Investigation Of The Effects Of Sacroiliac-Iliosacrulum Dysfunctions On The Body Center Of Gravity

Abstract

The sacroiliac joint (SIJ), a synovial joint located between the pelvis and spine, plays a vital role in mechanical load transfer, postural control, and dynamic stability. This joint preserves biomechanical integrity by ensuring balanced distribution of body weight to the lower extremities during activities such as walking, running, and static standing. However, factors such as trauma, repetitive microinjuries, pregnancy, obesity, or inflammatory processes can lead to functional or structural disorders defined as sacroiliac joint dysfunction (SIJD). SIJD is clinically associated with chronic low back pain, postural instability, and secondary compensations in the musculoskeletal system. Even minimal deviations in the center of body weight (CBW) can predispose individuals to long-term pathologies such as spinal curvatures, pelvic rotation, and joint degeneration. Therefore, early diagnosis of SIJD and prevention of CBW disturbances are critical for preserving individual quality of life and public health.

 The primary aim of this study is to investigate the relationship between SIJD and CBW from a multidisciplinary perspective and to evaluate the efficacy of non-invasive methods like the Double Balance Test (DBT) in early diagnosis. Additionally, the study analyzes the impact of demographic/clinical parameters such as gender, age, body mass index (BMI), pain duration, and severity on SIJD incidence and CBW deviations. The goals include enhancing understanding of SIJD pathomechanics, advancing preventive medicine practices, and promoting personalized approaches in disease management.

The study was conducted with 201 participants aged 20–65, divided into four age groups and analyzed by gender distribution. For SIJD diagnosis, seven provocation tests—including Faber (Patrick), Gaenslen, Compression, Distraction, Thigh Thrust, and Sacral Thrust tests—were applied, with SIJD confirmed if three or more tests yielded positive results. CBW deviations were assessed using a posture analysis ruler to determine neutral alignment, followed by DBT to measure weight distribution imbalances. Statistical analysis was performed using IBM SPSS 27, with normality tests (Kolmogorov-Smirnov, Kurtosis, Skewness), Mann-Whitney U, and Chi-square tests at a 95% confidence interval.

Results revealed a significant correlation between SIJD and CBW disturbances (p<0.05p<0.05). Women exhibited statistically higher SIJD incidence and CBW deviation rates compared to men. Participants with pain durations under five years demonstrated lower CBW disturbances than those with pain exceeding five years. Furthermore, parameters such as BMI, fatigue severity, and Oswestry Low Back Pain Questionnaire scores showed a linear relationship with SIJD.

This study highlights the causal relationship between SIJD and CBW disturbances, emphasizing the clinical importance of early diagnosis and prevention strategies. Findings suggest that the higher prevalence of SIJD in women may be linked to gender-specific anatomical-pelvic differences, hormonal factors, or pregnancy history. The lower CBW deviations in individuals with shorter pain histories support the hypothesis that chronic pain accelerates degenerative processes, underscoring the pivotal role of early intervention.

The Double Balance Test (DBT) demonstrated high sensitivity and specificity in SIJD diagnosis, alongside clinical practicality and cost-effectiveness. When integrated with postural analyses, DBT enables objective monitoring of CBW deviations and facilitates patient-specific rehabilitation programs. Interventions such as weight loss and postural training may reduce SIJD risk, particularly in individuals with elevated BMI. Multidisciplinary assessments incorporating tools like the Oswestry Low Back Pain Questionnaire and Fatigue Severity Scale could further enhance patient quality of life.

In conclusion, this study positions SIJD not merely as a localized joint pathology but as a systemic postural disorder. Future research should validate DBT across diverse ethnic and occupational populations, investigate long-term effects of early intervention on degenerative processes, and simulate dynamic CBW deviations via biomechanical modeling. These findings are anticipated to guide clinical practice across a broad spectrum, from physiotherapy protocols to surgical indications.