Year 2023 / Volume 30 / Number 2

Original

Effect of therapeutic exercise in persons with sacroiliac joint dysfunction: a systematic review and meta-analysis

Rev. Soc. Esp. Dolor. 2023; 30(2): 95-108 / DOI: 10.20986/resed.2023.4034/2022

Carolina Ramírez, Paula Ramírez


ABSTRACT

Background and objective: Sacroiliac joint dysfunction can explain 40 % of the cases of non-specific low back pain. Therapeutic exercise (TE) is a recommended treatment modality for the rehabilitation of this cases. The objective was to assess the effect of TE versus another interventions, on disability and pain intensity in people with sacroiliac pain or dysfunction.
Methods: Systematic review and meta-analysis of randomized clinical trials comparing the effect of any therapeutic exercise modality on pain intensity and/or disability. The risk of bias was determined with PEDro scale and the level of evidence according to GRADE.
Results: Eight studies with 422 participants were analyzed. TE was compared with manual therapy, surgical fixation of the sacroiliac joint, physical modalities, education, and the use of a pelvic belt. Overall, the risk of bias was moderate. In the quantitative analysis, low quality of evidence was found about whether the exercise and manual therapy achieve the same effect on pain intensity (MD -0.25 [IC 95 % -2.60 a 2.09]); likewise, low quality of evidence was observed for the estimated superior effect in favor of ET compared to manual therapy on disability (MD -8,74 [IC 95 % -10.92 a - 6.67]).
Conclusion: Low and very low-quality evidence suggests that TE is effective in reducing pain and disability in people with DASI or sacroiliac pain.



RESUMEN

Antecedentes y objetivo: La disfunción de la articulación sacroilíaca puede explicar el 40 % de los casos de dolor lumbar inespecífico. El ejercicio terapéutico (ET) es una modalidad de tratamiento recomendada para la rehabilitación de estos casos. El objetivo de este estudio fue evaluar el efecto del ET comparado con otras intervenciones, sobre la discapacidad y la intensidad del dolor en personas con disfunción o dolor sacroilíaco.
Materiales y métodos: Revisión sistemática y metanálisis de ensayos clínicos aleatorios en los que se comparara el efecto de cualquier modalidad de ejercicio terapéutico sobre la intensidad del dolor o la discapacidad. Se determinó el riesgo de sesgo con la escala PEDro y la calidad de la evidencia según GRADE.
Resultados: Se analizaron ocho estudios con 422 participantes en total. El ET se comparó con la terapia manual, la fijación quirúrgica de la articulación sacroilíaca, las modalidades físicas, la educación y el uso de cinturón pélvico. En general, el riesgo de sesgo en las publicaciones fue moderado. En el análisis cuantitativo, se encontró baja calidad de evidencia de que el ejercicio y la terapia manual logran el mismo efecto sobre la intensidad del dolor (MD-0,25 [IC 95 % -2,60 a 2,09]); asimismo, se registró baja calidad de evidencia para el efecto superior estimado a favor del ET comparado con la terapia manual sobre la discapacidad (MD -8,74 [IC 95 % -10,92 a - 6,67]).
Conclusión: Existe evidencia de calidad baja y muy baja que sugiere que el ET es efectivo para reducir el dolor y la discapacidad en personas con DASI o dolor sacroilíaco.





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Instrucciones para citar

Ramírez C, Ramírez P. Effect of therapeutic exercise in persons with sacroiliac joint dysfunction: a systematic review and meta-analysis. Rev Soc Esp Dolor 2023; 30(2): 95-108 / DOI: 1020986/resed20234034/2022


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Recibido: 29/09/2022

Aceptado: 09/05/2023

Prepublicado: 29/05/2023

Publicado: 20/09/2023

Tiempo de revisión del artículo: 149 días

Tiempo de prepublicación: 242 días

Tiempo de edición del artículo: 356 días


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