Effectiveness of the Compression Belt for Patients With Sacroiliac Joint Pain

Background: The estimated prevalence of sacroiliac joint (SIJ) pain is approximately 13-30%
in patients with non-specific low back pain. One common presentation for those with SIJ pain
is unilateral pain over the SIJ region, which is described as a positive Fortin's sign.
Common impairments for this population include pelvic asymmetry, lumbopelvic muscle
imbalance, and decreased lumbopelvic proprioceptive awareness and stability. Two common
physical therapy interventions for this population are lumbopelvic stabilization programs and
pelvic compression belts. The purpose of this randomized clinical trial is to examine the
usefulness of the addition of a pelvic compression belt to a lumbopelvic stabilization
program for patients with sacroiliac joint pain by comparing lumbopelvic stabilization
exercises with a pelvic compression belt to lumbopelvic stabilization exercises alone.
Participants: Thirty participants with unilateral pain near the SIJ will be recruited for the
study and randomly assigned to 1 of 2 treatment groups (stabilization plus belt or
stabilization alone). Both groups will receive a lumbopelvic stabilization program for 12
weeks. The stabilization plus belt group will also receive a pelvic compression belt to be
worn continuously for the first 4 weeks. Outcome measures including the Modified Oswestry Low
Back Pain Disability Index (OSW), the percentage change of TrA and IO muscle thickness (i.e.
muscle contraction from rest to contract) utilizing ultrasound imaging, the Numeric Pain
Rating Scale (NPRS) for pain, and a subjective rating of overall perceived improvement using
the Global Rating of Change (GROC) scale will be collected. These outcomes will be assessed
at baseline, 4 weeks, and 3 months post-intervention. Hypothesis: The OSW scores and NPRS
scores will be lower for those who receive the compression belt in addition to the
lumbopelvic stabilization program as compared to those who receive the lumbopelvic
stabilization alone. The percent change of muscle thickness for the deep abdominals as well
as the GROC scores will be higher for those who receive the compression belt in addition to
the lumbopelvic stabilization program as compared to those who receive the lumbopelvic
stabilization alone. Data Analysis: Two separate ANOVAs (group x time) with repeated measures
will be used to examine the effect of the interventions on disability and the percent change
of muscle thickness. Whitney U-test will be used to analyze the NPRS data, and descriptive
statistics will be used to report the GROC scores. Clinical Relevance: The results of the
study may provide evidence in prescribing pelvic compression belt for those with SIJ pain. It
will also offer guidance as to how and when pelvic compression belts should be used in this
population. Finally, it will guide physical therapists in prescribing effective interventions
for those with SIJ pain.

Inclusion Criteria:

- unilateral pain near the sacroiliac joint that does not extend pass the knee

- positive result on 2 of 6 sacroiliac joint provocation tests:

- compression test

- distraction test

- posterior shear test

- Gaenslens' test (left and right)

- sacral thrust test

Exclusion Criteria:

- current pregnancy or pregnancy in the last 6 months

- history of surgery to lumbar spine, pelvis, chest, abdomen

- history of congenital lumbar or pelvic anomalies

- any neurological signs in the lower extremity