Comparison of manipulation and stabilization exercises in patients with sacroiliac joint dysfunction patients: A randomized clinical trial.

BACKGROUND: Manual therapy and exercise therapy are two common treatments for low back pain. Although their effects have been discussed in several studies, the superiority of one over the other for patients with sacroiliac joint dysfunction is still unclear. OBJECTIVES: The aim of this study was to compare the effects of manipulation (M) and stabilization exercises (S) in patients with subacute or chronic sacroiliac joint dysfunction. METHODS: The participants in this randomized controlled trial study were patients with subacute or chronic sacroiliac joint dysfunction for more than 4 weeks and less than 1 year. A total of 40 patients were randomized with a minimization method to the M (n = 20) or S (n = 20) group; 15 patients in each group received treatment. The treatment program lasted 2 week in group M and 4 weeks in group S. Pain and the Oswestry Disability Index (ODI) were recorded before and immediately after the treatment period. RESULTS: Both groups showed significant improvement in assessed pain and ODI (P < 0.05). There were no statistically significant differences between groups in post-intervention assessed pain or ODI (P > 0.05). CONCLUSIONS: Despite the improvements seen after both manipulation and stabilization exercise therapies in patients with sacroiliac joint dysfunction, there was no significant between-group difference in the treatment effects. This result suggests that neither manual therapy nor stabilization exercise therapy is superior for treating subacute or chronic sacroiliac joint dysfunction.

Does core stability exercise improve lumbopelvic stability (through endurance tests) more than general exercise in chronic low back pain? A quasi-randomized controlled trial.

INTRODUCTION: The aim was to compare core stability and general exercises (GEs) in chronic low back pain (LBP) patients based on lumbopelvic stability (LPS) assessment through three endurance core stability tests. There is a controversy about preference of core stability exercise (CSE) over other types of exercise for chronic LBP. Studies which have compared these exercises used other outcomes than those related to LPS. As it is claimed that CSE enhances back stability, endurance tests for LPS were used. MATERIALS AND METHODS: A 16-session CSE program and a GE program with the same duration were conducted for two groups of participants. Frequency of interventions for both groups was three times a week. Forty-three people (aged 18-60 years) with chronic non-specific LBP were alternately allocated to core stability (n = 22) or GE group (n = 21) when admitted. The primary outcomes were three endurance core stability tests including: (1) trunk flexor; (2) trunk extensor; and (3) side bridge tests. Secondary outcomes were disability and pain. Measurements were taken at baseline and the end of the intervention. RESULTS: After the intervention, test times increased and disability and pain decreased within groups. There was no significant difference between two groups in increasing test times (p = 0.23 to p = 0.36) or decreasing disability (p = 0.16) and pain (p = 0.73). CONCLUSIONS: CSE is not more effective than GE for improving endurance core stability tests and reducing disability and pain in chronic non-specific LBP patients.