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Identification and Effectiveness of Physical Therapy Interventions for Sacroiliac Joint Dysfunction in Pregnant and Nonpregnant Adults: A Systematic Review

Sharma, Ajit PT, DPT, MS; Sharma, Shruti PT, DPT, MS; Steiner, Linda A. PT, DPT, MS, OCS; Brudvig, Tracy J. PT, PhD, DPT, OCS

Journal of Women's Health Physical Therapy: September/December 2014 - Volume 38 - Issue 3 - p 110–117
doi: 10.1097/JWH.0000000000000015
Literature Reviews

Objective: To determine whether physical therapy intervention is beneficial in the management of sacroiliac joint dysfunction (SIJD), and to identify the physical therapy interventions that are effective in managing SIJD in adults including pregnant individuals.

Study Design: This is a systematic review.

Background: Prevalence of SIJD has been found to be 22.5% in individuals with low back pain. To date, no systematic review has been done to identify the physical therapy management of SIJD in this group.

Methods and Measures: Fifteen studies were selected on the basis of inclusion and exclusion criteria and were evaluated independently by 2 reviewers using the Evaluation Guidelines for Rating the Quality of an Intervention Study developed by Joy MacDermid and Sackett's level of evidence. Discrepancies in scoring were resolved by a third and fourth reviewer.

Results: Twelve of the 15 studies on pregnant individuals suggested that specific stabilizing exercises, use of a nonelastic sacroiliac belt, and muscle energy techniques were the most effective interventions. Three of the 15 studies supported sacroiliac manipulation, soft-tissue mobilization, postural alignment, pelvic belt use, and exercises in individuals with SIJD. Out of the 15 studies, 7 were high-quality studies, 5 were moderate-quality studies, and 3 were low-quality studies.

Conclusions: Physical therapy intervention using specific stabilizing exercises and a nonelastic sacroiliac belt is effective in the management of SIJD. There is a moderate level of evidence for sacroiliac joint manipulation, soft-tissue mobilization, and muscle energy techniques. There is paucity of evidence on the general population, and more high-quality studies are needed.

MGH Institute of Health Professions, Boston, Massachusetts.

The authors declare no conflicts of interest.

Copyright © 2014 by the Section on Women's Health, American Physical Therapy Association.
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