Effect of Proprioceptive Neuromuscular Facilitation (PNF) in Improving Muscle Control in Patient with Sacroiliac Joint Dysfunction: A Case Report

Abstract

Introduction: This report talks about of a 43-year-old female with severe Sacroiliac Joint dysfunction (SIJ). Having pain due dysfunction from last 5 months, for which already taking physiotherapeutic intervention from last 3 weeks after consultation with orthopedic surgeon. Pain was present on right side lower back region around Posterior superior iliac spine which is radiating down to right thigh and even getting worse with prolonged standing, sitting, long travelling hours, ascending and descending long flights of stairs. Moreover, she found difficulty in cooking in her kitchen after spending one hour of standing. She had a history of caesarian section 3 months ago, after that she gradually started having severe pain in her lower back which even started to radiate due to which limping on opposite side is seen.
Examination: Local tenderness on posterior aspect of right side SIJ was observed on palpation. On examination limited lumbar flexion, extension, rotation and side bending was found due to pain bilaterally. VAS score shows 8 /10. Roland-Morris Disability questionnaire shows 16 out of 24 for functional disability scores. Special test like Gillet, Gaenslens, FABER, SLR and sacroiliac stress tests were performed on patient to confirm the diagnosis. Outcomes of treatment were assessed with same pre and posttest measures. Treatment: Physiotherapeutic intervention was given with Diagonal PNF pattern, Dynamic Tapping, hot fermentation applied pre and post intervention. After 2 months of intervention, improvement is seen in all the outcome parameters of patient. Evidence regarding the use of PNF as an intervention for correcting the SIJ dysfunction appears underreported so further research suggested. Patients complaining sacroiliac joint pain should be examined regularly to rule out sacroiliac component in LBP separately which usually not performed.