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Tiago P Barbosa Hospital de Braga E.P.E., Braga, Portugal

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Ana Rita Raposo Hospital de Braga E.P.E., Braga, Portugal

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Paulo Diogo Cunha Hospital de Braga E.P.E., Braga, Portugal

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Nuno Cruz Oliveira Hospital de Braga E.P.E., Braga, Portugal

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Armanda Lobarinhas Hospital de Braga E.P.E., Braga, Portugal

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Pedro Varanda Hospital de Braga E.P.E., Braga, Portugal

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Bruno Direito-Santos Hospital de Braga E.P.E., Braga, Portugal

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, alleviate residual symptoms and treat accompanying diseases ( 3 , 5 , 7 , 9 , 10 , 11 ). These programs can include physiotherapy (exercise therapy with stretching and strength training), cognitive-behavioral therapy and multidisciplinary protocols

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Juan Manuel Henríquez-Jurado Department of Health Sciences. University of Jaén. Campus Las Lagunillas s/n, Jaén, Spain

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María Catalina Osuna-Pérez Department of Health Sciences. University of Jaén. Campus Las Lagunillas s/n, Jaén, Spain

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Héctor García-López Department of Nursing, Physiotherapy and Medicine. University of Almería. Ctra Sacrament s/n, Almería, Spain

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Rafael Lomas-Vega Department of Health Sciences. University of Jaén. Campus Las Lagunillas s/n, Jaén, Spain

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María del Carmen López-Ruiz Department of Health Sciences. University of Jaén. Campus Las Lagunillas s/n, Jaén, Spain

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Esteban Obrero-Gaitán Department of Health Sciences. University of Jaén. Campus Las Lagunillas s/n, Jaén, Spain

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Irene Cortés-Pérez Department of Health Sciences. University of Jaén. Campus Las Lagunillas s/n, Jaén, Spain

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States where $134.5 billion is spent on CNP and CLBP management ( 15 ). The most prevalent conservative therapeutic approaches used for CNP and CLBP are pharmacotherapy and physiotherapy. In terms of drug therapies, non-steroidal anti-inflammatory drugs

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Gema Chamorro-Moriana Department of Physiotherapy, Research Group “Area of Physiotherapy CTS-305”, University of Seville, Seville, Spain

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Veronica Perez-Cabezas Department of Nursing and Physiotherapy, Research Group MOVEIT (eMpOwering health by physical actiVity, Exercise and nutrition) CTS-1038, University of Cadiz, Cadiz, Spain

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Marisa Benitez-Lugo Department of Physiotherapy, Research Group “Area of Physiotherapy CTS-305”, University of Seville, Seville, Spain

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standard scales: The Physiotherapy Evidence Database (PEDro) scale ( 28 , 29 , 30 ) for studies with randomized groups. It was valid and reliable to evaluate the internal validity of a study and the adequacy of the statistical information for

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E. Carlos Rodríguez-Merchán Department of Orthopaedic Surgery, ‘La Paz’ University Hospital-IdiPAZ, Madrid, Spain

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balance Surgical trauma to the patella tendon Implant malalignment Postoperative factors Inadequate physical medicine and rehabilitation (physiotherapy) combined with a poorly motivated patient Inadequate pain control Preoperative

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Jean-Charles Le Huec Polyclinique Bordeaux Nord Aquitaine, Bordeaux Univ, 33 300 Bordeaux, France

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Stephane Bourret Polyclinique Bordeaux Nord Aquitaine, Bordeaux Univ, 33 300 Bordeaux, France

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Wendy Thompson Polyclinique Bordeaux Nord Aquitaine, Bordeaux Univ, 33 300 Bordeaux, France

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Christian Daulouede Polyclinique Bordeaux Nord Aquitaine, Bordeaux Univ, 33 300 Bordeaux, France

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Thibault Cloché Polyclinique Bordeaux Nord Aquitaine, Bordeaux Univ, 33 300 Bordeaux, France

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treat sacro-iliac micro-traumatic pain? Physiotherapy Despite the widespread use of non-operative solutions for treatment of SIJ micro-traumatic pain (physical therapy, manual manipulations or stabilization exercises), there is no clear evidence of

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Bülent Atilla Hacettepe University Faculty of Medicine, Department of Orthopaedics and Traumatology, Ankara, Turkey

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Hande Güney-Deniz Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey

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. Physiotherapy and rehabilitation in haemophilic patients are important to return to the normal status of joint motion, to regain the muscle strength, to obtain the optimal functional levels and to improve the patients’ quality of life. 6 , 7 Primary

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Nikolaos Gougoulias Frimley Health NHS Foundation Trust. Frimley Park Hospital, UK

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Vasileios Lampridis Frimley Health NHS Foundation Trust. Frimley Park Hospital, UK

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Anthony Sakellariou Frimley Health NHS Foundation Trust. Frimley Park Hospital, UK

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, nonoperative management is recommended initially. This may include physiotherapy (intrinsic and gastrocnemius muscle stretching), modification of activities, use of appropriate (wide-fitting) footwear, injections (local anaesthetic, steroid, alcohol

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Mark F Siemensma Erasmus MC, University Medical Center Rotterdam, Department of Orthopaedics and Sports Medicine, 3000 CA, Rotterdam, The Netherlands

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Anna E van der Windt Erasmus MC, University Medical Center Rotterdam, Department of Orthopaedics and Sports Medicine, 3000 CA, Rotterdam, The Netherlands

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Eline M van Es Erasmus MC, University Medical Center Rotterdam, Department of Orthopaedics and Sports Medicine, 3000 CA, Rotterdam, The Netherlands

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Joost W Colaris Erasmus MC, University Medical Center Rotterdam, Department of Orthopaedics and Sports Medicine, 3000 CA, Rotterdam, The Netherlands

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Denise Eygendaal Erasmus MC, University Medical Center Rotterdam, Department of Orthopaedics and Sports Medicine, 3000 CA, Rotterdam, The Netherlands

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shown that IA corticosteroid injections are significantly associated with the development of postoperative infection ( 20 , 21 , 22 ). Conservative treatment Physiotherapy (PT) and splinting play an important role in the treatment of stiffness

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Anna Wawrzyniak Rehasport Clinic, Poznań, Poland

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Przemysław Lubiatowski Rehasport Clinic, Poznań, Poland
Sport Traumatology and Biomechanics Unit Department of Traumatology, Orthopaedics and Hand Surgery, Poznań University of Medical Science, Poznań, Poland

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); Treatment: conservative (physiotherapy, medication, splinting, radiotherapy) vs operative – treatment effectiveness. An improvement of ROM of at least 20° in flexion and/or internal rotation (IR) and/or external rotation (ER) or information from the author

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Anders Falk Brekke Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
Department of Clinical Research, University of Southern Denmark, Odense, Denmark
University College Absalon, Center of Nutrition and Rehabilitation, Department of Physiotherapy, Region Zealand, Denmark

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Søren Overgaard Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
Department of Clinical Research, University of Southern Denmark, Odense, Denmark

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Asbjørn Hróbjartsson Department of Clinical Research, University of Southern Denmark, Odense, Denmark
Odense Patient data Explorative Network (OPEN), Odense, Denmark
Centre for Evidence-Based Medicine Odense (CEBMO), Odense University Hospital, Odense, Denmark

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Anders Holsgaard-Larsen Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
Department of Clinical Research, University of Southern Denmark, Odense, Denmark

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  • Excessive anterior pelvic tilt is suspected of causing femoroacetabular impingement, low back pain, and sacroiliac joint pain. Non-surgical treatment may decrease symptoms and is seen as an alternative to invasive and complicated surgery. However, the effect of non-surgical modalities in adults is unclear. The aim of this review was to investigate patient- and observer-reported outcomes of non-surgical intervention in reducing clinical symptoms and/or potential anterior pelvic tilt in symptomatic and non-symptomatic adults with excessive anterior pelvic tilt, and to evaluate the certainty of evidence.

  • MEDLINE, EMBASE, Web of Science and Cochrane (CENTRAL) databases were searched up to March 2019 for eligible studies. Two reviewers assessed risk of bias independently, using the Cochrane Risk of Bias tool for randomized trials and the ROBINS-I tool for non-randomized studies. Data were synthesized qualitatively. The GRADE approach was used to assess the overall certainty of evidence.

  • Of 2013 citations, two randomized controlled trials (RCTs) (n = 72) and two non-RCTs (n = 23) were included. One RCT reported a small reduction (< 2°) in anterior pelvic tilt in non-symptomatic men. The two non-RCTs reported a statistically significant reduction in anterior pelvic tilt, pain, and disability in symptomatic populations. The present review was based on heterogeneous study populations, interventions, and very low quality of evidence.

  • No overall evidence for the effect of non-surgical treatment in reducing excessive anterior pelvic tilt and potentially related symptoms was found. High-quality studies targeting non-surgical treatment as an evidence-based alternative to surgical interventions for conditions related to excessive anterior pelvic tilt are warranted.

Cite this article: EFORT Open Rev 2020;5:37-45. DOI: 10.1302/2058-5241.5.190017

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