Background

Pelvic girdle pain (PGP) represents musculoskeletal pain disorders associated with the sacroiliac joint (SIJ) and/or the surrounding musculoskeletal structures. Its physical management is still a serious challenge as it has been considered the primary cause of LBP.

Objective

This review sought to determine the effectiveness of motor control exercises (MCE) for two clinically relevant measures; i.e., pain and disability, on patients with PGP of SIJ origin.

Methods

Online databases, such as PubMed, Embase, Scopus, and Cochrane Library, were searched from January 1990 to December 2019. PEDro scale was used to assess the methodological quality of included studies, while Review Manager was employed to synthesize data in view of meta-analysis.

Results

Twelve moderate-to-high quality RCTs were included in this review. They involved 1407 patients with a mean age ranging from 25.5 to 42.1 years as well as intervention and follow-up durations from 1 week to 2 years. MCE alone were not effective in terms of pain reduction (SMD = 0.29 [-0.64, 1.22]) compared to control interventions whereas they were slightly effective in terms of disability reduction (SMD =-0.07 [-0.67, 0.53]) at short-term. The combination of MCE with other musculoskeletal therapies (MSKTs), however, were more effective than control interventions in terms of pain reduction (SMD =-1.78 [- 2.49, -1.07]; 95%CI) and lessened disability (SMD =-1.80 [-3.03, -0.56]; 95%CI) at short-term.

Conclusion

MCE alone were not found to be effective in reducing pain at short-term. However, their combination with other MSKTs revealed a significant and clinically-relevant decrease in pain and disability at short-term, especially in peripartum period.

Implications

Clinicians should not focus only on MCE in their daily practice but they should combine MCE with other MSKTs in managing PGP of SIJ origin.

Key-words : Exercise therapy, physical therapy modalities, pelvic pain, pelvic girdle pain, sacroiliac joint, musculoskeletal manipulation, systematic review, meta-analysis