Department of Research, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada.
Parker Research Center, Parker University, Dallas, Texas.
J Manipulative Physiol Ther. 2020 Sep;43(7):732-743. doi: 10.1016/j.jmpt.2020.05.006. Epub 2020 Aug 30.
The purpose of this study was to conduct a systematic review (SR) of the literature to assess the effectiveness of specific chiropractic care options commonly used for postpartum low back pain (LBP), pelvic girdle pain (PGP), or combination (LBP and PGP) pain.
A search strategy was developed. Interventions were those manual or other nonpharmacologic therapies commonly used by chiropractors (not requiring additional certifications). The outcomes were self-reported changes in pain or disability self-reported outcomes. We used the Scottish Intercollegiate Guideline Network checklists. Strength of the evidence (excluding cohort studies) was determined using an adapted version of the US Preventive Services Task Force criteria as described in the UK report.
Of the 1611 published articles, 16 were included. These were 5 SRs, 10 randomized controlled trials (RCTs), and 1 cohort study. Postpartum LBP (1 RCT): moderate, favorable strength for spinal manipulation therapy/mobilization. Postpartum PGP (4 RCTs): moderate, unclear strength for exercise; and inconclusive, unclear strength for patient education. Postpartum LBP or PGP (3 SRs and 4 RCTs): inconclusive, unclear strength for exercise, self-management, and physiotherapy; while osteopathic manipulative therapy was inconclusive, favorable.
No treatment option was identified as having sufficient evidence to make a clear recommendation. This SR identified a scarcity of literature regarding chiropractic care and back pain for postpartum women, as well as inconsistency among the terms LBP, PGP, and combination pain.
本研究旨在进行系统评价（SR），以评估常用于产后腰痛（LBP）、骨盆带疼痛（PGP）或两者合并（LBP 和 PGP）疼痛的特定脊骨疗法选择的有效性。
制定了检索策略。干预措施为脊骨治疗师常用的手法或其他非药物疗法（不需要额外认证）。结局为疼痛或残疾自我报告的变化。我们使用苏格兰校际指南网络清单。证据强度（不包括队列研究）采用 UK 报告中描述的美国预防服务工作组标准的改编版本确定。
在 1611 篇已发表的文章中，有 16 篇被纳入。这些包括 5 篇 SR、10 项随机对照试验（RCT）和 1 项队列研究。产后 LBP（1 项 RCT）：脊柱手法治疗/松动术的中度、有利强度。产后 PGP（4 项 RCT）：运动的中度、不确定强度；患者教育的不确定、不确定强度。产后 LBP 或 PGP（3 项 SR 和 4 项 RCT）：运动、自我管理和物理治疗的不确定、不确定强度；而整骨疗法的治疗效果不确定，但有利。
没有一种治疗方法被确定具有足够的证据来做出明确的推荐。本 SR 发现有关产后女性脊骨疗法和背痛的文献稀缺，并且 LBP、PGP 和合并疼痛的术语之间存在不一致。
