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Salari N, Mohammadi A, Hemmati M, Hasheminezhad R, Kani S, Shohaimi S, Mohammadi M. The global prevalence of low back pain in pregnancy: a comprehensive systematic review and meta-analysis. BMC Pregnancy Childbirth 2023; 23:830. [PMID: 38042815 PMCID: PMC10693090 DOI: 10.1186/s12884-023-06151-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 11/22/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND Back pain during pregnancy is often considered as an unavoidable problem and can reduce the quality of life or disability of pregnant women. The aim of this study is to determine the global prevalence of back pain in pregnancy based on a systematic review and meta-analysis. METHODS In this study, Researchers systematically searched electronic databases PubMed, Scopus, Web of Science, Embase, ScienceDirect, and Google Scholar search engines for studies until September 2023. To analyze data, the random effects model was used, and the heterogeneity of the studies was checked with the I2 index. Data analysis was performed by software (Version 2 Comprehensive Meta-Analysis). RESULTS In the review of 28 studies with a sample size of 12,908 people, the I2 heterogeneity test showed high heterogeneity (I2: 98.4). Based on this, the random effects method was used to analyze the results. Therefore, the meta-analysis reported the global prevalence of back pain at 40.5 (95% CI: 33-48.4) during pregnancy. Also, according to the meta-analysis, the global prevalence of back pain in the first trimester of pregnancy is 28.3 (95%CI: 10.5-57.1), in the second trimester is 36.8 (95%CI: 30.4-43.7) and in the third trimester of pregnancy was reported as 47.8 (95% CI: 37.2-58.6). CONCLUSION In this meta-analysis, the overall prevalence of back pain in pregnant women was reported to be significant, so it is necessary for health policymakers to pay more attention to complications during pregnancy, in addition to increasing society's awareness of pregnant mothers, with timely diagnosis and treatment of such disorders, it can lead to improvement; and reduction in Complications caused by pregnancy and becoming more pleasant during pregnancy.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Aida Mohammadi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahvan Hemmati
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Razie Hasheminezhad
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Salim Kani
- Department of Orthopedic Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
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Fogarty S, McInerney C, Chalmers J, Veale K, Hay P. The Effectiveness of Massage in Managing Pregnant Women with Pelvic Girdle Pain: a Randomised Controlled Crossover Feasibility Study. Int J Ther Massage Bodywork 2023; 16:5-19. [PMID: 38046054 PMCID: PMC10665078 DOI: 10.3822/ijtmb.v16i4.877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
Introduction Pelvic girdle pain is a common problem experienced during pregnancy, with high incidence rates and significant impacts on quality of life. Remedial massage might be able to provide some reduction in pain. Aim This study aimed to investigate the feasibility of conducting a randomised controlled trial on the effectiveness of massage in treating pregnant women with pelvic girdle pain to determine its merits and viability for use in a large-scale study. Methods A two-arm pilot randomised feasibility crossover-controlled trial. The two treatment phases were a) remedial pregnancy massage, and b) exercise. Results Twenty-four women started the study and 19 women completed the study. Data were collected on recruitment and retention rates, crossover study design methodology, participant sub-characteristics, and acceptability of the outcome measures (pain, quality of life, and disability). Conclusion Recruiting participants for a pregnancy-related pelvic girdle pain study is indeed feasible; however, a crossover study design is not appropriate and future studies should consider a mixed methods study design.
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Affiliation(s)
- Sarah Fogarty
- Western Sydney University, School of Medicine, Campbelltown, NSW
| | | | - Jane Chalmers
- University South Australia, Allied Health & Human Performance, Adelaide, South Australia
- Western Sydney University, School of Science and Health, Campbelltown, NSW
| | - Kym Veale
- Womankind Physiotherapy, Melbourne, Victoria
| | - Phillipa Hay
- Western Sydney University, School of Medicine, Campbelltown, NSW
- Western Sydney University, Translational Health Research Institute, School of Medicine, Campbelltown, NSW, Australia
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Hameed F, Cesare A, Mariscal Del Moral N, Barton T, Chiarello C. Is Pregnancy-Related Lumbopelvic Pain Reported to Health Care Providers? J Womens Health (Larchmt) 2023; 32:1192-1199. [PMID: 37535018 DOI: 10.1089/jwh.2022.0459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Abstract
Background: Pregnancy-related lumbopelvic pain (PLPP) is a common ailment during pregnancy with physical, psychosocial, and economic consequences. Despite being common, prior literature has found that this symptom is widely underreported and therefore undertreated, especially in the United States. The objectives of this study were to determine the proportion of pregnant women who report PLPP during pregnancy to their health care providers (HCPs) and to determine what contributing factors for reporting exist. Materials and Methods: This is a cross-sectional survey design and was conducted at an academic medical center. All pregnant women attending a prenatal visit in obstetrical offices from July 2018 through March 2020 were asked to complete a questionnaire compiling demographic and socioeconomic information, answer validated survey instruments measuring physical and urinary function, and describe any pain, including intensity, frequency, and whether they told their HCPs about these symptoms and received any treatments. Results: Of the 538 respondents who had PLPP, only 43% (n = 233) reported PLPP to their provider. Of those who reported PLPP, 22% (n = 51) received treatment, of which 80% (n = 41) noted that treatment was effective. Factors that increased the likelihood of informing HCPs about PLPP were difficulty with daily mobility and a greater week of gestation. Conclusions: HCPs should inquire about PLPP throughout pregnancy. Any level of PLPP should be reported and monitored by a patient's HCP, and if it is interfering with activities of daily living, sleeping, or quality of life, it should be treated.
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Affiliation(s)
- Farah Hameed
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Ariana Cesare
- Program in Physical Therapy, Columbia University Irving Medical Center, New York, New York, USA
| | - Nura Mariscal Del Moral
- Program in Physical Therapy, Columbia University Irving Medical Center, New York, New York, USA
| | | | - Cynthia Chiarello
- Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, New York, USA
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Bernard-Giglio M, French SD, Myburgh C, de Luca K. Drivers, barriers, and response to care of Australian pregnant women seeking chiropractic care for low back and pelvic girdle pain: a qualitative case study. Chiropr Man Therap 2023; 31:43. [PMID: 37789336 PMCID: PMC10546639 DOI: 10.1186/s12998-023-00516-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 09/13/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Pregnancy-related low back and/or pelvic girdle pain is common, with a prevalence rate of up to 86% in pregnant women. Although 19.5% of Australian pregnant women visit a chiropractor for pelvic girdle pain, little is known about the experience of pregnant women who seek this care. The aim of this study was to describe and explore the experiences of Australian pregnant women who seek chiropractic care for their current pregnancy-related low back and/or pelvic girdle pain. METHODS A qualitative case study approach with purposive sampling from 27 chiropractic practices was used. A grounded theory approach was informed by a constructivist and interpretivist stance, which provided understanding and meaning to the pregnant women's experiences. Online unstructured interviews were recorded, transcribed, and anonymised. A thematic analysis was subsequently conducted on the primary data. Codes and major themes were developed with the use of critical self- reflection (memos), survey finding triangulation and respondent validation. RESULTS Sixteen potential respondents expressed interest in participating. After eligibility screening and data saturation, nine interviews were undertaken. Four key themes were identified: "Care drivers: what drives care seeking?", "Care barriers: what barriers are encountered?", "Chiropractic treatment: what does treatment consist of?" and "Response to care: what response was there to care?". CONCLUSION Four key themes: care drivers, care barriers, chiropractic treatment, and response to care support an emergent substantive-level theory in women's care seeking experiences for pregnancy-related back pain and chiropractic care. This theory is that chiropractic care for pregnant women experiencing low back pain and pelvic girdle pain may improve pain and function, while reducing pregnancy-related biopsychosocial concerns. The findings may inform antenatal health providers and the chiropractic profession about pregnant women's experience seeking chiropractic care as well as directing future research.
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Affiliation(s)
- Maria Bernard-Giglio
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.
| | - Simon D French
- Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Corrie Myburgh
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, Odense M, 5230, Denmark
- Chiropractic Knowledge Hub, University of Southern Denmark, Campusvej 55, Odense M, 5230, Denmark
| | - Katie de Luca
- Discipline of Chiropractic, School of Health, Medical and Applied Sciences, CQ University, Brisbane, Australia
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Ceprnja D, Chipchase L, Liamputtong P, Gupta A. "We are not there yet": perceptions, beliefs and experiences of healthcare professionals caring for women with pregnancy-related pelvic girdle pain in Australia. BMC Pregnancy Childbirth 2023; 23:682. [PMID: 37735360 PMCID: PMC10512538 DOI: 10.1186/s12884-023-06000-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 09/14/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Pregnancy-related pelvic girdle pain (PPGP) is a common condition worldwide. Women report being unprepared about PPGP, and state they receive little recognition and support from healthcare professionals. Situated within the Common-Sense Model and Convergent Care Theory, this study sought to gain a conceptual understanding of the perceptions, beliefs and experiences of healthcare professionals who provide routine care for women with PPGP in Australia. METHODS A qualitative research design, using individual, semi-structured interviews with purposive sampling of healthcare professionals (N=27) consisting of doctors (N=9), midwives (N=9) and physiotherapists (N=9). Most participants were female (22/27) with a range of professional experience. An interview guide consisting of open-ended questions was used with a flexible and responsive approach. Thematic analysis was performed where interview data were transcribed, coded, grouped into meaningful categories and then constructed into broad themes. RESULTS Four themes were identified: 1. Identity and impact of PPGP; 2. What works well?; 3. What gets in the way?; and 4. Quality care: What is needed? Healthcare professionals recognised PPGP as a common and disabling condition, which created a large impact on a woman's life during pregnancy. Stepped-level care, including education and physiotherapy intervention, was seen to be helpful and led to a positive prognosis. Barriers at patient, clinician and organisation levels were identified and led to consequences for women with PPGP not receiving the care they need. CONCLUSION This study elucidates important implications for health care delivery. Acknowledging that PPGP is a common condition causing difficulty for many women, healthcare professionals identified strong teamwork and greater clinical experience as important factors in being able to deliver appropriate healthcare. Whilst healthcare professionals reported being committed to caring for women during pregnancy, busy workloads, attitudes towards curability, and a lack of formal education were identified as barriers to care. The findings suggest timely access, clear referral pathways and an integrated approach are required for best care practice for women with PPGP. A greater emphasis on the need for multidisciplinary models of care during pregnancy is evident.
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Affiliation(s)
- Dragana Ceprnja
- School of Health Sciences, Western Sydney University, Sydney, Australia
- Physiotherapy Department, Westmead Hospital, Sydney, Australia
| | - Lucy Chipchase
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | | | - Amitabh Gupta
- School of Health Sciences, Western Sydney University, Sydney, Australia
- Physiotherapy Department, Westmead Hospital, Sydney, Australia
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Haakstad LAH, Benvenuti MB, Dalhaug EM, Bø K. Lumbopelvic pain and sick leave during pregnancy: A comparison of Italy and Norway. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231218197. [PMID: 38078361 PMCID: PMC10712273 DOI: 10.1177/17455057231218197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 11/01/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Pregnancy-related lumbopelvic pain is a frequently reported musculoskeletal disorder, but few studies have compared data between countries. OBJECTIVES Examine prevalence, severity, and sick leave and explore potential risk factors associated with pregnancy-related lumbopelvic pain in Italian women and compare the results to a similar study in Norway, utilizing the same questionnaire. DESIGN Cross-sectional. METHODS Italian (n = 481) and Norwegian women (n = 435) were allocated from two public hospitals in Rome (Fatebenefratelli San Giovanni Calibita-Isola Tiberina) and Oslo (Oslo University Hospital), as well as four antenatal clinics in Modena (Italy). The questionnaire was completed between gestation weeks 32 and 36, addressing women's experiences of pregnancy-related lumbopelvic pain and sick leave in current week, and retrospectively for prepregnancy, first and second trimesters. RESULTS In Italy and Norway, 39% and 57% of pregnant women reported pregnancy-related lumbopelvic pain, respectively, with 11% and 25% experiencing severe pregnancy-related lumbopelvic pain. Pregnancy-related lumbopelvic pain was associated with sick leave in Norway (p < 0.01), but not in Italy (p = 0.66) at late gestation. In both countries, women with pregnancy-related lumbopelvic pain versus those with no pregnancy-related lumbopelvic pain were more likely to be multiparous (Italy: 40% versus 31%, p = 0.06 and Norway: 53% versus 38%, p < 0.01), and have gestational weight gain above guidelines (Italy: 21% versus 13%, p = 0.02% and Norway: 27% versus 14%, p < 0.01) and previous experience of pregnancy-related lumbopelvic pain (Italy: 15% versus 2%, p < 0.01 and Norway: 31% versus 4%, p < 0.01). Maternal exercise (⩾2 times weekly) was associated with less pregnancy-related lumbopelvic pain (Italy: odds ratio = 0.33, 95% confidence interval = 0.11-1.0, p = 0.05 and Norway: odds ratio = 0.55, 95% confidence interval = 0.29-1.0, p = 0.06). CONCLUSION We observed high rates of pregnancy-related lumbopelvic pain in Italy and Norway, with Norwegian women reporting the highest prevalence and severity level. While both countries had similar rates of sick leave in late gestation, an association between pregnancy-related lumbopelvic pain and sick leave was observed among Norwegian women only. Health care providers should be proactive in addressing pregnancy-related lumbopelvic pain through open communication and seeking input from pregnant individuals. However, it is essential to acknowledge that the current evidence on effective treatments remains limited and inconclusive, highlighting the need for further research in this field.
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Affiliation(s)
| | | | - Emilie Mass Dalhaug
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Kari Bø
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Obstetrics and Gynecology, Akershus University Hospital, Nordbyhagen, Norway
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Al Sad S, Start AR. Primary care providers' experiences treating low back pain. J Osteopath Med 2022; 122:263-269. [PMID: 35128904 DOI: 10.1515/jom-2021-0229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/16/2021] [Indexed: 11/15/2022]
Abstract
CONTEXT Our original work addresses the biological sex impact on low back pain (LBP) management and prognosis in primary care settings. To our knowledge, our study is the first in the United States to evaluate the differences in clinicians' approaches to LBP in the ambulatory setting specifically based on patient gender. Our findings suggest that there is a knowledge gap among primary care providers (PCPs) toward the potential impact of biological sex on LBP and a bias toward gender roles when counseling patients for home chores or occupational tasks. Further evaluation of this knowledge gap and its impact on LBP management and prognosis is recommended in US healthcare settings. OBJECTIVES This study aims to explore PCP experiences and practice patterns regarding LBP in females compared to males in US healthcare settings. METHODS We utilized a cross-sectional study design and convenience sampling. Data were collected anonymously utilizing a 27-item online survey sent periodically via email to PCPs working in Ohio. We had 58 responses for analysis; data were analyzed utilizing bivariate and multivariate analyses. RESULTS On average, approximately 9 out of 10 responding clinicians reported experiencing LBP. PCPs were not in agreement that LBP is different in women than men. Clinicians with a women's health, osteopathic, or sport's medicine background were more likely to agree that LBP is different in women than in men. PCPs were more likely to counsel female patients about pelvic floor exercises; however, their intake of present pelvic symptoms in LBP female patients is suboptimal. PCPs were more likely to counsel females for home chores than males, which is aligned with the perceived traditional gender roles among PCPs. CONCLUSIONS There may be a knowledge gap among PCPs toward the potential impact of biological sex on LBP and a bias toward gender roles when counseling patients for home chores or occupational tasks. Further investigation of this knowledge gap and counseling approaches is recommended to better bridge the gender disparity.
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Affiliation(s)
- Sondos Al Sad
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Amanda R Start
- The Ohio State University College of Medicine Office of Curriculum and Scholarship, Columbus, OH, USA
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Ceprnja D, Chipchase L, Liamputtong P, Gupta A. "This is hard to cope with": the lived experience and coping strategies adopted amongst Australian women with pelvic girdle pain in pregnancy. BMC Pregnancy Childbirth 2022; 22:96. [PMID: 35109793 PMCID: PMC8809214 DOI: 10.1186/s12884-022-04426-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 01/24/2022] [Indexed: 12/13/2022] Open
Abstract
Background Women with pregnancy-related pelvic girdle pain (PPGP) report diminished ability to perform physical activities and experience higher rates of mood disorders, such as anxiety and depression, than pregnant women without PPGP. Despite these physical and psychological impacts, little is known about the lived experiences of PPGP amongst Australian women and the ways in which they cope. Situated within biographical disruption and social support theories, this study sought to gain a conceptual understanding of the experience and impact of PPGP on daily life, and how women cope with this condition during pregnancy. Methods A qualitative research design, situated within a phenomenological framework, using individual, semi-structured interviews consisting of open-ended questions was used with a flexible and responsive approach. Purposive sampling of pregnant women attending a single hospital included 20 participants between 14 and 38 weeks gestation, classified with PPGP as per recommended guidelines, with a mean (SD) age of 31.37 (4.16) years. Thematic analysis was performed where interview data was transcribed, coded, grouped into meaningful categories and then constructed into broad themes. Results Three themes were identified: 1. a transformed biography; 2. coping strategies; and 3. what women want. The pain experienced created a dramatic change in women’s lives, making the pregnancy difficult to endure. Women utilised social support, such as family, to help them cope with pain, and a self-care approach to maintain a positive mindset and reduce stress. Although a few women received support from healthcare professionals, many reported a lack information on PPGP and limited societal recognition of the condition. Women wanted early education, personalised information and prompt referral to help them cope with PPGP. Conclusions Findings from this study highlighted the complexity of living with PPGP as women attempted to deal with the unexpected impact on daily life by seeking support from partners and families, while also struggling with societal expectations. Although women with PPGP used a number of coping strategies, they sought greater support from healthcare professionals to effectively manage PPGP. These findings have important implications for the provision of health care to women living with PPGP. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12618001423202.
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Affiliation(s)
- Dragana Ceprnja
- Western Sydney University, Sydney, New South Wales, Australia. .,Physiotherapy Department, Westmead Hospital, Sydney, Australia.
| | | | | | - Amitabh Gupta
- Western Sydney University, Sydney, New South Wales, Australia.,Physiotherapy Department, Westmead Hospital, Sydney, Australia
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Ceprnja D, Chipchase L, Fahey P, Liamputtong P, Gupta A. Prevalence and Factors Associated with Pelvic Girdle Pain During Pregnancy in Australian Women: A Cross-Sectional Study. Spine (Phila Pa 1976) 2021; 46:944-949. [PMID: 33492087 PMCID: PMC8221721 DOI: 10.1097/brs.0000000000003954] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/04/2020] [Accepted: 12/03/2020] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-sectional study conducted between December 2017 and October 2019. OBJECTIVE To determine the prevalence and risk factors associated with pregnancy-related pelvic girdle pain (PPGP) in Australia. SUMMARY OF BACKGROUND DATA PPGP is a common condition worldwide yet the prevalence and associated risk factors are not known in Australia. METHODS A random sample of pregnant women (N = 780) of (mean [SD]) 31 (5) years of age between 14 and 38 weeks gestation attending ante-natal care in a tertiary referral hospital in Sydney, Australia was conducted. The main outcome measure was point-prevalence of PPGP as classified by recommended guidelines including a physical examination. A number of potential risk factors, including socio-demographic characteristics, country of birth, ethnicity, history of low back pain (LBP) and PPGP, family history of PPGP, occupational factors, and physical activity were investigated with logistic regression. RESULTS The point-prevalence of PPGP in a random sample of 780 Australian women was 44% with the odds of having PPGP increasing with each additional week of gestation (odds ratio [OR]) (OR 1.02). Increasing parity (P = 0.03, OR 1.15), country of birth (P = 0.03), and greater duration of time spent standing (P = 0.009, OR 1.06) were associated with PPGP. The strongest predictors of PPGP were previous LBP and/or PPGP both pregnancy (P < 0.001, OR 4.35) and not pregnancy related (P < 0.001, OR 2.24), and a family history of PPGP (P < 0.001, OR 3.76). CONCLUSION The prevalence of PPGP in Australian women was high with almost half the sample classified with PPGP, matching data reported worldwide. The identified risk factors associated with PPGP can be included in routine ante-natal care to screen women and identify those at risk of this common and disabling condition.Level of Evidence: 1.
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Affiliation(s)
- Dragana Ceprnja
- Western Sydney University, Sydney, New South Wales, Australia
- Westmead Hospital, Sydney, New South Wales, Australia
| | | | - Paul Fahey
- Western Sydney University, Sydney, New South Wales, Australia
| | | | - Amitabh Gupta
- Western Sydney University, Sydney, New South Wales, Australia
- Westmead Hospital, Sydney, New South Wales, Australia
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Weis CA, Stuber K, Murnaghan K, Wynd S. Adverse events from spinal manipulations in the pregnant and postpartum periods: a systematic review and update. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2021; 65:32-49. [PMID: 34035539 PMCID: PMC8128327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND The purpose of this study is to update a previous critical review of adverse events in pregnant and postpartum populations. METHODS The following databases were searched: PubMed, CINAHL, Index to Chiropractic Literature, Cochrane Database of Systematic Reviews/Cochrane Central Register of Controlled Trials and MEDLINE. We included all study design types as it was determined a priori that there would not be enough high-quality research on spinal manipulative therapy (SMT) in these populations to make any determinations. The Scottish Intercollegiate Guidelines Network (SIGN) and CARE (CAse REport) checklists were used for quality rating. RESULTS This update found one case study that demonstrated a serious adverse event in the cervical spine following SMT and a handful of minor and transient adverse events in the low back following SMT. CONCLUSIONS There was limited evidence of adverse events following SMT in these populations. Although we are calling for improved reporting of such events in future studies, it may be that such injuries are rare.
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Remus A, Smith V, Gutke A, Mena JJS, Mørkved S, Wikmar LN, Öberg B, Olsson C, Robinson HS, Stuge B, Wuytack F. A core outcome set for research and clinical practice in women with pelvic girdle pain: PGP-COS. PLoS One 2021; 16:e0247466. [PMID: 33630941 PMCID: PMC7906405 DOI: 10.1371/journal.pone.0247466] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 02/07/2021] [Indexed: 12/12/2022] Open
Abstract
Background Inconsistent reporting of outcomes in clinical trials of women with Pelvic Girdle Pain (PGP) hinders comparison of findings and the reliability of evidence synthesis. A core outcome set (COS) can address this issue as it defines a minimum set of outcomes that should be reported in all clinical trials on the condition. The aim of this study was to develop a consensus-based COS for evaluating the effectiveness of interventions in PGP during pregnancy and postpartum for use in research and clinical practice. Methods A systematic review of previous studies on PGP and semi-structured interviews with women were undertaken to identify all outcomes that were reported in prior studies and that are relevant to those experiencing the condition. Key stakeholders (clinicians, researchers, service providers/policy makers and individuals with PGP) then rated the importance of these outcomes for including in a preliminary PGP-COS using a 3-round Delphi study. The final COS was agreed at a face-to-face consensus meeting. Results Consensus was achieved on five outcomes for inclusion in the final PGP-COS. All outcomes are grouped under the “life impact” domain and include: pain frequency, pain intensity/severity, function/disability/activity limitation, health-related quality of life and fear avoidance. Conclusion This study identified a COS for evaluating the effectiveness of interventions in pregnancy-related and postpartum-related PGP in research and clinical settings. It is advocated that all trials, other non-randomised studies and clinicians in this area use this COS by reporting these outcomes as a minimum. This will ensure the reporting of meaningful outcomes and will enable the findings of future studies to be compared and combined. Future work will determine how to measure the outcomes of the PGP-COS. Core outcome set registration This PGP-COS was registered with COMET (Core Outcome Measures for Effectiveness Trials) in January 2017 (http://www.comet-initiative.org/studies/details/958).
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Affiliation(s)
- Alexandria Remus
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Valerie Smith
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Annelie Gutke
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Göteborg, Sweden
| | | | - Siv Mørkved
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lena Nilsson Wikmar
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Academic Primary Healthcare Centre, Stockholm, Sweden
| | - Birgitta Öberg
- Department of Medicine and Health, Linköping University, Linköping, Sweden
| | | | - Hilde Stendal Robinson
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Britt Stuge
- Division for Neuroscience and Musculoskeletal Medicine, Oslo University Hospital, Oslo, Norway
| | - Francesca Wuytack
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
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Gashaw M, Gedlu S, Janakiraman B. Burden of pelvic girdle pain during pregnancy among women attending ante-natal clinic, Ethiopia:a cross-sectional study. BMC Pregnancy Childbirth 2020; 20:494. [PMID: 32854667 PMCID: PMC7457245 DOI: 10.1186/s12884-020-03184-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/17/2020] [Indexed: 12/03/2022] Open
Abstract
Background Pelvic girdle pain (PGP) is a commonly reported maternal morbidity that negatively impacts the well-being of women during pregnancy and extends long term into the post-partum period. The burden of maternal morbidity; including pregnancy-related PGP; has been overlooked in Ethiopia to date. This study aimed to determine the prevalence and identify factors associated with pelvic girdle pain during pregnancy in North West Ethiopia. Methods A hospital-based cross-sectional study was conducted among pregnant women visiting the antenatal care clinic in Obstetrics ‘outpatient department at the University of Gondar comprehensive specialized hospital in Gondar. Data were collected by interview method using structured questionnaires, patient medical record reviews, and physical measurements. Univariate and multivariable logistic regression model analyses were used to identify factors associated with PGP. Results A total of 424 participants with gestational ages ranging from 6 to 39 weeks participated in this study. The age of the study participants ranged from 18 to 44 years with a mean age of (27 ± 4.6 years). The overall cumulative prevalence of pelvic girdle pain among pregnant women was 103 (24.3%),95% CI (20.3, 28.8). The major associated factors with pelvic girdle pain were previous history of pelvic girdle pain (AOR 16.08; 95% CI, 8.47–30.51), previous history of back pain (AOR 1.66; 95% CI, 1.5–4.24) and having children (AOR 1.42; 95% CI, 1.29–3.76). Conclusion One-quarter of pregnant Ethiopian women reported pelvic girdle pain. PGP must be considered as major pregnancy-related morbidity, and progress in the intervention of PGP is vital to enhance the quality of life in this population.
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Affiliation(s)
- Moges Gashaw
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, P.O. Box: 196, Gondar, Ethiopia.
| | - Solomon Gedlu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Balamurugan Janakiraman
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, P.O. Box: 196, Gondar, Ethiopia
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Fogarty S, McInerney C, Hay P. Pregnancy-related Pelvic Girdle Pain and Pregnancy Massage: Findings from a Subgroup Analysis of an Observational Study. Int J Ther Massage Bodywork 2020; 13:1-8. [PMID: 32523639 PMCID: PMC7260134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND Pregnancy-related pelvic girdle pain (PPGP) significantly impacts women's lives both physically and psychologically. Given the severity and impact of PPGP on pregnancy, the authors anticipated that pregnant women with PPGP might respond differently to massage than pregnant women without PPGP. PURPOSE The aim of the study was to further analyze a published 2017 study to assess the response of pregnancy massage in participants with and without PPGP. SETTING Two massage clinics, one in Sydney and one in Melbourne, recruited participants from December 2016 to December 2017. PARTICIPANTS Nineteen women with PPGP and 78 without PPGP. RESEARCH DESIGN PPGP and non-PPGP women receiving at least one massage, with outcome measures assessed immediately prior to and after massage, and again one week postmassage. MAIN OUTCOME MEASURES Visual analog scales for pain, stress, range of movement, sleep, and self-reported side effects of massage. RESULTS Both groups changed significantly and similarly over time for measures of pain, stress, range of motion, and sleep (all p < .05). Post hoc analysis found significant reduction in all outcome measures immediately following massage, but returned to baseline at one week postmassage for all measures except pain, which remained reduced for the PPGP group (49.79±25.68 to 34.75±34.75, p = .03, effect size 0.593), and stress remained reduced in the non-PPGP group (33.36±21.54 to 24.90±19.18, p = .002, effect size 0.373). The PPGP group entered the study with higher baseline levels of pain (p = .01) and a greater restriction in range of motion (p = .006) than the non-PPGP group. There was no difference in the number of side effects experienced between the two groups (p = .130). CONCLUSIONS Although PPGP clients report greater pain and restriction in range of motion at baseline than non-PPGP clients, the response to pregnancy massage was similar. Results support a role of pregnancy massage in the management of PPGP. More research on massage for PPGP is needed to confirm a lasting effect of pain reduction from massage.
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Affiliation(s)
- Sarah Fogarty
- School of Medicine, Western Sydney University, Sydney NSW, Australia,Corresponding author: Sarah Fogarty, PhD, School of Medicine, Western Sydney University, PO Box 8218 Ferntree Gully, Victoria, Australia 3156,
| | | | - Phillipa Hay
- School of Medicine, Western Sydney University, Sydney NSW, Australia
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Szkwara JM, Milne N, Rathbone E. A prospective quasi-experimental controlled study evaluating the use of dynamic elastomeric fabric orthoses to manage common postpartum ailments during postnatal care. WOMEN'S HEALTH (LONDON, ENGLAND) 2020; 16:1745506520927196. [PMID: 32525761 PMCID: PMC7290251 DOI: 10.1177/1745506520927196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/04/2020] [Accepted: 04/21/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of a postnatal dynamic elastomeric fabric orthoses to manage postpartum pain, improve functional capacity and enhance the quality of life arising from postnatal ailments immediately to an 8-week postpartum, compared with patients who did not wear dynamic elastomeric fabric orthoses. METHOD A total of 51 postpartum women were recruited (day 0 to 10 days post-delivery) from hospitals and community-based health clinics to participate in a prospective quasi-experimental controlled study using parallel groups without random allocation. The subgroup of the compression shorts group wore SRC recovery shorts and received standard postnatal care. The comparison group received standard postnatal care alone. Wear compliance was monitored throughout the study. Primary outcome measure, Numeric Pain Rating Scale, and secondary outcome measures, Roland Morris Disability Questionnaire, Pelvic Floor Impact Questionnaire-7, and Short Form (SF-36) were assessed fortnightly over 8 weeks for both groups. RESULTS The compression shorts group reported a larger reduction in mean (SD) Numeric Pain Rating Scale score (-3.09 (2.20)) from baseline to 8 weeks, compared to the comparison group (-2.00 (1.41)). However, there was insufficient evidence of a statistical difference in Numeric Pain Rating Scale score at 8 weeks when comparing the compression shorts group and comparison group (-1.17; 95%CI: (-2.35, -0.01), R2 = .19, p = .050). The compression shorts group met the wear compliance of the dynamic elastomeric fabric orthoses and reported an average wear of the dynamic elastomeric fabric orthoses as 9 out of 14 days for 11 h per day (SD 4.8 h) between the fortnightly timepoints. CONCLUSION The use of dynamic elastomeric fabric orthoses may be considered during postnatal care as a non-pharmacological therapeutic intervention to manage pain resulting from common postpartum ailments. While the dynamic elastomeric fabric orthoses was clinically well accepted by participants with high wearing compliance, future research with larger population samples are needed to enable statistical conclusions on the effectiveness of a dynamic elastomeric fabric orthoses in postnatal care to be made. REGISTRATION Trial registration was not required as per the Australian Government Department of Health, Therapeutic Goods Administration.
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Affiliation(s)
- Jaclyn Michele Szkwara
- Physiotherapy Program, Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Nikki Milne
- Physiotherapy Program, Bond Institute of Health and Sport, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Evelyne Rathbone
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
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15
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Moon HY, Kim MR, Hwang DS, Jang JB, Lee J, Shin JS, Ha I, Lee YJ. Safety of acupuncture during pregnancy: a retrospective cohort study in Korea. BJOG 2019; 127:79-86. [PMID: 31483927 DOI: 10.1111/1471-0528.15925] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The present study aimed to analyse the Korean National Health Insurance Service (NHIS) cohort data to examine the safety of acupuncture therapy during pregnancy. DESIGN Retrospective cohort. SETTING Korea. POPULATION OR SAMPLE Women with confirmed pregnancy between 2003 and 2012 from the 2002-13 NHIS sample cohort (n = 20 799). METHODS Women with confirmed pregnancy were identified and divided into acupuncture or control group for comparison of their outcomes. Differences in other factors such as age, and rate of high-risk pregnancy and multiple pregnancy were examined. In the acupuncture group, the most frequent acupuncture diagnosis codes and the timing of treatment were also investigated. MAIN OUTCOME MEASURES Incidence of full-term delivery, preterm delivery and stillbirth by pregnancy duration and among the high-risk and multiple pregnancy groups. RESULTS Of 20 799 pregnant women analysed, 1030 (4.95%) and 19 749 were in the acupuncture and control groups, respectively. Both overall (odds ratio [OR] 1.23; 95% CI 0.98-1.54), and in the stratified analysis of high-risk pregnancies (OR 1.09; 95% CI 0.73-1.64), there was no significant difference between acupuncture and control groups in preterm deliveries. No stillbirths occurred in the acupuncture group and 0.035% of pregnancies resulted in stillbirths in the control group. CONCLUSION No significant difference in delivery outcomes (preterm delivery and stillbirth) was observed between confirmed pregnancies in the acupuncture and control groups. Therefore, in pregnancy, acupuncture therapy may be a safe therapeutic modality for relieving discomfort without an adverse delivery outcome. TWEETABLE ABSTRACT In pregnancy, acupuncture therapy may be a safe therapeutic modality for relieving discomfort without an adverse outcome.
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Affiliation(s)
- H-Y Moon
- Jaseng Hospital of Korean Medicine, Seoul, Korea
| | - M-R Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Korea
| | - D-S Hwang
- College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - J-B Jang
- College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - J Lee
- Jaseng Hospital of Korean Medicine, Seoul, Korea
| | - J-S Shin
- Jaseng Hospital of Korean Medicine, Seoul, Korea
| | - I Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Korea
| | - Y J Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Korea
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Shaballout N, Neubert TA, Boudreau S, Beissner F. From Paper to Digital Applications of the Pain Drawing: Systematic Review of Methodological Milestones. JMIR Mhealth Uhealth 2019; 7:e14569. [PMID: 31489841 PMCID: PMC6753689 DOI: 10.2196/14569] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 06/17/2019] [Accepted: 06/27/2019] [Indexed: 12/21/2022] Open
Abstract
Background In a pain drawing (PD), the patient shades or marks painful areas on an illustration of the human body. This simple yet powerful tool captures essential aspects of the subjective pain experience, such as localization, intensity, and distribution of pain, and enables the extraction of meaningful information, such as pain area, widespreadness, and segmental pattern. Starting as a simple pen-on-paper tool, PDs are now sophisticated digital health applications paving the way for many new and exciting basic translational and clinical applications. Objective Grasping the full potential of digital PDs and laying the groundwork for future medical PD apps requires an understanding of the methodological developments that have shaped our current understanding of uses and design. This review presents methodological milestones in the development of both pen-on-paper and digital PDs, thereby offering insight into future possibilities created by the transition from paper to digital. Methods We conducted a systematic literature search covering PD acquisition, conception of PDs, PD analysis, and PD visualization. Results The literature search yielded 435 potentially relevant papers, from which 53 methodological milestones were identified. These milestones include, for example, the grid method to quantify pain area, the pain-frequency maps, and the use of artificial neural networks to facilitate diagnosis. Conclusions Digital technologies have had a significant influence on the evolution of PDs, whereas their versatility is leading to ever new applications in the field of medical apps and beyond. In this process, however, there is a clear need for better standardization and a re-evaluation of methodological and technical limitations that no longer apply today.
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Affiliation(s)
- Nour Shaballout
- Somatosensory and Autonomic Therapy Research, Institute for Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Till-Ansgar Neubert
- Somatosensory and Autonomic Therapy Research, Institute for Neuroradiology, Hannover Medical School, Hannover, Germany
| | - Shellie Boudreau
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Florian Beissner
- Somatosensory and Autonomic Therapy Research, Institute for Neuroradiology, Hannover Medical School, Hannover, Germany
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Shijagurumayum Acharya R, Tveter AT, Grotle M, Eberhard-Gran M, Stuge B. Prevalence and severity of low back- and pelvic girdle pain in pregnant Nepalese women. BMC Pregnancy Childbirth 2019; 19:247. [PMID: 31307421 PMCID: PMC6631866 DOI: 10.1186/s12884-019-2398-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 07/04/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Low back pain (LBP) and pelvic girdle pain (PGP) are commonly reported during pregnancy and are known to affect pregnant women's well-being. Still, these conditions are often considered to be a normal part of pregnancy. This study assesses the prevalence and severity of LBP and/or PGP among pregnant Nepalese women, as well as exploring factors associated with LBP and PGP. METHODS A cross-sectional study with successive recruitment of pregnant women was conducted at two district hospitals in Nepal from May 2016 to May 2017. The data was collected using self-reported questionnaires. Univariate and multivariate logistic regression were used to assess the associations between independent variables and LBP and/or PGP. RESULTS A total of 1284 pregnant women were included in the study. The reported prevalence of pregnancy-related LBP and/or PGP was 34%. Pain intensity was high with a mean score (standard deviation) of 6 (2). The median (25th-75th percentiles) disability scores according to the total Pelvic Girdle Questionnaire and Oswestry Disability Index were 20 (10-32) and 30 (21-38), respectively. Even though only 52% of the women believed that the pain would disappear after delivery, concern about LBP and/or PGP was reported to be low (median 2 (0-4) (Numeric Rating Scale 0-10)). In the final model for women with LBP and/or PGP the adjusted odds ratios were for body mass index (20-24, 25-30, > 30) 0.7 (95% confidence interval (CI), 0.44-1.21), 1.1 (95% CI, 0.66-1.83), and 1.5 (95% CI, 0.78-2.94) respectively, for pelvic organ prolapse symptoms 6.6 (95% CI, 4.93-8.95) and for women with educated husbands (primary or secondary, higher secondary or above) 1.1 (95% CI, 0.53-2.16) and 1.7 (95% CI, 0.84-3.47), respectively. CONCLUSIONS Pregnant Nepalese women commonly report LBP and/or PGP. The women experienced low disability despite severe pain intensity and poor beliefs in recovery after delivery.
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Affiliation(s)
- Ranjeeta Shijagurumayum Acharya
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Kathmandu University Dhulikhel Hospital, Kavre, Nepal
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Anne Therese Tveter
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Margreth Grotle
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- FORMI, Oslo University Hospital, Oslo, Norway
| | - Malin Eberhard-Gran
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
- Department for Infant Mental Health, Regional Center for Child and Adolescent Mental Health, Oslo, Eastern and Southern Norway Norway
| | - Britt Stuge
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
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Szkwara JM, Milne N, Hing W, Pope R. Effectiveness, Feasibility, and Acceptability of Dynamic Elastomeric Fabric Orthoses (DEFO) for Managing Pain, Functional Capacity, and Quality of Life during Prenatal and Postnatal Care: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2408. [PMID: 31284612 PMCID: PMC6651323 DOI: 10.3390/ijerph16132408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/03/2019] [Accepted: 07/04/2019] [Indexed: 12/11/2022]
Abstract
Conservative interventions for addressing prenatal and postnatal ailments have been described in the research literature. Research results indicated that maternity support belts assist with reducing pain and other symptoms in these phases; however, compliance in wearing maternity support belts is poor. To combat poor compliance, commercial manufacturers designed dynamic elastomeric fabric orthoses (DEFO)/compression garments that target prenatal and postnatal ailments. This systematic review aimed to identify, critically appraise, and synthesize key findings on the effectiveness, the feasibility, and the acceptability of using DEFO to manage ailments during pre-natal and postnatal phases of care. Electronic databases were systematically searched to identify relevant studies, resulting in 17 studies that met the eligibility criteria. There were variations in DEFO descriptors, including hosiery, support belts, abdominal binders and more, making it difficult to compare findings from the research articles regarding value of DEFO during prenatal and/or postnatal phases. A meta-synthesis of empirical research findings suggests wearing DEFOs during pregnancy has a significant desirable effect for managing pain and improving functional capacity. Further research is required to investigate the use of DEFOs for managing pain in the postnatal period and improving quality life during prenatal and postnatal care.
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Affiliation(s)
- Jaclyn M Szkwara
- Department of Physiotherapy/Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4229, Australia.
| | - Nikki Milne
- Department of Physiotherapy/Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4229, Australia
| | - Wayne Hing
- Department of Physiotherapy/Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4229, Australia
| | - Rodney Pope
- Department of Physiotherapy/Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4229, Australia
- School of Community Health, Charles Sturt University, Thurgoona, NSW 2640, Australia
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Saxena AK, Chilkoti GT, Singh A, Yadav G. Pregnancy-induced Low Back Pain in Indian Women: Prevalence, Risk Factors, and Correlation with Serum Calcium Levels. Anesth Essays Res 2019; 13:395-402. [PMID: 31198266 PMCID: PMC6545952 DOI: 10.4103/aer.aer_196_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Pregnancy-induced low back pain (LBP) is a common problem during the pregnancy which usually begins between the 20th and the 28th weeks of gestation, and the exact duration varies. Aims: The aim of this study is to determine the prevalence of LBP including pelvic girdle pain (PGP) and its various aspects such as nature, intensity, character, radiation, circadian pattern, and its correlation with serum calcium levels. Setting and Design: This was a cross-sectional survey conducted in a tertiary care hospital in the capital of Delhi. Materials and Methods: In this cross-sectional study, 200 pregnant women completed a questionnaire and also underwent clinical examinations if PGP is suspected. The clinical examination included various pain provocation tests including active straight leg raise test. Venous blood samples were drawn to evaluate the serum calcium levels in pregnant women complaining of back pain. Possible associating factors were studied by nonparametric tests and logistic regression analysis. Statistical Analysis: Bivariant correlation of serum calcium levels, total duration of pain, and Visual Analog Scale score was done with various factors such as parity, socioeconomic status, and nature of pain. Results: The point prevalence of LBP was found to be 80% with a significantly lower prevalence of PGP, i.e., 2%, when compared to the international figures. Majority of women graded their pain as dull aching type (47.5%) and moderate to severe in intensity. The circadian rhythm of back pain was observed in 56% of the patients, and out of that, insomnia was complained by 33% of the patients. Limitation of physical activity was observed in 62.5% of the patients. Conclusion: A negative correlation was observed between the serum calcium levels and parity; however, a positive correlation between the intensity of pain and parity was observed.
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Affiliation(s)
- Ashok Kumar Saxena
- Department of Anesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Geetanjali T Chilkoti
- Department of Anesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Anshul Singh
- Department of Anesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Gaurav Yadav
- Department of Anesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Starzec M, Truszczyńska-Baszak A, Stuge B, Tarnowski A, Rongies W. Cross-cultural Adaptation of the Pelvic Girdle Questionnaire for the Polish Population. J Manipulative Physiol Ther 2018; 41:698-703. [PMID: 30594333 DOI: 10.1016/j.jmpt.2018.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 04/03/2018] [Accepted: 04/05/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The purpose of this study was to translate and culturally adapt the Pelvic Girdle Questionnaire (PGQ) into Polish to allow pelvic girdle pain (PGP) assessment in Polish women. METHODS The translation process comprised 4 stages: forward translation, backward translation, committee review, and pretest. We then conducted a pilot study of the final version of the questionnaire in 49 women (mean age: 31.2 years, standard deviation: 3.74 years) who had PGP when pregnant or within a year postpartum. RESULTS The internal consistency of the newly created questionnaire assessed with Cronbach's α was 0.916. CONCLUSION The internal consistency of the process of translation and cross-cultural adaptation of the Polish version of the PGQ was satisfactory. The Polish version of the PGQ may be used both in clinical practice and for research among Polish women with PGP.
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Affiliation(s)
- Małgorzata Starzec
- Department of Rehabilitation, Physiotherapy Division, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.
| | | | - Britt Stuge
- Division of Orthopaedics, Oslo University Hospital, Oslo, Norway
| | | | - Witold Rongies
- Department of Rehabilitation, Physiotherapy Division, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
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Ceprnja D, Gupta A. Does muscle energy technique have an immediate benefit for women with pregnancy-related pelvic girdle pain? PHYSIOTHERAPY RESEARCH INTERNATIONAL 2018; 24:e1746. [PMID: 30209851 DOI: 10.1002/pri.1746] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/30/2018] [Accepted: 08/15/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Pregnancy-related pelvic girdle pain (PPGP) is a common and debilitating condition. Muscle energy techniques (METs) are used in the management of PPGP. This study aimed to determine the immediate effectiveness of a MET in the management of pain in women with PPGP within a single session of physiotherapy. METHODS This study was a randomized, crossover, sham-controlled trial. Women (N = 80), M (SD), 30 (5) years of age and 29 (5) weeks of gestation with PPGP were included in the study. All participants were treated with a MET and sham transcutaneous electrical nerve stimulation in a randomized order, followed by standard physiotherapy during a single physiotherapy session. The primary outcome measures were the self-report of pain using a visual analogue scale and function using the Timed Up and Go. The secondary outcome was the duration of single leg stance (SLS). Clinical measures were taken prior to the first intervention and immediately following each of the interventions, a total of four times. RESULTS There was no statistically significant difference between scores for the visual analogue scale, Timed Up and Go, or duration of SLS between participants following the use of a MET, sham transcutaneous electrical nerve stimulation, or standard care, which was recorded after each intervention (p ≥ 0.72). There was a consistent and statistically significant (p value, mean difference) improvement in pain (p < 0.001, 2.6), function (p < 0.001, 1.0 s), and left SLS (p < 0.001, 4.4 s) and right SLS (p < 0.001, 4.7 s) from baseline compared with each time of measurement thereafter. CONCLUSIONS The improvements measured may have been due to a placebo effect with the knowledge that care is being provided, mechanical unloading during the session, or familiarization with the test procedures. The mechanism(s) that led to improvements in pain and function remain unknown, however, does not preclude from women with PPGP being offered physiotherapy care.
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Affiliation(s)
- Dragana Ceprnja
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia.,Physiotherapy Department, Westmead Hospital, Sydney, New South Wales, Australia
| | - Amitabh Gupta
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia.,Physiotherapy Department, Westmead Hospital, Sydney, New South Wales, Australia
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Pekçetin S, Özdinç S, Ata H, Can HB, Elter K. Effect of telephone-supported ergonomic education on pregnancy-related low back pain. Women Health 2018; 59:294-304. [PMID: 29920177 DOI: 10.1080/03630242.2018.1478364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study investigated the effect of telephone-supported ergonomic education on pregnancy-related low back pain. This study was performed at Trakya University Hospital in Edirne, Turkey between December 15, 2016 and April 4, 2017. One hundred ten pregnant women were included in the study and randomly assigned to one of two groups. Sixty pregnant women received one face-to-face session of ergonomic education followed by three weekly sessions of telephone-supported ergonomic education (intervention group). Fifty pregnant women received only one session of standard face-to-face ergonomic education. Before and after the intervention, low back pain was evaluated using the Visual Analog Scale. Pain-related disability was evaluated with the Oswestry Disability Index, and health-related quality of life was evaluated with the SF-36. Telephone-supported ergonomic education was more effective than standard ergonomic education and can be used as an effective solution for pregnancy-related low back pain.
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Affiliation(s)
- Serkan Pekçetin
- a Health Sciences Occupational Therapy Department, Trakya University , Edirne , Turkey
| | - Sevgi Özdinç
- b Physical Therapy and Rehabilitation Department, Trakya University , Edirne , Turkey
| | - Hilal Ata
- b Physical Therapy and Rehabilitation Department, Trakya University , Edirne , Turkey
| | - Hilal Başak Can
- b Physical Therapy and Rehabilitation Department, Trakya University , Edirne , Turkey
| | - Koray Elter
- c Obstetrics and Gynecology Department, Trakya University , Edirne , Turkey
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Ceprnja D, Chipchase L, Liamputtong P, Gupta A. How do Australian women cope with pelvic girdle pain during pregnancy? A qualitative study protocol. BMJ Open 2018; 8:e022332. [PMID: 30012793 PMCID: PMC6057464 DOI: 10.1136/bmjopen-2018-022332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Pelvic girdle pain is commonly experienced during pregnancy and results in significant physical, psychosocial and work-related challenges. Few studies have investigated the lived experiences of pregnant women with pelvic girdle pain and their coping strategies. There is a need to develop a greater understanding of this prevalent condition among Australian women. Thus, this study seeks to gain information about the impact of pelvic girdle pain on daily life and how women cope with this condition during pregnancy. METHODS AND ANALYSIS A qualitative research design, situated within a phenomenological framework, is adopted. The participants will be invited to describe their lived experiences of pregnancy-related pelvic girdle pain, the impact on their daily life and the strategies they use to cope with the condition. A stratified purposive sample will be undertaken to ensure the sample provides information-rich cases representative of women with pregnancy-related pelvic girdle pain. Face-to-face, individual, semistructured interviews will be conducted with participants at Westmead Hospital, Sydney, Australia. A solicited diary will be offered to any participants who may find attending the interview difficult. All participants will also be invited to attend a focus group session. The different methods of data collection used in this study will allow for triangulation, thereby increasing the trustworthiness of findings. ETHICS AND DISSEMINATION Ethical approval has been granted by the Human Research Ethics Committees of Westmead Hospital, Sydney, and Western Sydney University, Sydney. Dissemination of results will be via journal articles and conference presentations.
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Affiliation(s)
- Dragana Ceprnja
- School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia
- Physiotherapy Department, Westmead Hospital, Sydney, New South Wales, Australia
| | - Lucinda Chipchase
- School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia
- University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Pranee Liamputtong
- School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia
| | - Amitabh Gupta
- School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia
- Physiotherapy Department, Westmead Hospital, Sydney, New South Wales, Australia
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Virgara R, Maher C, Van Kessel G. The comorbidity of low back pelvic pain and risk of depression and anxiety in pregnancy in primiparous women. BMC Pregnancy Childbirth 2018; 18:288. [PMID: 29973235 PMCID: PMC6032543 DOI: 10.1186/s12884-018-1929-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 06/28/2018] [Indexed: 11/10/2022] Open
Abstract
Background Approximately 50% of Australian women experience low back pain in pregnancy, with somewhere between 8 and 36% of women suffering from pregnancy related depression/anxiety. Both low back and pelvic pain and depression and anxiety are associated with poor maternal health outcomes, including increased sick leave, higher rates of functional disability, and increased access to healthcare. It also impacts upon time and mode of delivery with an increase in inductions and elective caesarean sections. For babies of women with depression and anxiety preterm birth, low birth weight and intrauterine growth restriction are all common complications. Given these poor health outcomes, it is important to determine the co-morbidity of low back and pelvic pain and depression/anxiety in pregnancy. Methods A cross sectional study of a hospital based sample of 96 nulliparous women were assessed at 28 weeks as part of their routine antenatal appointment. Data was collected via interview and clinical records and included the Edinburgh Depression Scale (EDS), the Numerical Rating Scale (NRS) and the Modified Oswestry Low Back Pain Disability Questionnaire (MODQ). Spearman’s correlation co-efficients, prevalence ratios and ANOVA were used to determine comorbidity. Results 96 women consented to participation in the study. All study outcomes were moderately correlated. There were three main findings: One, there was a positive correlation between low back and pelvic girdle pain (LBPP) and depression/anxiety was rho = 0.39, p < 0.001, between LBPP and functional disability was rho = 0.51, p < 0.001 and between risk of depression/anxiety and functional disability was rho = 0.54, p < 0.001. Two, a woman with LBPP was 13 times more likely to have increased risk of depression/anxiety, whilst a woman with increased risk of depression/anxiety was 2.2 times more likely to have LBPP and finally three, amongst women who reported LBPP, the level of disability experienced was significantly higher in women who had concurrent increased risk of depression/anxiety (p = 0.003). This occurred even though the severity of pain did not differ between groups (NRS score mean p = 0.38). Conclusions This study found a high level of co-occurrence of LBPP, functional disability and depression/anxiety in women in their third trimester of pregnancy. Importantly women who reported higher depression/anxiety symptoms appeared to experience higher levels of functional disability in relation to their LBPP, than women with lower depression/anxiety symptoms and LBPP.
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Affiliation(s)
- Rosa Virgara
- Lyell McEwin Hospital, Haydown Road, Elizabeth Vale, SA, 5112, Australia. .,Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, City East Campus, Playford Building Level 7 Room 02, PO Box 2471, Adelaide, SA, 5001, Australia.
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences & Sansom Institute for Health Research. School of Health Sciences, University of South Australia, City East Campus, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Gisela Van Kessel
- School of Health Sciences and Sansom Institute for Health Research University of South Australia, City East Campus GPO Box 2471, Adelaide, SA, 5001, Australia
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Filipec M, Jadanec M, Kostovic-Srzentic M, van der Vaart H, Matijevic R. Incidence, pain, and mobility assessment of pregnant women with sacroiliac dysfunction. Int J Gynaecol Obstet 2018; 142:283-287. [DOI: 10.1002/ijgo.12560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 04/26/2018] [Accepted: 06/05/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Manuela Filipec
- Department of Physical Medicine and Rehabilitation; Clinical Hospital “Sveti Duh”; Zagreb Croatia
| | - Marinela Jadanec
- Department of Physical Medicine and Rehabilitation; Clinical Hospital “Sveti Duh”; Zagreb Croatia
| | | | | | - Ratko Matijevic
- Department of Obstetrics and Gynecology; University of Zagreb; Zagreb Croatia
- School of Medicine; Merkur University Hospital; Zagreb Croatia
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Ceprnja D, Chipchase L, Gupta A. Prevalence of pregnancy-related pelvic girdle pain and associated factors in Australia: a cross-sectional study protocol. BMJ Open 2017; 7:e018334. [PMID: 29146651 PMCID: PMC5695351 DOI: 10.1136/bmjopen-2017-018334] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/03/2017] [Accepted: 10/04/2017] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Pregnancy-related pelvic girdle pain (PPGP) is a common musculoskeletal disorder. Women with PPGP report difficulty performing everyday functional activities, such as standing and walking. However, the magnitude of the problem remains unknown in Australia. It is important to determine how many women are affected by this condition and the factors associated with PPGP as this will direct healthcare services to being able to better manage women during pregnancy. Thus, this study aims to determine the prevalence of PPGP and associated factors in a Western Sydney population. METHODS AND ANALYSIS This study is a cross-sectional study to be conducted at a single hospital in Australia. Participants will be over 18 years of age, between 14 and 38 weeks gestation and recruited randomly from all pregnant women attending antenatal care. Participants will have anthropomorphic measures recorded, such as height and body weight, and be asked to complete questionnaires about their current pregnancy, sociodemographic information, ethnoculture, occupational factors and participation in functional activities. The classification of PPGP will be made as per the published guidelines and will include a physical examination. ETHICS AND DISSEMINATION Ethical approval has been granted by the Human Research Ethics Committees of Westmead Hospital, Sydney, and Western Sydney University, Sydney. Dissemination of results will be via journal articles and conference presentations. TRIAL REGISTRATION NUMBER ACTRN12617000904370.
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Affiliation(s)
- Dragana Ceprnja
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
- Department of Physiotherapy, Westmead Hospital, Sydney, New South Wales, Australia
| | - Lucinda Chipchase
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
| | - Amitabh Gupta
- School of Science and Health, Western Sydney University, Sydney, New South Wales, Australia
- Department of Physiotherapy, Westmead Hospital, Sydney, New South Wales, Australia
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Starzec M, Truszczyńska-Baszak A. Pregnancy-related lumbopelvic pain: classification and diagnostics according to European guidelines and a review of literature. REHABILITACJA MEDYCZNA 2017. [DOI: 10.5604/01.3001.0010.5005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Lumbopelvic pain associated with pregnancy may originate from the lumbar spine, the pelvic girdle or may be mixed. According to European guidelines, individual subtypes of pain require different procedures, for which a detailed differential diagnosis is necessary. These ailments arouse a lot of controversy.
The aim of the work was to present the current state of knowledge on the aforementioned ailments, including European guidelines and the latest trends in foreign literature.
The diagnosis of lumbopelvic pain, with particular emphasis on the pathophysiology and methods of differentiation of both pain syndromes, was discussed. Lumbar spine pain is mainly related to the mechanical load caused by a pregnant uterus. In the case of pelvic girdle pain, the main cause is the disorder of optimal stability, which depends on the correct mechanisms of force and form closure. Pelvic girdle pain is characterized by other clinical symptoms and risk factors, it also often remains after pregnancy, having negative impact on the daily functioning of a woman even years after giving birth. Depending on the location (one or both sacroiliac joints, pubic symphysis), several types of this pain syndrome are distinguished. The worst prognosis is pelvic pain associated with the involvement of all three joints at the same time. Until now, this term has not been more widely used in the Polish-language literature.
The complexity of chronic pain syndromes, in which the discomforts of the pregnancy period may develop, entails the necessity of early identifi cation and deliberate action. Knowledge of the etiopathogenesis of these ailments is a prerequisite for therapeutic success. Introduction of terminology popular in foreign literature will improve treatment of these diseases, adapting it to current standards and will also enable better exchange of experience between professionals.
pelvic girdle pain, lumbar pain, pregnancy
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Affiliation(s)
- Małgorzata Starzec
- Zakład Rehabilitacji, Oddział Fizjoterapii, II Wydział Lekarski, Warszawski Uniwersytet Medyczny / Department of Rehabilitation, Physiotherapy Division, Medical University of Warsaw, Poland
| | - Aleksandra Truszczyńska-Baszak
- Wydział Rehabilitacji, Akademia Wychowania Fizycznego Józefa Piłsudskiego w Warszawie / Jozef Pilsudski University of Physical Education, Faculty of Rehabilitation, Poland
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Close C, Sinclair M, Liddle D, Mc Cullough J, Hughes C. Women's experience of low back and/or pelvic pain (LBPP) during pregnancy. Midwifery 2016; 37:1-8. [DOI: 10.1016/j.midw.2016.03.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 02/12/2016] [Accepted: 03/25/2016] [Indexed: 10/22/2022]
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Bernard M, Tuchin P. Chiropractic Management of Pregnancy-Related Lumbopelvic Pain: A Case Study. J Chiropr Med 2016; 15:129-33. [PMID: 27330515 DOI: 10.1016/j.jcm.2016.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 01/28/2016] [Accepted: 02/03/2016] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The purpose of this case report is to describe chiropractic management of a patient with pregnancy-related lumbopelvic pain. CLINICAL FEATURES A pregnant 35-year-old woman experienced insidious moderate to severe pregnancy-related lumbopelvic pain and leg pain at 32 weeks' gestation. Pain limited her endurance capacity for walking and sitting. Clinical testing revealed a left sacroiliac joint functional disturbance and myofascial trigger points reproducing back and leg pain. INTERVENTION AND OUTCOME A diagnosis of pregnancy-related low back pain and pregnancy-related pelvic girdle pain was made. The patient was treated with chiropractic spinal manipulation, soft tissue therapy, exercises, and ergonomic advice in 13 visits over 6 weeks. She consulted her obstetrician for her weekly obstetric visits. At the end of treatment, her low back pain reduced from 7 to 2 on a 0-10 numeric pain scale rating. Functional activities reported such as walking, sitting, and traveling comfortably in a car had improved. CONCLUSION This patient with pregnancy-related lumbopelvic pain improved in pain and function after chiropractic treatment and usual obstetric management.
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Affiliation(s)
| | - Peter Tuchin
- Associate Professor, Department of Chiropractic Faculty Science, Macquarie University, Sydney, NSW, Australia
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Gorginzadeh M, Imani F, Safari S. Pregnancy-Related Pelvic Pain: A Neglected Field in Developing Countries. Anesth Pain Med 2016; 6:e35506. [PMID: 27110540 PMCID: PMC4834745 DOI: 10.5812/aapm.35506] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Revised: 01/02/2016] [Accepted: 01/13/2016] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mansoureh Gorginzadeh
- Department of Gynecology and Obstetrics, Tehran University of Medical sciences, Tehran, Iran
| | - Farnad Imani
- Pain Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeid Safari
- Pain Research Center, Iran University of Medical Sciences, Tehran, Iran
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Prevalence of musculoskeletal dysfunctions among Indian pregnant women. J Pregnancy 2015; 2015:437105. [PMID: 25642349 PMCID: PMC4302374 DOI: 10.1155/2015/437105] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 12/18/2014] [Accepted: 12/19/2014] [Indexed: 12/01/2022] Open
Abstract
Background and Objectives. Pregnancy triggers a wide range of changes in a woman's body leading to various musculoskeletal dysfunctions. Most commonly reported musculoskeletal discomforts by pregnant women are low back pain and symphysis pubis pain. The culture and the environmental factors may influence the discomforts experienced by a pregnant woman. There is a dearth of literature in India, regarding the common musculoskeletal dysfunctions experienced by a pregnant woman, and hence this study. Method. A questionnaire to identify the musculoskeletal dysfunction was developed; content was validated and was translated to local languages through parallel back translation. 261 primiparous pregnant women participated in the study and filled the questionnaire in their native language. Results. Among the musculoskeletal dysfunctions reported by the pregnant women, 64.6% reported calf muscle cramps, 37.1% reported foot pain, and 33.7% experienced low back pain in their third trimester. In the second trimester, common musculoskeletal dysfunctions experienced by the women were that of calf pain (47.8%), low back pain (42%), and pelvic girdle pain (37%). Conclusion. Musculoskeletal dysfunctions and general discomforts very commonly affect the activities of daily living of pregnant women. Understanding the common discomforts during various trimesters of pregnancy will help to develop a comprehensive program for prevention and cure.
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Engeset J, Stuge B, Fegran L. Pelvic girdle pain affects the whole life--a qualitative interview study in Norway on women's experiences with pelvic girdle pain after delivery. BMC Res Notes 2014; 7:686. [PMID: 25277975 PMCID: PMC4196110 DOI: 10.1186/1756-0500-7-686] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 09/29/2014] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The aim of this study was to explore how pelvic girdle pain after delivery influences women's daily life in Norway. Knowledge about living with post-partum pelvic girdle pain is lacking. METHOD A phenomenological-hermeneutical design with qualitative semi-structured interviews was used. A strategic selection procedure was chosen to recruit participants from physiotherapy clinics and a regional hospital in Norway. Five women with clinically verified pelvic girdle pain after delivery were included. Data were imported into NVivo9 and analysed in three steps: naïve reading, structural analysis and comprehensive understanding of the text. RESULTS Three themes influencing the women's daily life were identified: 1) activity and pain, 2) lack of acknowledgment of pain and disability, and 3) changed roles. A daily life with pain and limited physical activity was difficult to accept and made some of the women feel discouraged, isolated and lonely. Despite this, the women had a positive attitude to their problems, which may have positively increased their ability to cope. The findings also revealed the importance of a reciprocal influence between the woman and her environment, and that social support was crucial. CONCLUSIONS Pelvic girdle pain may influence women's lives for months and years after delivery. Health care professionals should appreciate and focus on the patient's knowledge and skills. Understanding the daily experiences of women with pelvic girdle pain might help improve rehabilitation strategies for these patients.
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Affiliation(s)
- Jorun Engeset
- Department of Physical Medicine and Rehabilitation, Sørlandet Hospital, Post Box 416, NO-4604 Kristiansand, Norway.
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Persson M, Winkvist A, Dahlgren L, Mogren I. "Struggling with daily life and enduring pain": a qualitative study of the experiences of pregnant women living with pelvic girdle pain. BMC Pregnancy Childbirth 2013; 13:111. [PMID: 23668823 PMCID: PMC3661342 DOI: 10.1186/1471-2393-13-111] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Accepted: 05/06/2013] [Indexed: 11/10/2022] Open
Abstract
Background Few studies have investigated the experiences of living with pelvic girdle pain (PGP) and its impact on pregnant women’s lives. To address this gap in knowledge, this study investigates the experiences of women living with PGP during pregnancy. Methods A purposive sample, of nine pregnant women with diagnosed PGP, were interviewed about their experiences. Interviews were recorded, transcribed to text and analysed using a Grounded Theory approach. Results The core category that evolved from the analysis of experiences of living with PGP in pregnancy was “struggling with daily life and enduring pain”. Three properties addressing the actions caused by PGP were identified: i) grasping the incomprehensible; ii) balancing support and dependence and iii) managing the losses. These experiences expressed by the informants constitute a basis for the consequences of PGP: iv) enduring pain; v) being a burden; vi) calculating the risks and the experiences of the informants as vii) abdicating as a mother. Finally, the informants’ experiences of the consequences regarding the current pregnancy and any potential future pregnancies is presented in viii) paying the price and reconsidering the future. A conceptual model of the actions and consequences experienced by the pregnant informants living with PGP is presented. Conclusions PGP during pregnancy greatly affects the informant’s experiences of her pregnancy, her roles in relationships, and her social context. For informants with young children, PGP negatively affects the role of being a mother, a situation that further strains the experience. As the constant pain disturbs most aspects of the lives of the informants, improvements in the treatment of PGP is of importance as to increase the quality of life. This pregnancy-related condition is prevalent and must be considered a major public health concern during pregnancy.
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Affiliation(s)
- Margareta Persson
- Dalarna University, School of Health and Social studies, Falun, SE-791 88, Sweden.
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Verstraete EH, Vanderstraeten G, Parewijck W. Pelvic Girdle Pain during or after Pregnancy: a review of recent evidence and a clinical care path proposal. Facts Views Vis Obgyn 2013; 5:33-43. [PMID: 24753927 PMCID: PMC3987347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PROBLEM STATEMENT Pelvic girdle pain (PGP) is a common condition during or after pregnancy with pain and disability as most important symptoms. These symptoms have a wide range of clinical presentation. Most doctors perceive pregnancy related pelvic girdle pain (PPGP) as 'physiologic' or 'expected during pregnancy', where no treatment is needed. As such women with PPGP mostly experience little recognition. However, many scientific literature describes PPGP as being severe with considerable levels of pain and disability and socio-economic consequences in about 20% of the cases. OBJECTIVES We aimed to (1) inform the gynecologist/obstetrician about the etiology, diagnosis, risk factors, and treatment options of PPGP and (2) to make a proposition for an adequate clinical care path. METHODS A systematic search of electronic databases and a check of reference lists for recent researches about the diagnosis, etiology, risk factors and treatment of PPGP. RESULTS Adequate treatment is based on classification in subgroups according to the different etiologic factors. The various diagnostic tests can help to make a differentiation in the several pelvic girdle pain syndromes and possibly reveal the underlying biomechanical problem. This classification can guide appropriate multidimensional and multidisciplinary management. A proposal for a clinical care path starts with recognition of gynecologist and midwife for this disorder. Both care takers can make a preliminary diagnosis of PPGP and should refer to a physiatrist, who can make a definite diagnosis. Together with a physiotherapist, the latter can determine an individual tailored exercise program based on the influencing bio-psycho-social factors.
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Affiliation(s)
- E H Verstraete
- Department of Internal Medicine, Ghent University Hospital and Faculty of Medicine and Health Science, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
| | - G Vanderstraeten
- Department of Physical and Rehabilitation Medicine, Ghent University Hospital and Faculty of Medicine and Health Science, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
| | - W Parewijck
- Department of Uro-Gynecology, Ghent University Hospital and Faculty of Medicine and Health Science, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
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Life's pregnant pause of pain: pregnant women's experiences of pelvic girdle pain related to daily life: a Swedish interview study. SEXUAL & REPRODUCTIVE HEALTHCARE 2012; 4:29-34. [PMID: 23427930 DOI: 10.1016/j.srhc.2012.11.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 11/07/2012] [Accepted: 11/08/2012] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Pelvic girdle pain (PGP) is a universally disabling condition affecting three of 10 pregnant women. Qualitative studies on the subject are lacking. OBJECTIVE To describe pregnant women's experiences of PGP as related to daily life. METHODS In all, 27 women with PGP participating in a randomised controlled study were interviewed during 2010-2011. Qualitative content analysis was used. RESULTS Five main categories emerged: PGP affects the ability to cope with everyday life; Coping with motherhood; Relationships between partners often reached the breaking point; Questioning one's identity as defined by profession and work, and Lessons learned from living with PGP. The categories illustrate how women's everyday lives were interrupted. Their inability to meet their own and others' expectations put a strain on their lives causing disappointment, sadness and frustration. It made them question and doubt their roles and identities as mothers, partners and professionals, and kept them from looking forward to future pregnancies, in the absence of effective treatment for PGP. Knowledge gained was that women with PGP should seek help immediately, listen to their bodies, and acknowledge their limitations. CONCLUSION PGP severely affects pregnant women's everyday lives. There appears to be a lack of knowledge and awareness in general, as well as among caregivers and employers of PGP that needs to be highlighted and rectified. There is also a great need to learn how to support those suffering from it. Appropriate support during this important and rare phase in a woman's life is highly warranted.
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