Influence of massage and selective gymnastics on roentgenometric parameters of the spinopelvic sagittal balance in patients with sacroiliac joint dysfunction

Abstract

Spinopelvic sagittal balance (SSB) and standing posture are influenced by pelvic morphology and especially pelvic inclination (PI). Abnormal sagittal spine alignment makes it difficult to maintain proper balance. Purpose of the research is to study the effect of massage and special physical exercises on roentgenometric parameters of SSB in patients with sacroiliac joint dysfunction (SJD). Data and methods. A prospective roentgenometric study was performed. The study involved 39 patients with sacroiliac joint dysfunction (SJD). The volunteer group consisted of 24 students who regularly go in for sports. The inclusion criteria for patients in the study were: localization of pain in the area of the spinae iliaca posterior superior, radiating to the groin, buttocks or thigh; history of pain for more than 3 months; failure of previous conservative treatment; positive 4 or more of 6 provocative tests. The exclusion criterion was positive only 1– 3 of the listed provocative tests. The research materials were approved by the Bioethics Committee of the State institute “Sytenko Institute of Spine and Joint Pathology of National Academy of Medical Sciences of Ukraine” (Protocol No. 201 dated 02.03.2020). All volunteers and patients underwent roentgenography of the lumbar spine with hip joints in the standing position according to the standard technique. Patients underwent roentgenography before and after the course of massage and special physical exercises. Results. The pelvic tilt PT parameter in patients was 38⁰ (33⁰; 40⁰) versus 11⁰ (4.5⁰; 15.5⁰) in the volunteer group. The sacral cranial plate slope SS parameter in patients and volunteers was, respectively, 14⁰ (7⁰; 19⁰) and 42⁰ (39⁰; 46⁰). At the same time, there were no statistically significant differences in the PI parameter (52⁰ (46⁰; 62⁰) – patients, 53.5⁰ (46⁰; 62⁰) – volunteers. Despite the change in the roentgenometric parameter of the pelvic inclination PI by an average of 5⁰, multidirectional relative to the rate of change in SS and PT parameters in patients with SJD in the aggregate ensure the stability of this PI parameter, keeping its values as close to the original as possible. Conclusions. Massage and physical exercises are effective treatments for recovery of SSB in patients with SJD. Changes in the anatomical roentgenometric parameter of the inclination of pelvis (PI) are associated, firstly, with degenerative changes in the sacroiliac joint, spine, hip joints, and secondly, with a measurement error.