Added Marco Aurélio N, de Freitas Diego G, Kasawara Karina T, Martin Robroy L, Fukuda Thiago Y
Physical Therapy Department, Santa Casa of São Paulo, Brazil.
Ibirapuera University and Guarulhos University, Brazil.
Int J Sports Phys Ther. 2018 Feb;13(1):114-120.
Case series.
The literature has emphasized the use of exercise as an intervention for individuals with lumbopelvic pain. However, there is limited information to guide clinicians in exercise selection for those with sacroiliac (SI) joint dysfunction. Altered function of the gluteus maximus has been found in those with SI joint dysfunction. The objective of this case series was to assess the effectiveness of an exercise program directed at increasing gluteus maximus strength in those with clinical tests positive for SI joint dysfunction.
The eight subjects in this series presented with lumbopelvic pain and clinical evidence of SI joint dysfunction. Each subject underwent 10 treatments over five weeks consisting of five exercises directed at strengthening the gluteus maximus. Radiological assessment and clinical examination were performed to rule out potential concurrent pathologies. Visual analog pain scale, the Oswestry Disability Index, and strength assessed via hand held dynamometry were measured pre- and post-intervention.
A significant (p<0.001) weakness in gluteus maximus was noted when comparing the uninvolved and involved sides pre-intervention. After completing the strengthening exercise program over 10 visits, statistically significant (p<0.002) increases in gluteus maximus strength and function were found, as well as a decrease in pain. All subjects were discharged from physical therapy and able to return to their normal daily activities.
The results of this case series support the use of gluteus maximus strengthening exercises in those with persistent lumbopelvic pain and clinical tests positive for SI joint dysfunction.
病例系列。
文献强调运动作为腰骶部疼痛个体的一种干预措施。然而，对于骶髂（SI）关节功能障碍患者的运动选择，指导临床医生的信息有限。在骶髂关节功能障碍患者中发现臀大肌功能改变。本病例系列的目的是评估一项针对臀大肌力量增强的运动计划对骶髂关节功能障碍临床检查呈阳性患者的有效性。
本系列中的8名受试者表现为腰骶部疼痛及骶髂关节功能障碍的临床证据。每位受试者在五周内接受10次治疗，包括五项旨在增强臀大肌的运动。进行放射学评估和临床检查以排除潜在的并发疾病。在干预前后测量视觉模拟疼痛量表、Oswestry功能障碍指数以及通过手持测力计评估的力量。
干预前比较患侧和未患侧时，发现臀大肌存在显著（p<0.001）无力。在完成10次强化运动计划后，发现臀大肌力量和功能有统计学意义的显著（p<0.002）增加，同时疼痛减轻。所有受试者均从物理治疗中出院，并能够恢复正常日常活动。
本病例系列结果支持对持续腰骶部疼痛且骶髂关节功能障碍临床检查呈阳性的患者使用增强臀大肌的运动。
