Department of Physical Medicine and Rehabilitation, Medicine Private Hospital, Atlas University, İstanbul, Turkey.
Department of Physical Medicine and Rehabilitation, İstanbul Faculty of Medicine, İstanbul University, İstanbul, Turkey.
Pain Physician. 2021 May;24(3):223-233.
Manual therapy, exercise therapy, and the combination of these 2 are common treatments for sacroiliac joint dysfunction syndrome. The effects of these treatments have been discussed in several studies; the superiority of one over the other for patients with sacroiliac joint dysfunction syndrome is still the subject of discussion.
This study aims to assess the effects of manual therapy for sacroiliac joints, sacroiliac joints home-based exercises, and home-based lumbar exercises.
A comparative, prospective, single-blind, randomized, controlled trial.
This trial was conducted at a single center at the Istanbul University, Istanbul Medical Faculty, Department of Physical Medicine and Rehabilitation.
Within the scope of this study, 69 women diagnosed with sacroiliac joint dysfunction syndrome through specific sacroiliac joints clinical diagnostic tests were randomized into 3 groups. The first group was assigned manual therapy and a sacroiliac joints home-based exercise program (n = 23), the second group was assigned sacroiliac joints manual therapy and a home-based lumbar exercise program (n = 23), and the third group was assigned a home-based lumbar exercise program (n = 23). All patients who participated in the study were evaluated at the beginning of the study and on the twenty-eighth and ninetieth day.
All 3 groups showed a significant decrease in the sacroiliac joints -related pain parameter, which is checked with the visual analogue scale (P < 0.05) after the treatment. The Gillet test, Vorlauf test, Posterior Shear test, Compression test, and irritation Point tests after the treatment yielded a significant (P < 0.05) negative trend in all groups. Short Form-36 health survey for screening form, Modified Oswestry Pain Questionnaire, and Douleur Neuropathique 4 questions patient interview questionnaire for the assessment of neuropathic pain forms revealed a significant (P < 0.05) improvement in patients' complaints after the treatment in all 3 groups. Significant improvement in patients with sacroiliac joint dysfunction syndrome in all 3 groups was identified after the treatment.
The absence of a healthy control group is one of the important limitations of the study.
Manual therapy is effective in the long term in sacroiliac joint dysfunction syndrome. Adding specific exercises for sacroiliac joints to the sacroiliac joints manipulation treatment further increases this effectiveness.
手法治疗、运动疗法以及两者的结合是治疗骶髂关节功能障碍综合征的常用方法。这些治疗方法的效果已经在几项研究中进行了讨论；对于骶髂关节功能障碍综合征患者，一种方法优于另一种方法的问题仍在讨论中。
本研究旨在评估手法治疗骶髂关节、骶髂关节家庭运动和家庭腰部运动的效果。
一项比较、前瞻性、单盲、随机、对照试验。
该试验在伊斯坦布尔大学伊斯坦布尔医学系物理医学和康复系的一个单一中心进行。
在这项研究中，通过特定的骶髂关节临床诊断测试诊断为骶髂关节功能障碍综合征的 69 名女性被随机分为 3 组。第一组接受手法治疗和骶髂关节家庭运动计划（n=23），第二组接受骶髂关节手法治疗和家庭腰部运动计划（n=23），第三组接受家庭腰部运动计划（n=23）。所有参加研究的患者在研究开始时以及第 28 天和第 90 天进行评估。
所有 3 组患者的骶髂关节相关疼痛参数均显著下降，视觉模拟评分（VAS）在治疗后（P<0.05）下降。治疗后，吉尔伯特试验、前跑试验、后剪切试验、压缩试验和激痛点试验均呈显著（P<0.05）负向趋势。所有 3 组的健康调查简表（Short Form-36）、改良 Oswestry 疼痛问卷和神经病理性疼痛 4 个问题患者访谈问卷（Douleur Neuropathique 4 questions）的评估结果显示，所有 3 组患者在治疗后疼痛症状均有显著（P<0.05）改善。所有 3 组的骶髂关节功能障碍综合征患者在治疗后均有显著改善。
研究的一个重要局限性是缺乏健康对照组。
手法治疗在骶髂关节功能障碍综合征的长期治疗中有效。在骶髂关节手法治疗中加入特定的骶髂关节运动可进一步提高这种效果。
