Department of Sports medicine and Exercise Medicine, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Pain Physician. 2019 Jan;22(1):53-61.
The sacroiliac joint dysfunction (SIJD) has been found to be the primary culprit for lower back pain (LBP), but it is still overlooked and treated as LBP. There are no guidelines or appropriate therapeutic protocols for SIJD. Thus, there is a need for an effective treatment strategy for SIJD.
To compare exercise therapy (ET), manipulation therapy (MT), and a combination of the 2 (EMT) in terms of their effectiveness in treating SIJD.
A comparative, prospective, single-blind randomized controlled trial .
Sports Medicine Department of Rasoul Akram Hospital.
A total of 51 patients with lower back or buttock pain resulting from SIJD were randomly assigned to 1 of 3 study groups: ET, MT, or EMT. The ET group received posterior innominate self-mobilization, sacroiliac joint stretching, and spinal stabilization exercises. The MT group underwent posterior innominate mobilization and SIJ manipulation. Lastly, the EMT group received manipulation maneuvers followed by exercise therapy. Pain and disability were assessed at 6, 12, and 24 weeks after the interventions.
All 3 groups demonstrated significant improvement in pain and disability scores compared to the baseline (P < 0.05). The difference among these therapeutic protocols was found to be a function of time. At week 6, MT showed notable results, but at week 12, the effect of ET was remarkable. Finally, at week 24, no significant difference was observed among the study groups.
A major limitation of the present study is lack of a control group receiving a type of intervention other than the experimental protocols. Another limitation is the short duration of follow-ups.
Exercise and manipulation therapy appear to be effective in reducing pain and disability in patients with SIJD. However, the combination of these 2 therapies does not seem to bring about significantly better therapeutic results than either approach implemented separately.
Exercise therapy, manipulation therapy, sacroiliac joint dysfunction.
骶髂关节功能障碍（SIJD）已被发现是下腰痛（LBP）的主要原因，但它仍被忽视并被视为 LBP 进行治疗。目前针对 SIJD 尚无指导原则或适当的治疗方案。因此，需要一种针对 SIJD 的有效治疗策略。
比较运动疗法（ET）、手法治疗（MT）和两者联合（EMT）在治疗 SIJD 方面的疗效。
一项比较、前瞻性、单盲随机对照试验。
Rasoul Akram 医院运动医学科。
共有 51 例因 SIJD 导致下腰痛或臀部疼痛的患者被随机分配到 3 个研究组之一：ET 组、MT 组或 EMT 组。ET 组接受后髂骨自我松动、骶髂关节伸展和脊柱稳定练习。MT 组接受后髂骨松动和骶髂关节手法治疗。最后，EMT 组先接受手法治疗，再进行运动疗法。在干预后 6、12 和 24 周评估疼痛和残疾程度。
与基线相比，所有 3 组的疼痛和残疾评分均有显著改善（P < 0.05）。这些治疗方案之间的差异是时间的函数。在第 6 周时，MT 组效果显著，但在第 12 周时，ET 组的效果显著。最后，在第 24 周时，各组之间无显著差异。
本研究的主要局限性是缺乏接受除实验方案以外的干预类型的对照组。另一个局限性是随访时间短。
运动和手法治疗似乎可有效减轻 SIJD 患者的疼痛和残疾。然而，与单独使用任何一种方法相比，联合使用这两种方法并不能带来显著更好的治疗效果。
运动疗法，手法治疗，骶髂关节功能障碍。
