Chiropractic Care of Adults With Postpartum-Related Low Back,Pelvic Girdle,or Combination Pain: A Systematic Review |
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| Affiliation: | 1. Department of Research, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada;2. Parker Research Center, Parker University, Dallas, Texas;3. Undergraduate Department, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada;4. Canadian Memorial Chiropractic College, Toronto, Ontario, Canada;5. Department of Research, Texas Chiropractic College, Pasadena, Texas;1. Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping, Sweden;2. Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Division of Physiotherapy, University of Gothenburg, Sweden;3. Department of Biomedical Engineering, Linköping University, Linköping, Sweden;1. Director of Research, Centre for Chiropractic Research, New Zealand College of Chiropractic;2. Professor, Kinesiology, Faculty of Health Sciences, University of Ontario Institute of Technology;3. Research Fellow, Auckland Bioengineering Institute at The University of Auckland in New Zealand;1. Outpatient Teaching Clinic, AECC University College, Bournemouth, Dorset, UK;2. Private practice, Werkhoven, Utrecht, the Netherlands;3. AECC University College Teaching Clinic, Bournemouth, Dorset, UK |
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| Abstract: | ObjectiveThe purpose of this study was to conduct a systematic review (SR) of the literature to assess the effectiveness of specific chiropractic care options commonly used for postpartum low back pain (LBP), pelvic girdle pain (PGP), or combination (LBP and PGP) pain.MethodsA search strategy was developed. Interventions were those manual or other nonpharmacologic therapies commonly used by chiropractors (not requiring additional certifications). The outcomes were self-reported changes in pain or disability self-reported outcomes. We used the Scottish Intercollegiate Guideline Network checklists. Strength of the evidence (excluding cohort studies) was determined using an adapted version of the US Preventive Services Task Force criteria as described in the UK report.ResultsOf the 1611 published articles, 16 were included. These were 5 SRs, 10 randomized controlled trials (RCTs), and 1 cohort study. Postpartum LBP (1 RCT): moderate, favorable strength for spinal manipulation therapy/mobilization. Postpartum PGP (4 RCTs): moderate, unclear strength for exercise; and inconclusive, unclear strength for patient education. Postpartum LBP or PGP (3 SRs and 4 RCTs): inconclusive, unclear strength for exercise, self-management, and physiotherapy; while osteopathic manipulative therapy was inconclusive, favorable.ConclusionNo treatment option was identified as having sufficient evidence to make a clear recommendation. This SR identified a scarcity of literature regarding chiropractic care and back pain for postpartum women, as well as inconsistency among the terms LBP, PGP, and combination pain. |
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