A study to determine the effectiveness of chiropractic manipulative therapy of the sacroiliac joint and pelvic stabilisation exercises in the management of post-partum lower back pain

Abstract

This study compared the effectiveness of three different Chiropractic treatment protocols in the treatment of post-partum low back pain. This was done in order to establish whether or not a combined treatment of Chiropractic Manipulative Therapy (CMT) of the sacroiliac joint combined with slow dynamic strengthening exercises to strengthen and stabilise the pelvis is a more effective treatment than CMT of the sacroiliac joint alone, or slow dynamic strengthening exercises in isolation. Thirty participants were used for this study. They were randomly placed into one of three groups namely; group 1, group 2 and group 3. Group 1 received CMT solely to the involved sacroiliac joint. Group 2 received slow dynamic strengthening exercises of gluteus medius, piriformis and psoas muscles. These exercises were designed to strengthen and stabilise the pelvis. Group 3 received a combination of the above two treatments. Six treatments were administered over a period of three weeks with each participant receiving two treatments per week. Prior to the commencement of treatments one, three and six; each participant was objectively measured for forward flexion range of motion using the Modified Schober’s test. The subjective measurements used in this study were the Numerical Pain Rating Scale and the Oswestry Lower Back Pain and Disability Questionnaire, these were also completed prior to first, third and sixth treatments. All the collected data was statistically analysed using the one-way Anova test, the Scheffe Multiple Comparisons test and the Paired-t test. This statistical analysis revealed statistical differences on intra-group analysis, for all the three groups involved, mostly between treatment three and treatment six for both the objective and subjective measurements. On inter-group analysis no statistical differences were found although group three subjective and objective measurements improved by a larger percentage than both group one and group two. It was thus concluded that a combined treatment of CMT and slow dynamic strengthening exercises of gluteus medius, piriformis and psoas muscles was the most effective protocol to use on women with post-partum low back pain.Dr. C.D. Losco Dr. B. Losc