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| A randomized clinical trial of manual versus mechanical force manipulation in the treatment of sacroiliac joint syndrome |
| Shearar KA, Colloca CJ, White HL |
| Journal of Manipulative and Physiological Therapeutics 2005 Sep;28(7):493-501 |
| clinical trial |
| 5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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OBJECTIVE: To investigate the effect of instrument-delivered compared with traditional manual-delivered thrust chiropractic adjustments in the treatment of sacroiliac joint syndrome. METHODS: Prospective, randomized, comparative clinical trial. Sixty patients with sacroiliac syndrome were randomized into two groups of 30 subjects. Each subject received 4 chiropractic adjustments over a 2-week period and was evaluated at 1-week follow-up. One group received side-posture, high-velocity, low-amplitude chiropractic adjustments; the other group received mechanical-force, manually-assisted chiropractic adjustments using an Activator Adjusting Instrument (Activator Methods International, Ltd, Phoenix, Ariz). RESULTS: No significant differences between groups were noted at the initial consultation for any of the outcome variables. Statistically significant improvements were observed in both groups from the first to third, third to fifth, and first to fifth consultations for improvements (p < 0.001) in mean numerical pain rating scale 101 (group 1 49.1 to 23.4; group 2 48.9 to 22.5), revised Oswestry Low Back Pain Disability Questionnaire (group 1 37.4 to 18.5; group 2 36.6 to 15.1), orthopedic rating score (group 1 7.6 to 0.6; group 2 7.5 to 0.8), and algometry measures (group 1 4.8 to 6.5; group 2 5.0 to 6.8) for first to last visit for both groups. CONCLUSIONS: The results indicate that a short regimen of either mechanical-force, manually-assisted or high-velocity, low-amplitude chiropractic adjustments were associated with a beneficial effect of a reduction in pain and disability in patients diagnosed with sacroiliac joint syndrome. Neither mechanical-force, manually-assisted nor high-velocity, low-amplitude adjustments were found to be more effective than the other in the treatment of this patient population.
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