The effects of ischaemic compression vs integrated neurosmuscular inhibition technique on the gluteus medius muscle in the treatment of sacroiliac joint syndrome

M.Tech. (Chiropractic)Objective: The purpose of the study was to determine the most effective way of treating Sacroiliac (SI) joint syndrome with associated Gluteus Medius muscle myofascial trigger points (MFTP) by using adjustive techniques performed on the SI joint with a soft tissue technique. The soft tissue techniques were either ischaemic compression (IC) vs integrated neuromuscular inhibition technique (INIT). Study Design: This was a randomised comparative trial. Setting: The participants were treated at the University of Johannesburg Chiropractic day clinic. Subjects: Thirty participants were randomly divided into two groups consisting of fifteen individuals each. There was a random selection of males and females which was not limited to any particular race or gender. Participants were limited to between the ages of 18 to 35 years of age. Participants diagnosed with SI joint syndrome and who had active Gluteus Medius myofascial trigger points were eligible for this study. Method: Subjective data was collected, by the participants completing an Oswestry low back pain and disability questionnaire and a Numerical pain rating scale (NPRS). The objective data readings involved assessing the range of motion of the hip joint, with a goniometer. Algometry readings of the most active Gluteus medius trigger point were taken, to measure the amount of force on the muscle trigger point before pain was felt. Each participant was seen seven times over the span of three weeks and underwent six treatments. Group 1 received ischemic compression to the Gluteus Medius trigger points followed by an adjustment to the predetermined restricted SI joint during visit 1-6. Group 2 received INIT to the Gluteus medius trigger points followed by an adjustment to the predetermined restricted SI joint during visits 1-6. Measurements were taken at visit 1, 4, and 7 before the treatment. Results: The results indicated that neither the IC group nor the INIT group showed statistically significant improvements when comparing the two treatment methods to each other. The comparison between the two techniques did however show clinical benefit in the subjective and objective readings throughout in the intra group analysis. It appears that that the ischemic compression had more clinical benefit in terms of subjective pain readings for the Oswestry low back pain and disability questionnaire and the NPRS. The INIT seemed to provide greater clinical improvement in terms of hip range of motion as it showed to be more beneficial in increasing hip adduction and abduction. Conclusion: The results of this study was that neither group had showed statistically significant improvements when comparing the two treatment methods to each other and therefore neither method exhibited superiority over the other according to the statistical analysis in the treatment of Gluteus Medius myofascial trigger points and SI joint syndrome