1. 2021;24;223-233The Efficiency of Manual Therapy and Sacroiliac and Lumbar Exercises in Patients with Sacroiliac Joint Dysfunction Syndrome
   Randomized Controlled Trial
   Aghalar Javadov, MD, Aysegül Ketenci, MD, and Cihan Aksoy, MD.

BACKGROUND: 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.

OBJECTIVE: This study aims to assess the effects of manual therapy for sacroiliac joints, sacroiliac joints home-based exercises, and home-based lumbar exercises.

STUDY DESIGN: A comparative, prospective, single-blind, randomized, controlled trial.

SETTING: This trial was conducted at a single center at the Istanbul University, Istanbul Medical Faculty, Department of Physical Medicine and Rehabilitation.

METHODS: 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.

RESULTS: 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.

LIMITATION: The absence of a healthy control group is one of the important limitations of the study.

CONCLUSIONS: 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.

KEY WORD: Sacroiliac joint, sacroiliac joint dysfunction syndrome, manual therapy, sacroiliac joint exercises, lumbar exercises