EFFECTS OF MODIFIED CLAMSHELL TRAINING VERSUS SLING SYSTEM TRAINING ON PAIN, FUNCTIONAL DISABILITY AND SIJ NUTATION CONTROL IN POSTPARTUM WOMEN WITH SIJ DYSFUNCTION

Abstract

Background: Postpartum sacroiliac joint (SIJ) dysfunction is a common musculoskeletal condition associated with pelvic pain, impaired lumbopelvic stability and functional disability. Modified Clamshell Training (MCT) and Sling System Training (SST) are used to improve pelvic stability, gluteal muscle activation and neuromuscular control; however, limited evidence is available regarding their comparative effectiveness in postpartum women with SIJ dysfunction.

Objective: The objective of the study was to compare the therapeutic effects of MCT and SST on pain, functional disability and SIJ nutation control in postpartum women with SIJ dysfunction.

Method: The study was a randomized clinical trial. Total 36 postpartum women diagnosed with SIJ dysfunction. Participants were allocated into two groups with 18 participants receiving MCT and 18 receiving SST. MCT consisted of modified side-lying clamshell exercises emphasizing pelvic control and activation of the gluteal muscles. SST targeted LS, POS and DLS through functional exercises designed to improve lumbopelvic stability and force transfer. For six weeks, both interventions were carried out three times a week for 30 to 40 minutes each. NPRS was used to measure pain, PGQ was used to measure functional disability and a digital inclinometer was used to measure SIJ nutation control. Paired samples t test and independent samples t tests were used to examine the data with a statistical significance level of p >0.05.

 Results: The MCT group demonstrated a significantly lower NPRS score (1.67±0.97) compared with the SST group (3.78±0.81), p<0.001. Similarly, the post-treatment PGQ score was significantly lower in the SST group (30.11±2.49) than in the MCT group (34.39±2.68), p<0.001. Digital inclinometer measurements were significantly higher in the SST group (9.42±1.13°) compared with the MCT group (8.22±1.43°), p=0.009. Both interventions produced significant within-group improvements in pain, functional disability, and SIJ nutation control.

Conclusion: Both Modified Clamshell Training and Sling System Training were effective in reducing pain and improving functional disability and SIJ nutation control in postpartum women with SIJ dysfunction. However, Modified Clamshell Training demonstrated greater effectiveness in reducing pain, whereas Sling System Training showed greater improvements in functional disability and SIJ nutation control.