Does adding extracorporeal shock wave therapy to postural correction exercises improve pain and functional disability in postpartum sacroiliac joint pain? A randomized controlled trial

Abstract

El objetivo de este estudio fue examinar el resultado de la terapia de ondas de choque extracorpóreas (TOCH) en mujeres con dolor en la articulación sacroilíaca posparto. Cuarenta mujeres primigrávidas (seis semanas después del parto) con dolor sacroilíaco participaron en este estudio. Fueron asignadas al azar a los grupos A y B. El grupo A fue tratado mediante TOCH, además de ejercicios de corrección postural y ejercicios de inclinación pélvica posterior. El grupo B fue tratado únicamente con el mismo programa de ejercicios. Ambos grupos recibieron dos sesiones por semana durante cuatro semanas. Las variables estudiadas fueron el dolor sacroilíaco y el nivel de función, las cuales se midieron mediante la escala visual analógica (EVA) y la escala funcional de dolor de espalda (EFDE), respectivamente. Todas las mediciones se evaluaron antes y después de las cuatro semanas de intervención. El análisis dentro de los grupos mostró una mejora significativa en la EVA y un aumento significativo en la EFDE en ambos grupos después del tratamiento en comparación con el valor inicial. Con respecto a los análisis entre grupos, hubo una mejora significativa en la EVA y un aumento significativo en la EFDE en el grupo A en comparación al grupo B. En conclusión, tanto la TOCH como el programa de ejercicios son efectivos para disminuir el dolor y mejorar la función en mujeres con dolor sacroilíaco posparto. Sin embargo, al agregar TOCH a los ejercicios en el programa de tratamiento, los resultados son mejores, por lo que esta combinación se recomienda en el tratamiento de mujeres con dolor sacroilíaco posparto. Examining the outcome of the extracorporeal shock wave therapy (ESWT) on females with postpartum sacroiliac joint pain was the aim of this study. Forty primigravida (six weeks postpartum) females with sacroiliac pain was the sample in this study. The subjects equally randomly allocated in group A and B. Group A was treated by ESWT in addition to postural correction and posterior pelvic tilting exercises. Group B was treated by the same exercise program only. Two sessions every week for four weeks were received by both groups. The measurement variables were sacroiliac pain and function level that were measured by visual analogue scale (VAS) and the back pain functional scale (BPFS), respectively. All measurements were evaluated pre and post four weeks of intervention. The within groups analysis showed a significant improvement in VAS and a significant increase in BPFS in both groups after treatment compared with baseline. Regarding between groups analyses there was a significant improvement in VAS and a significant increase in BPFS in group A compared with group B. In conclusion, both ESWT and exercise program are effective in decreasing the pain and improving the function in females with postpartum sacroiliac pain. However, by adding ESWT to exercises in the treatment program the results are better, so this combination is recommended in treatment of females with postpartum sacroiliac pain.

Effect of Shockwave Therapy on Postmenopausal Sacroiliac Joint Pain: A Randomized Controlled Trial

“…These findings could be reinforced by Elhosary et al [11] , who found that 8-week of combined application of shockwave therapy and a program of posture correction exercise had superior effects on lowering VAS scores of sacroiliac pain and enhancing the function of postnatal women with sacroiliac joint pain than did the exercise program alone. Additionally, Saleh et al [24] reported that the addition of shockwave therapy to Mulligan mobilization for 8 weeks resulted in significantly greater PPT increase, ODI scores reduction, and mobility improvement when compared to only Mulligan mobilization in female and males patients with sacroiliac joint dysfunction.…”

“…The probe was moved upward and downward along the posterior sacroiliac joint line while being held perpendicular to the joint line (Figure 2). The parameters were 2400 pulses, frequency of 8 Hz, and an energy density of 0.11 mJ/mm 2 [11] .…”

“…Shockwave therapy is a novel conservative method of treatment for musculoskeletal pain produced by a range of illnesses [9] . Since it inhibits pain transmission and suppresses the inflammatory response, it is considered a good choice for alleviating lumbo-pelvic pain and enhancing its function in recent years [10][11][12] . Although menopause is a difficult time for most women and its symptoms have a significant influence on their well-being and life quality [13] , research regarding the benefit of physical therapy interventions on postmenopausal sacroiliac joint pain is lacking.…”

Effectiveness and safety of tendon-bone-setting in postpartum women with sacroiliac joint pain: A retrospective multicenter study

“…A higher score indicates more functional limitation due to back problems. (3) Patients function level by using back pain function scale (BPFS) [18] : it consists of 12 objects of daily activities with 5 different answers. Patient response to each item was reported by each participant conferring to her capability to apply this activity.…”

The association of pain with suicidal ideation and suicide attempts with depressive symptoms among adults aged ≥50 years from low‐ and middle‐income countries

“…8 Moreover, pain can lead to insomnia and problemsolving deficits, 9 and these conditions may increase risk for suicidality. 10,11 Pain may be an important risk factor for suicidality especially in older adults in LMICs as studies have shown a trend toward increasing prevalence of pain with increasing age with the highest prevalence being observed among older adults, [12][13][14] while the prevalence of chronic pain has been reported to be particularly high in LMICs. 15 Cancer pain, acute pain, and chronic non-cancer pain all contribute to a large burden of pain in LMICs, which is frequently underdiagnosed and undertreated.…”