Efficacy of Mulligan Mobilization, Maitland Mobilization, High-Velocity Thrust, and Muscle Energy Technique for Pain, Disability, and Center-of-Gravity Displacement in Patients With Sacroiliac Joint Dysfunction: Protocol for a Randomized Controlled Trial

Background: Sacroiliac joint (SIJ) dysfunction is associated with significant pain, disability, and altered postural control in adults. Manual therapies, including Mulligan mobilization, Maitland mobilization, high-velocity thrust (HVT), and muscle energy technique (MET), are routinely applied for the management of SIJ dysfunction. However, comparative evidence regarding their effects on pain, disability, and center-of-gravity (COG) displacement remains insufficient. Objective: This study aims to compare the efficacy of Mulligan mobilization, Maitland mobilization, HVT, and MET in improving pain, functional disability, and COG displacement in individuals with SIJ dysfunction. Methods: A randomized controlled, parallel-group trial will be conducted on participants diagnosed with unilateral SIJ dysfunction. Participants will be assigned in equal numbers to 4 groups, each receiving Mulligan mobilization, Maitland mobilization, HVT, or MET interventions administered 5 days per week for 3 weeks, in addition to a standardized exercise regimen. The primary outcomes will be pain (assessed using a visual analog scale [VAS]) and functional disability (assessed using the Modified Oswestry Disability Index [MODI]), and the secondary outcome will be COG displacement (measured by sway velocity, lift-up index on the left and right, COG alignment, movement time, and impact index). Results: We hypothesize that all interventions will lead to statistically significant reductions in pain and disability. Results will be analyzed after the completion of the study. Conclusions: This protocol is designed to provide robust comparative data on manual therapy approaches for SIJ dysfunction. Findings may guide physiotherapy practice by informing evidence-based recommendations for optimal management strategies.