The effectiveness of physiotherapy interventions for sacroiliac joint dysfunction: a systematic review

Abstract

[Purpose] The aim of this study is to investigate the effectiveness of physical therapy interventions in the treatment of sacroiliac joint dysfunction (SIJD). [Subjects and Methods] MEDLINE, PUBMED, CINAHL, AMED, PEDro, and CIRRIE databases were searched and only relevant data from studies that matched the inclusion criteria were included. CASP tools for critical appraisal were used to assess the quality of studies included. [Results] Nine articles met the inclusion criteria, of which, three examined the effect of exercise on SIJD, three used kinesio tape and four studies examined the effect of manipulation. Various outcomes were used including the visual analogue pain scale (VAS), Oswestry disability questionnaire (ODQ), numerical pain rating scale (NPRS) and pelvic position measurement (PALM, pelvimeter and photogrammetry). The quality of included studies ranged from low to average as the CASP tools revealed several limitations that affect the validity of the studies. The results showed that physiotherapy interventions are effective in reducing pain and disability associated with SIJD, with manipulation being the most effective approach and most commonly used within physical therapy clinics. [Conclusion] Manipulation, exercise and kinesio tape are effective in the treatment of pain, disability and pelvic asymmetry in SIJD.

Comparing the Effectiveness of the Muscle Energy Technique and Kinesiotaping in Mechanical Sacroiliac Joint Dysfunction: A Non-blinded, Two-Group, Pretest–Posttest Randomized Clinical Trial Protocol

“…Another study by Shinde and Jagtap [2] revealed significant improvements in the muscle energy technique (MET), hot moist pack, mulligan mobilization, and mulligan taping groups. Al-Subahi et al [5] also reported that manipulation, exercise, and �inesiotaping (�T) were ef-�inesiotaping (�T) were ef-inesiotaping (�T) were effective in treating pain, disability, and pelvic asymmetry in SIJD. Another study by Yoo [6] showed that gluteus medius strengthening exercises can help reduce SIJ pain.…”

Use of Manual Therapy for Posterior Pelvic Girdle Pain

“…The first line of treatment for these patients often involves referral to a physical therapist or chiropractor, whose treatment plans often include manual therapy in the form of a thrust or nonthrust manipulation, massage, or other “hands on” technique aimed at modulating pain, increasing range of motion (ROM), reducing inflammation, and/or improving tissue extensibility. A recent systematic review of intervention trials for posterior pelvic pain indicated favorable effects on pain after manual therapies . However, other reviews have been less favorable with respect to manual interventions, resulting in conflicting support for these interventions for posterior pelvic pain .…”

“…A recent systematic review of intervention trials for posterior pelvic pain indicated favorable effects on pain after manual therapies. 10 However, other reviews have been less favorable with respect to manual interventions, resulting in conflicting support for these interventions for posterior pelvic pain. 11 Consequently, if manual therapy is to be used in the treatment of SI joint pain, providers should understand what manual therapy may accomplish, as well as its limitations.…”

Alternative Approach to Psoas Release in Posterior Pelvic Pain

“…Additionally, many of these muscles change function depending on whether or not the lower extremity is fixed or moving, or if the patient is in single limb or double limb stance. Therefore, proper exercise prescription and proper instruction of prescribed exercises are essential for treating posterior pelvic pain …”

“…Therefore, proper exercise prescription and proper instruction of prescribed exercises are essential for treating posterior pelvic pain. 5,6 Finally, although strengthening exercises are necessary to ensure proper muscle function for this region, I recommend that static stretching should be used on a more limited basis. 7 Static stretching has limited ability to change muscle length and requires long hold times that may not be practical for some patients.…”