title: A randomized clinical trial of manual versus mechanical force manipulation in the treatment of sacroiliac joint syndrome.
abstract: 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 < .001) in mean numerical pain rating scale 101 (group 1, 49.1-23.4; group 2, 48.9-22.5), revised Oswestry Low Back Pain Disability Questionnaire (group 1, 37.4-18.5; group 2, 36.6-15.1), orthopedic rating score (group 1, 7.6-0.6; group 2, 7.5-0.8), and algometry measures (group 1, 4.8-6.5; group 2, 5.0-6.8) 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.
authors.affiliation: Chiropractic Department, Durban Institute of Technology, Durban, South Africa.
authors.forename: Kirstin A
authors.initials: KA
authors.lastname: Shearar
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Colloca
authors.forename: Horace L
authors.initials: HL
authors.lastname: White
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000628:therapy*; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D026882:Manipulation, Chiropractic / Q000379:methods*; D019563:Mechanics; D008875:Middle Aged; D011446:Prospective Studies; D012446:Sacroiliac Joint; D013577:Syndrome