Lead sponsor

Riphah International University is the lead sponsor of 2,133 studies on the registry; 633 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
20 Years to 30 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • 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.

Exclusion criteria

Exclusion Criteria:

  • 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
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
41 participants (actual)

Study arms

  • Experimental
    Mulligan Mobilization with conservative treatment.

    Participants receive Mulligan mobilization and baseline physical therapy.

    Other: Mulligan mobilization with movement.

  • Active comparator
    Only conservative treatment.

    Participants receive baseline physical therapy intervention.

    Other: Conservative Physical Therapy.

Interventions

  • OtherMulligan 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).

  • OtherConservative 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)

06

What researchers measure

Primary outcomes

  1. 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

    Time frame: 8 weeks

  2. 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)

    Time frame: 8 weeks

  3. 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.

    Time frame: 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

    Time frame: 8 weeks

07

Study locations

1 site
  • Gosh-e-Shifa Hospital and Al Raheem Physiotherapy Centre, Lahore.
    Lahore, 56700, Pakistan
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 27, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07441018
Lead sponsor
Riphah International University
Responsible party
Sponsor
First posted
Feb 27, 2026
Start date
Feb 15, 2025
Primary completion
Jan 15, 2026
Completion
Jan 15, 2026
Last update
Feb 27, 2026

Study contacts

Faiza Taufiq
principal investigator · Riphah International University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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