{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:52:31Z","timestamp":1790196751742,"version":"4.1.0"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Sacroiliac joint dysfunction (SIJD), while being the primary contributor to low back pain, is still disregarded and treated as low back pain. Mulligan\u2019s Mobilization with Movement (MWM) Techniques and Core Stability Exercises (CSE) are often used to treat low back pain. There is not much evidence that it is effective in SIJD. To evaluate the effectiveness of CSE coupled with MWM (CSE + MWM) in the treatment of SIJD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>39 patients with SIJD were recruited and randomly divided into distinct groups as follows: control group (n = 13), CSE group (n = 13) and CSE + MWM group (n = 13). The Numerical Pain Rating Scale (NPRS), the Roland Morris Disability Questionnaire (RMDQ), the Range of Motion (ROM), the Pressure Pain Threshold (PPT) and the pelvic tilt angle asymmetry ratio in the sagittal plane (PTAR) were used to gauge the intervention\u2019s success both before (M0) and after (M1) it. All experimental data were statistically analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The SIJ-related pain metric significantly decreased in both the CSE + MWM group and the CSE group between M0 and M1, as determined by the NPRS and RMDQ. Between M0 and M1, The CSE group\u2019s left axial rotation ROM and lumbar flexion ROM were significantly decreased. The CSE + MWM group\u2019s extension ROM and left lateral flexion ROM both significantly increased between M0 and M1. In the difference variable (M1-M0), the CSE + MWM group substantially outperformed control group in the left lateral flexion ROM and outperformed the CSE group in the left axial rotation ROM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In individuals with SIJD, CSE + MWM is beneficial in lowering pain, disability, and function. Treatment with CSE and MWM approaches for SIJ appears to boost this efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphys.2024.1337754","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T01:12:34Z","timestamp":1713402754000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["The effects of Core Stability Exercises and Mulligan\u2019s mobilization with movement techniques on sacroiliac joint dysfunction"],"prefix":"10.3389","volume":"15","author":[{"given":"Huiqian","family":"Yan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuanhui","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,4,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"71","DOI":"10.2519\/jospt.1991.13.2.71","article-title":"The sacroiliac joint: review of anatomy, mechanics, and function","volume":"13","author":"Alderink","year":"1991","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1689","DOI":"10.1589\/jpts.29.1689","article-title":"The effectiveness of physiotherapy interventions for sacroiliac joint dysfunction: a systematic review","volume":"29","author":"Al-Subahi","year":"2017","journal-title":"J. Phys. Ther. Sci."},{"key":"B3","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1016\/s0140-6736(99)01312-4","article-title":"Epidemiological features of chronic low-back pain","volume":"354","author":"Andersson","year":"1999","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"33","DOI":"10.3233\/BMR-2012-0347","article-title":"Manipulation and selective exercises decrease pelvic anteversion and low-back pain: a pilot study","volume":"26","author":"Barbosa","year":"2013","journal-title":"J. Back Musculoskelet. Rehabil."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e10706","DOI":"10.7717\/peerj.10706","article-title":"Myofascial release versus Mulligan sustained natural apophyseal glides' immediate and short-term effects on pain, function, and mobility in non-specific low back pain","volume":"9","author":"Bhat","year":"2021","journal-title":"PeerJ"},{"key":"B6","doi-asserted-by":"publisher","first-page":"154","DOI":"10.3138\/ptc.2009-37","article-title":"Managing a female patient with left low back pain and sacroiliac joint pain with therapeutic exercise: a case report","volume":"63","author":"Boyle","year":"2011","journal-title":"Physiother. Can."},{"key":"B7","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1177\/1941738113502451","article-title":"Core stabilization exercise prescription, part I: current concepts in assessment and intervention","volume":"5","author":"Brumitt","year":"2013","journal-title":"Sports Health"},{"key":"B8","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1016\/j.jmpt.2021.06.005","article-title":"Effect of sustained natural apophyseal glides on stiffness of lumbar stabilizer muscles in patients with nonspecific low back pain: randomized controlled trial","volume":"44","author":"Buran \u00c7irak","year":"2021","journal-title":"J. Manip. Physiol. Ther."},{"key":"B9","doi-asserted-by":"publisher","first-page":"75","DOI":"10.2165\/00007256-200232010-00004","article-title":"Aggressive exercise as treatment for chronic low back pain","volume":"32","author":"Cohen","year":"2002","journal-title":"Sports Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1440","DOI":"10.1213\/01.ANE.0000180831.60169.EA","article-title":"Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment","volume":"101","author":"Cohen","year":"2005","journal-title":"Anesth. Analg."},{"key":"B11","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1586\/ern.12.148","article-title":"Sacroiliac joint pain: a comprehensive review of epidemiology, diagnosis and treatment","volume":"13","author":"Cohen","year":"2013","journal-title":"Expert Rev. Neurother."},{"key":"B12","doi-asserted-by":"publisher","first-page":"155","DOI":"10.2519\/jospt.1997.26.3.155","article-title":"A three-paradigm treatment model using soft tissue mobilization and guided movement-awareness techniques for a patient with chronic low back pain: a case study","volume":"26","author":"Cottingham","year":"1997","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"B13","doi-asserted-by":"publisher","first-page":"A1","DOI":"10.2519\/jospt.2012.42.4.A1","article-title":"Low back pain","volume":"42","author":"Delitto","year":"2012","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"B14","doi-asserted-by":"publisher","first-page":"489","DOI":"10.36076\/ppj.2018.5.489","article-title":"Comparison of efficacy of lateral branch pulsed radiofrequency denervation and intraarticular depot methylprednisolone injection for sacroiliac joint pain","volume":"21","author":"Dutta","year":"2018","journal-title":"Pain Physician"},{"key":"B15","doi-asserted-by":"publisher","first-page":"754","DOI":"10.2519\/jospt.2007.2471","article-title":"Electromyographic analysis of core trunk, hip, and thigh muscles during 9 rehabilitation exercises","volume":"37","author":"Ekstrom","year":"2007","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"B16","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1054\/math.2001.0435","article-title":"The Mulligan concept: its application in the management of spinal conditions","volume":"7","author":"Exelby","year":"2002","journal-title":"Man. Ther."},{"key":"B17","doi-asserted-by":"publisher","first-page":"4490","DOI":"10.3390\/ijerph17124490","article-title":"Effectiveness of the muscle energy technique versus osteopathic manipulation in the treatment of sacroiliac joint dysfunction in athletes","volume":"17","author":"Garc\u00eda-Pealver","year":"2020","journal-title":"Int. J. Environ. Res. Public Health."},{"key":"B18","doi-asserted-by":"publisher","first-page":"2936","DOI":"10.1007\/s00586-021-06927-9","article-title":"Sacroiliac joint dysfunction: pathophysiology, diagnosis, and treatment","volume":"30","author":"Gartenberg","year":"2021","journal-title":"Eur. Spine J."},{"key":"B19","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/j.clinph.2006.09.014","article-title":"Cervical spine manipulation alters sensorimotor integration: a somatosensory evoked potential study","volume":"118","author":"Haavik-Taylor","year":"2007","journal-title":"Clin. Neurophysiol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.jcm.2017.01.003","article-title":"Effect of mulligan concept lumbar SNAG on chronic nonspecific low back pain","volume":"16","author":"Hussien","year":"2017","journal-title":"J. Chiropr. Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"223","DOI":"10.36076\/ppj.2021\/24\/223","article-title":"The efficiency of manual therapy and sacroiliac and lumbar exercises in patients with sacroiliac joint dysfunction syndrome","volume":"24","author":"Javadov","year":"2021","journal-title":"Pain Physician"},{"key":"B22","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1016\/j.jmpt.2007.01.015","article-title":"Flexion mobilizations with movement techniques: the immediate effects on range of movement and pain in subjects with low back pain","volume":"30","author":"Konstantinou","year":"2007","journal-title":"J. Manip. Physiol. Ther."},{"key":"B23","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1016\/j.spinee.2020.04.006","article-title":"Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of low back pain","volume":"20","author":"Kreiner","year":"2020","journal-title":"Spine J."},{"key":"B24","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1123\/ijatt.2014-0066","article-title":"Patient outcomes utilizing the selective functional movement assessment and mulligan mobilizations with movement on recreational dancers with sacroiliac joint pain: a case series","volume":"20","author":"Krzyzanowicz","year":"2015","journal-title":"Int. J. Athl. Ther. Trai."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1093\/ptj\/79.11.1043","article-title":"Four clinical tests of sacroiliac joint dysfunction: the association of test results with innominate torsion among patients with and without low back pain","volume":"79","author":"Levangie","year":"1999","journal-title":"Phys. Ther."},{"key":"B26","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/s12891-022-05021-5","article-title":"Sagittal imbalance of the spine is associated with poor sitting posture among primary and secondary school students in China: a cross-sectional study","volume":"23","author":"Li","year":"2022","journal-title":"BMC Musculoskelet. Disord."},{"key":"B27","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1016\/s0140-6736(16)30970-9","article-title":"Non-specific low back pain","volume":"389","author":"Maher","year":"2017","journal-title":"Lancet."},{"key":"B28","volume-title":"Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms","author":"Merskey","year":"1994"},{"key":"B29","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1007\/s00420-020-01572-z","article-title":"Effects of a workplace exercise program on physical capacity and lower back symptoms in hospital nursing assistants: a randomized controlled trial","volume":"94","author":"Moreira","year":"2021","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1265","DOI":"10.1519\/JSC.0b013e31824f2351","article-title":"Hip joint range of motion improvements using three different interventions","volume":"26","author":"Moreside","year":"2012","journal-title":"J. Strength Cond. Res."},{"key":"B31","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1186\/1471-2474-9-131","article-title":"The effects of the Mulligan Sustained Natural Apophyseal Glide (SNAG) mobilisation in the lumbar flexion range of asymptomatic subjects as measured by the Zebras CMS20 3-D motion analysis system","volume":"9","author":"Moutzouri","year":"2008","journal-title":"BMC Musculoskelet. Disord."},{"key":"B32","volume-title":"Manual therapy: NAGS, SNAGS, MWMS, etc","author":"Mulligan","year":"2004"},{"key":"B33","first-page":"1218","article-title":"The effect of manipulation in sacroiliac joint dysfunction","volume":"34","author":"Nejati","year":"2016","journal-title":"J. Isfahan Med. Sch."},{"key":"B34","doi-asserted-by":"publisher","first-page":"53","DOI":"10.36076\/ppj\/2019.22.53","article-title":"Effectiveness of exercise therapy and manipulation on sacroiliac joint dysfunction: a randomized controlled trial","volume":"22","author":"Nejati","year":"2019","journal-title":"Pain Physician"},{"key":"B35","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.apmr.2011.05.027","article-title":"Sacroiliac joint manipulation attenuates alpha-motoneuron activity in healthy women: a quasi-experimental study","volume":"93","author":"Orakifar","year":"2012","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"B36","doi-asserted-by":"publisher","first-page":"2959","DOI":"10.1097\/00007632-199712150-00020","article-title":"Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis","volume":"22","author":"O'Sullivan","year":"1997","journal-title":"Spine"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1136\/bjsports-2019-100886","article-title":"Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis","volume":"54","author":"Owen","year":"2019","journal-title":"Br. J. Sports Med."},{"key":"B38","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1249\/jsr.0000000000000410","article-title":"Sacroiliac joint dysfunction in the athlete: diagnosis and management","volume":"16","author":"Peebles","year":"2017","journal-title":"Curr. Sports Med. Rep."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.1177\/0269215518778321","article-title":"Effectiveness of mobilization with movement (Mulligan concept techniques) on low back pain: a systematic review","volume":"32","author":"Pourahmadi","year":"2018","journal-title":"Clin. Rehabil."},{"key":"B40","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1097\/00007632-198303000-00004","article-title":"A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain","volume":"8","author":"Roland","year":"1983","journal-title":"Spine"},{"key":"B41","doi-asserted-by":"publisher","first-page":"Cd012004","DOI":"10.1002\/14651858.Cd012004","article-title":"Motor control exercise for chronic non-specific low-back pain","volume":"2016","author":"Saragiotto","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"B42","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1097\/00007632-199606010-00011","article-title":"Lumbar range of motion: reliability and validity of the inclinometer technique in the clinical measurement of trunk flexibility","volume":"21","author":"Saur","year":"1996","journal-title":"Spine"},{"key":"B43","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.clinbiomech.2017.07.006","article-title":"Comparison of spinal stability following motor control and general exercises in nonspecific chronic low back pain patients","volume":"48","author":"Shamsi","year":"2017","journal-title":"Clin. Biomech. Bristol, Avon."},{"key":"B44","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1016\/j.jmpt.2005.07.006","article-title":"A randomized clinical trial of manual versus mechanical force manipulation in the treatment of sacroiliac joint syndrome","volume":"28","author":"Shearar","year":"2005","journal-title":"J. Manip. Physiol. Ther."},{"key":"B45","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1016\/j.jmpt.2017.09.004","article-title":"Effect of sacroiliac joint mobilization on the level of soft tissue pain threshold in asymptomatic women","volume":"41","author":"Sipko","year":"2018","journal-title":"J. Manip. Physiol. Ther."},{"key":"B46","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/j.jmpt.2019.04.001","article-title":"Effectiveness of Mulligan's mobilization with movement techniques on range of motion in peripheral joint pathologies: a systematic review with meta-analysis between 2008 and 2018","volume":"42","author":"Stathopoulos","year":"2019","journal-title":"J. Manip. Physiol. Ther."},{"key":"B47","doi-asserted-by":"publisher","first-page":"85","DOI":"10.5435\/jaaos-d-17-00132","article-title":"Diagnosing sacroiliac joint pain","volume":"27","author":"Thawrani","year":"2019","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"B48","doi-asserted-by":"publisher","first-page":"159","DOI":"10.3233\/bmr-2002-16407","article-title":"Criterion validity study of lumbar goniometers BROM II and EDI-320 for range of motion of lumbar flexion of low back pain patients","volume":"16","author":"Tousignant","year":"2002","journal-title":"J. Back Musculoskelet. Rehabil."},{"key":"B49","first-page":"394","article-title":"Use of chiropractic manipulation in lumbar rehabilitation","volume":"34","author":"Triano","year":"1997","journal-title":"J. Rehabil. Res. Dev."},{"key":"B50","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1054\/math.1996.0276","article-title":"Pressure algometry in manual therapy","volume":"1","author":"Vanderwee\u00ebn","year":"1996","journal-title":"Man. Ther."},{"key":"B51","volume-title":"Low Back Pain and radicular pain: assessment and management \u2013 summary","author":"Van Wambeke","year":"2017"},{"key":"B52","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.math.2006.07.012","article-title":"Mulligan's mobilization-with-movement, positional faults and pain relief: current concepts from a critical review of literature","volume":"12","author":"Vicenzino","year":"2007","journal-title":"Man. Ther."},{"key":"B53","doi-asserted-by":"publisher","first-page":"3140","DOI":"10.1097\/00007632-200012150-00009","article-title":"Assessing global pain severity by self-report in clinical and health services research","volume":"25","author":"Von Korff","year":"2000","journal-title":"Spine"},{"key":"B54","doi-asserted-by":"publisher","first-page":"2163","DOI":"10.1016\/S0140-6736(12)61729-2","article-title":"Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010","volume":"380","author":"Vos","year":"2012","journal-title":"Lancet"},{"key":"B55","doi-asserted-by":"publisher","first-page":"476","DOI":"10.12669\/pjms.322.9127","article-title":"McKenzie treatment versus mulligan sustained natural apophyseal glides for chronic mechanical low back pain","volume":"32","author":"Waqqar","year":"2016","journal-title":"Pak. J. Med. Sci."},{"key":"B56","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1186\/s12891-020-03617-3","article-title":"The association between pelvic asymmetry and non-specific chronic low back pain as assessed by the global postural system","volume":"21","author":"Yu","year":"2020","journal-title":"BMC Musculoskelet. Disord."},{"key":"B57","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1097\/01.ajp.0000131413.07468.8e","article-title":"Sacroiliac joint dysfunction: evaluation and management","volume":"21","author":"Zelle","year":"2005","journal-title":"Clin. J. Pain."}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2024.1337754\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T01:12:39Z","timestamp":1713402759000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2024.1337754\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,18]]},"references-count":57,"alternative-id":["10.3389\/fphys.2024.1337754"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2024.1337754","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,18]]},"article-number":"1337754"}}