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BACKGROUND: Pregnancy-related low back pain (LBP) and pelvic girdle pain (PGP) significantly affect the quality of life of pregnant women. Understanding their severity and risk factors may help prevent and alleviate such pain and their resulting dysfunction. OBJECTIVE: This study investigated the prevalence, severity, and biopsychosocial risk factors of pregnancy-related LBP and PGP in Zhengzhou, China. METHODS: The Numeric Pain Rating Scale (NPRS), Chinese version of the Roland-Morris Disability Questionnaire (RMDQ), and other questionnaires were self-administered by 1020 pregnant women undergoing treatment at a tertiary hospital between July and December 2019. Binary logistic regression was used to identify factors associated with pregnancy-related LBP and/or PGP. RESULTS: The prevalence of LBP and/or PGP during pregnancy was 63.0%, and most participants (80.4%) had both. The mean NPRS and RMDQ disability scores were 2.44 ± 2.10 and 6.66 ± 4.65, respectively. A higher gestational body mass index, LBP and/or PGP during menstruation, history of pregnancy-related LBP and/or PGP, and constant pressure were significantly associated with pregnancy-related LBP and/or PGP. Subjective support was a protective factor against LBP and/or PGP. CONCLUSION: The prevalence of LBP and/or PGP was high. The risk factors should be included in routine prenatal care to identify patients at risk of LBP and/or PGP. [ABSTRACT FROM AUTHOR]

Pregnancy is an exciting, unique, and usually one of the happiest moments in a woman's life. It highlights the woman's amazing creative and nurturing powers while providing a bridge to the future. It is a state of having implanted products of conception located in the uterus. Database search was conducted, using the MeSH terms "Pelvic girdle pain," "prevalence," "trimester," and "pregnancy" for relevant peer-reviewed articles. Google Scholar, Science Direct (Elsevier), Scopus, CINAHL, Cochrane Library (Wiley), Healthcare Journals, Medline/PubMed, and Google were the areas of the database search. Out of 817 articles, ineligible studies were excluded after initial manual title and abstract screening. Only 55 studies which were full articles were retrieved. Of them, 19 fulfilled the inclusion criteria and were included in the review. The prevalence rates varied from 4% to 76% globally based on the country and ethnicity. The causes and concerns leading to pelvic girdle pain (PGP) were described. The complications pertaining to PGP in pregnancy were stated. When compared globally we could retrieve only one Indian study which directs our attention toward need for documentation and publishing of Indian findings. PGP in pregnancy is found to be a universal and disabling issue that needs to be addressed. [ABSTRACT FROM AUTHOR]

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Abstract Background Pelvic girdle pain (PGP) is a type of pregnancy-related lumbopelvic pain. This study aimed to examine the prevalence, severity, and factors associated with postpartum PGP in a selected group of postpartum women in Poland. Methods This was a prospective, observational study. In phase 1, 411 women were recruited 24–72 h postpartum. The prevalence of PGP was assessed by a physiotherapist using a series of dedicated tests. Pelvic floor muscle function and presence of diastasis recti were assessed via palpation examination. Age, education, parity, mode of delivery, infant body mass, body mass gain during pregnancy, the use of anesthesia during delivery and were recorded. In a phase 2, 6 weeks postpartum, the prevalence of PGP and its severity were assessed via a self-report. Results In phase 1 (shortly postpartum), PGP was diagnosed in 9% (n = 37) of women. In phase 2 (6 weeks postpartum), PGP was reported by 15.70% of women (n = 42). The univariable analyses showed a higher likelihood of PGP shortly postpartum in women who declared PGP during pregnancy (OR 14.67, 95% CI 4.43–48.61) and among women with abdominal midline doming (OR 2.05, 95% CI 1.04–4.06). The multivariable regression analysis showed significant associations in women with increased age (OR 1.12, 95% CI 1.01–1.21) and declaring PGP during pregnancy (OR 14.83, 95% CI 4.34–48.72). Conclusion Although the prevalence of postpartum PGP among women in Poland is lower than reported in other countries, it is experienced by almost every tenth women shortly postpartum and every sixth can report similar symptoms 6 weeks later. Age, PGP during pregnancy and abdominal midline doming were associated with experiencing PGP shortly postpartum.

Introduction: The aim was to investigate whether common pregnancy‐related symptoms—nausea, vomiting, back pain, pelvic girdle pain, pelvic cavity pain, vaginal bleeding, itching of vulva, pregnancy itching, leg cramps, uterine contractions and varicose veins—in the first trimester of pregnancy add to the identification of women at high risk of future pregnancy and birth complications. Material and methods: Survey data linked to national register data. All women booking an appointment for a first prenatal visit in one of 192 randomly selected General Practices in East Denmark in the period April 2015–August 2016. The General Practices included 1491 women to this prospective study. Two outcomes, pregnancy complications and birth complications, were collected from the Danish Medical Birth Register. Results: Among the 1413 included women, 199 (14%) experienced complications in later pregnancy. The most serious complication, miscarriage, was experienced by 65 women (4.6%). Other common pregnancy complications were gestational diabetes mellitus (n = 11, 0.8%), gestational hypertension without proteinuria (n = 34, 2.4%), mild to moderate preeclampsia (n = 34, 2.4%) and gestational itching with effect on liver (n = 17, 1.2%). Women who experienced pelvic girdle pain, pelvic cavity pain or vaginal bleeding in the first trimester of pregnancy had a higher risk of pregnancy complications later on in later pregnancy. None of the other examined symptoms showed associations to pregnancy complications. No associations were found between pregnancy‐related physical symptoms in first trimester and birth complications. Conclusions: Symptoms in early pregnancy do not add much information about the risk of pregnancy or birth complications, although pain and bleeding may give reason for some concern. This is an important message to women experiencing these common symptoms and to their caregivers. [ABSTRACT FROM AUTHOR]

Women with generalized joint hypermobility may be at increased risk of pregnancy-related pelvic girdle pain, but evidence is inconclusive. In this prospective cohort study of 283 pregnant women in Norway, we aimed to study the association of generalized joint mobility with pelvic girdle pain, and to evaluate if pre-pregnancy body mass index was a modifier of the association. Generalized joint hypermobility was defined as a score of ≥5/9 positive tests on the Beighton score measured in early pregnancy. Primary outcome was evening pain intensity in gestation week 30, measured by a 100 mm visual analogue scale. We applied linear regression analyses to estimate age-adjusted unstandardized beta coefficients. Evening pain intensity was similar among women with Beighton score ≥ 5/9 and women with Beighton score < 5/9 (age-adjusted mean difference 2.8 mm; 95% CI: −9.2 to 14.9 mm). Women with Beighton score ≥ 5/9 and pre-pregnancy body mass index ≥ 25 kg/m2, reported higher evening pain than women with Beighton score < 5/9 and pre-pregnancy body mass index <25 kg/m2 (age-adjusted mean difference 28.7 mm; 95% CI: 14.3–43.1 mm). Overall, evening pain intensity was similar among pregnant women with and without generalized joint hypermobility. However, women with a combination of generalized joint hypermobility and body mass index ≥25 kg/m2 reported higher evening pain compared to women with normal joint mobility and body mass index <25 kg/m2, suggesting that body mass index may modify the association. The estimates could be imprecise due to the small study sample, and our findings should be interpreted with caution. [ABSTRACT FROM AUTHOR]

Background: Pelvic girdle pain (PGP) is one of the most common pelvic pains during pregnancy. PGP often occurs in pregnant women with an incidence of around 25?. Several methods have been developed to relax muscles or ligaments that can alleviate pelvic pain. Purpose: This study aimed to determine the effectiveness of exercise for pain relief in yoga in reducing pelvic girdle pain during the third trimester of pregnancy. Methods: This was a non-randomized controlled experimental study of 50 pregnant women in the third trimester with pelvic pain. The study was conducted in an antenatal clinic that provides prenatal yoga class. The treatment group (25 pregnant women) was given prenatal yoga for 2 weeks and the control group was provided with regular prenatal care. The level of pain was measured using a visual analog scale (VAS) with score from 0 to 10 before and after 2 week-prenatal yoga was given. Results: The level of pelvic pain was lower in the treatment group that was given prenatal yoga for pain relief. The mean value of pelvic pain before intervention was 4.36 and after intervention was 2.08. The two groups had different scores for pelvic pain (p value =0.000 and mean difference -2.28). There was a significant effect of prenatal yoga for pelvic pain relief on the intervention group. The mean difference was -2.130 (95%CIs=-2.583, -1.657), p value was 0.000. Conclusion: Exercise for pain relief in yoga was effective in reducing pelvic girdle pain during the third trimester of pregnancy. Pregnant women with pelvic girdle pain may practice a combination of regular pregnancy exercise and prenatal yoga to lessen the pain.

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 .

• Group-based trajectory modelling provided five distinct trajectory classes of pelvic girdle pain. • A high increase in body weight during pregnancy was associated with pelvic girdle pain. • Physical activity in pregnancy was not associated with pain trajectories classes. The aims of this study were first, to explore pain trajectories of pelvic girdle pain, and second, to explore if weight gain during pregnancy and/or physical activity before and during pregnancy were associated with the severity of pelvic girdle pain. The study included data from a retrospective cohort study in 2009, with data collection performed via questionnaires. Group-based trajectory modelling was performed on the reported intensity of pelvic girdle pain in each pregnancy month, and associations between the latent classes and physical activity and/or weight gain were assessed. A total of 569 women were included in the analyses. Five distinct trajectory classes for the course of pelvic girdle pain were identified. A higher body mass index (BMI) increase during pregnancy was negatively associated with the probability of being pain free, with –3.2 percentage points per unit increase in BMI (95 % CI −5.3 to −1.1; p = 0.003), and positively associated with the probability of experiencing early onset moderate to severe pain, +1.1 percentage points per unit increase in BMI (95 % CI 0.2 to 2.1; p = 0.022). Weight gain below recommendations was negatively associated with early onset moderate to severe pain; –10.6 percentage points per unit increase in BMI (95 % CI −18.8 to -2.4; p = 0.011). Physical activity in pregnancy was not significantly associated with pain trajectory classes when adjusting for pre-pregnancy variables. Our findings suggest that pelvic girdle pain intensity during pregnancy can take multiple courses and is associated with weight gain during pregnancy. [ABSTRACT FROM AUTHOR]

Caroline Feldthusen,1,2 Monika Fagevik Olsen,1,2 Hasse Ejnell,3 Helen Elden4,5 1Region Västra Götaland, Department of Physical Therapy, Sahlgrenska University Hospital, Gothenburg, Sweden; 2Institute of Neuroscience and Physiology/Physiotherapy, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 3Region Västra Götaland, Department of Rhinolaryngology, Head and Neck, Sahlgrenska University Hospital, Gothenburg, Sweden; 4Region Västra Götaland, Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital, Gothenburg, Sweden; 5Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenCorrespondence: Helen Elden Diagnosvägen 15, Gothenburg, 416 85, SwedenTel +46-702887882Email helen.elden@vgregion.seObjective: To evaluate the efficacy of a memory-foam mattress and pillow plus standard treatment for nightly pelvic girdle pain (PGP) during pregnancy.Method: In this randomised controlled study conducted at a tertiary-care hospital, 66 pregnant women who had nightly PGP were enrolled to receive standard treatment with the mattress and pillow (intervention group, n = 34) or solely standard treatment (control group, n = 32). The primary outcome was change in nightly posterior PGP on a visual analogue scale, VAS from baseline to 4 weeks. Secondary outcomes include nightly anterior PGP, the evening PGP score, estimated sleep duration, number of nightly wake-ups, daytime sleepiness (Epworth sleepiness scale), function (Pelvic Girdle Questionnaire), health-related quality of life, and pain catastrophizing.Results: Forty-four women (67%) completed the treatment. The difference in nightly posterior pain intensity was significantly different in favour of the intervention group (VAS, 16.5 mm (95% CI 1.4:31.6) p = 0.028). Sleep duration increased within both groups (intervention group: 26 min, p = 0.022; control group: 14 min, p = 0.014) and the difference between groups was significant (p = 0.046). In addition, the intervention group indicated a decreased evening PGP intensity (p = 0.008) and fewer nightly wake-ups (p = 0.049). The control group showed a deterioration in function (Pelvic Girdle Questionnaire) (p = 0.018) and an increase in daytime sleepiness (Epworth sleepiness scale) (p = 0.021) from baseline to 4 weeks.Conclusion: In conclusion, significantly lower nightly posterior PGP intensity was noted after the use of a mattress and pillow as an adjunct to standard treatment. Nightly PGP can have adverse effects on various aspects of the health and quality of life of pregnant women, and although the results of this study should be interpreted with caution considering the high drop-out rate and the inadequate statistical power, the findings indicate the potential for the use of such interventions to improve PGP in pregnant women.Keywords: nightly pain, pregnancy, pelvic girdle pain, randomised controlled trial, sleep disturbance

Abstract Background Postpartum septic symphysitis (PPSS) is defined as acute onset of severe pain around the symphysis, restricted movement, fever, and elevated inflammatory parameters. It is a rare but serious condition requiring urgent diagnosis and treatment. The aim of this study was to describe the incidence, symptoms, diagnosis, treatment, and long-term follow-up of PPSS. Methods This follow-up study included 19 out of 21 women diagnosed with PPSS from 1989 to 2017 at one tertiary care hospital in Sweden. Clinical data were retrieved from hospital records and compared to those retrieved from a regional registry. Women completed a postal questionnaire, and those who reported lumbopelvic pain (LPP) were offered a clinical examination. Results 1) PPSS was diagnosed after a normal postpartum period of 24 to 50 h by blood tests (n = 19/19), ultrasonography (n = 9 /19), computer tomography (n = 8/19) or magnetic resonance imaging (n = 16/19) Treatment included aspiration of symphyseal abscesses, i.v. antibiotics and different physiotherapeutic interventions. Women with PPSS more frequently were primiparous (n = 14/19, p = 0.001), had an instrumental delivery (n = 14/19, p = 0.003), longer time of active labour (p = 0.01) and second stage of labour (p = 0.001) than women in the regional registry. 2) Ten out of 19 (52%) women reported LPP at follow-up. These women more often suffered impaired function related to LPP (Pelvic Girdle Questionnaire, 27 versus 0, p

Background: Pelvic girdle pain (PGP) is a type of pregnancy-related lumbopelvic pain. This study aimed to examine the prevalence, severity, and factors associated with postpartum PGP in a selected group of postpartum women in Poland.Methods: This was a prospective, observational study. In phase 1, 411 women were recruited 24-72 h postpartum. The prevalence of PGP was assessed by a physiotherapist using a series of dedicated tests. Pelvic floor muscle function and presence of diastasis recti were assessed via palpation examination. Age, education, parity, mode of delivery, infant body mass, body mass gain during pregnancy, the use of anesthesia during delivery and were recorded. In a phase 2, 6 weeks postpartum, the prevalence of PGP and its severity were assessed via a self-report.Results: In phase 1 (shortly postpartum), PGP was diagnosed in 9% (n = 37) of women. In phase 2 (6 weeks postpartum), PGP was reported by 15.70% of women (n = 42). The univariable analyses showed a higher likelihood of PGP shortly postpartum in women who declared PGP during pregnancy (OR 14.67, 95% CI 4.43-48.61) and among women with abdominal midline doming (OR 2.05, 95% CI 1.04-4.06). The multivariable regression analysis showed significant associations in women with increased age (OR 1.12, 95% CI 1.01-1.21) and declaring PGP during pregnancy (OR 14.83, 95% CI 4.34-48.72).Conclusion: Although the prevalence of postpartum PGP among women in Poland is lower than reported in other countries, it is experienced by almost every tenth women shortly postpartum and every sixth can report similar symptoms 6 weeks later. Age, PGP during pregnancy and abdominal midline doming were associated with experiencing PGP shortly postpartum. [ABSTRACT FROM AUTHOR]

Women's postpartum health is a public health issue that has lifelong consequences. Timely recognition and treatment of physical and mental health issues can have positive health consequences while lack of access to effective treatments or health care services can lead to long-term health problems. To advance knowledge of priority health symptoms and trajectories of postpartum recovery from women's health perspectives, we share findings from the Maternal health And Maternal Morbidity in Ireland (MAMMI) study. Data from 3047 first-time mothers recruited to a longitudinal maternal health study in Ireland from 2012 to 2017 reveal the trajectories of maternal health and health problems experienced up to 12 months postpartum. Morbidities explored include urinary incontinence, pelvic girdle pain, and sexual and mental health issues. Viewed together, and over time, the scale and persistent nature of many physical and mental health problems become apparent, yet considerable proportions of women were not asked directly about health problems by health care professionals. When women do not know what is and is not normal postpartum, they may suffer in silence and the consequence is that health problems/issues that are preventable, and treatable, are likely to become chronic. To make positive contributions to women's health, maternity care systems must be truly woman-centered and structured in ways that place emphasis on women's own health needs. In systems where women's voices and concerns are acknowledged and central, women are likely to thrive and flourish in motherhood. [ABSTRACT FROM AUTHOR]

The purpose of this project was to develop a best-practices document on chiropractic care for pregnant and postpartum patients with low back pain (LBP), pelvic girdle pain (PGP), or a combination. A modified Delphi consensus process was conducted. A multidisciplinary steering committee of 11 health care professionals developed 71 seed statements based on their clinical experience and relevant literature. A total of 78 panelists from 7 countries were asked to rate the recommendations (70 chiropractors and representatives from 4 other health professions). Consensus was reached when at least 80% of the panelists deemed the statement to be appropriate along with a median response of at least 7 on a 9-point scale. Consensus was reached on 71 statements after 3 rounds of distribution. Statements included informed consent and risks, multidisciplinary care, key components regarding LBP during pregnancy, PGP during pregnancy and combined pain during pregnancy, as well as key components regarding postpartum LBP, PGP, and combined pain. Examination, diagnostic imaging, interventions, and lifestyle factors statements are included. An expert panel convened to develop the first best-practice consensus document on chiropractic care for pregnant and postpartum patients with LBP or PGP. The document consists of 71 statements on chiropractic care for pregnant and postpartum patients with LBP and PGP. [ABSTRACT FROM AUTHOR]

Pelvic girdle pain (PGP) is an important postpartum musculoskeletal problem in women and negatively affects pain, quality of life, perceived occupational performance, and satisfaction. In this report, we present the effectiveness of a client-centered intervention consisting of 45-min sessions, 4 days a week for 4 weeks, on pain, quality of life, perceived occupational performance, and satisfaction level in a patient with PGP. We determined that the client-centered intervention positively affected the perceived activity performance and satisfaction level in her daily life. In conclusion, client-centered intervention in women with PGP may be an important solution in ensuring compliance with activities of daily living, reducing pain, and increasing functional levels. [ABSTRACT FROM AUTHOR]

The primary objective of this study was to examine the effect of gestational diabetes mellitus (GDM) on pelvic girdle pain (PGP) occurrence and symptom severity. Pregnant women who were with/without GDM, 20–40 years of age, and also in the second and third trimesters of pregnancy were included in the study. PGP provocation tests were administered to 187 pregnant women to determine the presence and severity of PGP. Based on the test results, the study subjects were divided into two groups; Group 1 (GDM+, PGP+; n:32) and Group 2 (GDM−, PGP+; n:35). Both groups were asked to fill in the Pelvic Girdle Questionnaire (PGQ). The relationship between the presence of GDM and the presence of PGP was found to be significant (p =.043). It was found the groups were similar in view of pain, and also in PGQ total/subscale scores (p >.05). Although GDM has no effect on symptom severity, it has been determined that it may relate to the development of PGP. Therefore, early interventions (nutrition, exercise, belt using, etc.) are recommended to prevent the development of PGP in pregnant women with a family history of diabetes, with a previous diagnosis of diabetes and/or with GDM detected in their previous pregnancies. Clinical Trial Number: 04769375 What is already known on this subject? Gestational diabetes mellitus and pelvic girdle pain are pathologies that develops secondary to pregnancy-related systemic and biomechanical changes. What do results on this study add? GDM may related the development of PGP. What are the implications of these findings for clinical practice and/or further research? Early interventions (nutrition, exercise, belt using, etc.) and strict control of pregnant women in view of PGP is recommended to prevent the development of PGP in pregnant women with a family history of diabetes, with previous diagnosis of diabetes and/or with GDM detected in their previous pregnancies. The evaluation of pregnant women for PGP before administering interventions, such as exercise and diet (both decrease the pro-inflammatory markers), following the diagnosis of GDM and the measurement of plasma anti- and pro-inflammatory marker values in the same time period will further reveal the relationship between GDM and PGP. [ABSTRACT FROM AUTHOR]

Objectives: Investigate effects of integrated training for pelvic floor muscles (PFM) with and without transabdominal ultrasonography (TAUS) imaging-guided biofeedback in postpartum women with pregnancy-related pelvic girdle pain (PPGP)., Design: Three-arm, single-blinded randomized controlled trial SETTING: University laboratory PARTICIPANTS: Fifty-three postpartum women with PPGP randomized into stabilization exercise with TAUS-guided biofeedback (BIO+EXE), exercise (EXE), and control (CON) groups., Interventions: The BIO+EXE and EXE groups underwent an 8-week exercise program, with the BIO+EXE group receiving additional TAUS-guided biofeedback for PFM training during the first 4 weeks. The CON group only received a pelvic educational session., Main Outcome Measures: Primary outcomes included self-reported pain (numeric rating scale) and disability (pelvic girdle questionnaire). Secondary outcomes included functional tests (active straight leg raising [ASLR] fatigue, timed up-and-go, and 6-meter walking tests) and muscle contractibility indicated by muscle thickness changes for abdominal muscles and bladder base displacement for PFM (ultrasonographic measures)., Results: The BIO+EXE group had lower pain [1.8 (1.5) vs. 4.4 (1.5), mean difference -2.6, 95% confidence interval (CI) -3.9 to -1.2] and disability [14% (10) vs. 28% (21), mean difference -14, 95% CI -25 to -2] and faster walking speed [3.1 seconds (1) vs. 3.3 seconds (1), mean difference -0.2, 95% CI -1.0 to -0.2] than the CON group. The EXE group only had lower pain intensity compared to the CON group [2.7 (2.0) vs. 4.4 (1.5), mean difference -1.7, 95% CI -3.1 to -0.4]. No significant differences were observed among groups in timed up-and-go, ASLR fatigue, or muscle contractibility., Conclusions: Integrated training for PFM and stabilization with TAUS-guided biofeedback seems to be beneficial for reducing pain and disability in postpartum women with PPGP. CONTRIBUTION OF THE PAPER., (Copyright © 2024 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.)

BACKGROUND: Pelvic girdle pain represents a group of musculoskeletal pain disorders associated with the sacroiliac joint and/or the surrounding musculoskeletal and ligamentous structures. Its physical management is still a serious challenge as it has been considered the primary cause of low back pain. OBJECTIVE: This review sought to determine the effectiveness of motor control exercises for two clinically relevant measures; i.e., pain and disability, on patients with pelvic girdle pain of sacroiliac joint origin. METHODS: This review covered only randomized controlled studies. Online databases, such as PubMed, Embase, Scopus, and Cochrane Library, were searched from January 1, 1990, to December 31, 2019. PEDro scale was used to assess the methodological quality of included studies, while Review Manager was employed to synthesize data in view of meta-analysis. The PRISMA guidelines were applied for this review. RESULTS: Twelve randomized controlled trials of moderate-to-high quality were included in this review. The studies involved 1407 patients with a mean age ranging from 25.5 to 42.1 years as well as intervention and follow-up durations from 1 week to 2 years. Motor control exercises alone for pelvic girdle pain of sacroiliac joint origin were not effective in terms of pain reduction (SMD = 0.29 [ - 0.64,1.22]) compared to control interventions whereas they were slightly effective in terms of disability reduction (SMD = - 0.07 [ - 0.67, 0.53]) at short-term. The combination of motor control exercises with other musculoskeletal therapies, however, revealed to be more effective than control interventions in terms of pain reduction (SMD = - 1.78 [ - 2.49, - 1.07]; 95%CI) and lessened disability (SMD = - 1.80 [ - 3.03, - 0.56]; 95%CI) at short-term. CONCLUSION: Motor control exercises alone were not found to be effective in reducing pain at short-term. However, their combination with other musculoskeletal therapies revealed a significant and clinically-relevant decrease in pain and disability at short-term, especially in peripartum period. [ABSTRACT FROM AUTHOR]

The scope of this study is women's descriptions of symptoms experienced through persistent pregnancy-related lumbopelvic pain (PPLP) as well as their strategies to cope with the condition. This is a mixed-method study based on questionnaire responses and inductive interviews with 12 Swedish women with self-reported PLP during pregnancy 2002 partaking in a 12-year postpartum follow-up questionnaire cohort. Test of statistical differences between the interview cohort and the total cohort was performed and the interviews were analysed through inductive qualitative content analysis. The questionnaire data showed that the interview sample reported significantly more pain than the questionnaire respondents but resembled the questionnaire respondents on most other characteristics. The theme "Balancing avoidance and activity" and its sub-themes illustrate the strategies the participants used to manage their situation on a daily basis. The pain was a constant reminder that led to evaluation of pros and cons for physical, social, and mental activities as well as the search for therapies and treatments. For the women who participated in the interviews, living with persistent pregnancy-related lumbopelvic pain caused limitations and negatively affected various and major parts of life to a far greater extent than previously known. Persisting pregnancy-related lumbopelvic pain affects various and major parts of life, including working, physical and social activities, and psychological well-being. Rehabilitation should focus on individualized physical activities and effective coping strategies. Effort should be put into helping the patient find fulfilling explanatory reasons for the persisting pregnancy-related lumbopelvic pain. [ABSTRACT FROM AUTHOR]

Abstract Background The Pelvic Girdle Questionnaire (PGQ) is the only specific instrument designed to evaluate pain and activity limitations in pregnant or postpartum women with pelvic girdle pain (PGP). This study aimed to translate and culturally adapt the PGQ for Chinese patients and to verify the validation of the psychometric items of the PGQ in the Chinese population. Methods First, the translation and cultural adaptation process of the PGQ was conducted on the basis of international guidelines. Eighteen women suffering from PGP (11 pregnant women and 7 postpartum women) were enrolled in the pilot tests. Second, a total of 130 pregnant and postpartum women with PGP were enrolled to evaluate the validation of the psychometric items of the Chinese version. Results The calculated Cronbach’s alphas demonstrated a high level of internal consistency for the Chinese version of the PGQ, ranging from 0.77 to 0.93. The convergent validity showed a high positive correlation between the PGQ total score and the Oswestry Disability Index (0.84) and Numeric Rating Scale (0.73) for pain intensity. Furthermore, a good discriminatory ability was found for the Chinese version of the PGQ for distinguishing women who needed treatment from those not (area under the curve [AUC] = 0.843, p

Introduction: Physical Activity (PA) is an important component of a healthy pregnancy, for both the mother and her child. Sedentary lifestyle during pregnancy may increase development of pregnancy related musculoskeletal discomforts. Studies showed that 25% of women experience severe Pelvic Girdle Pain (PGP) during pregnancy and 8% are severely disabled due to PGP. Aim: To analyse the association between the PA and PGP during pregnancy. Materials and Methods: This cross-sectional study was conducted at antenatal Outpatient Department (OPD), Sri Ramachandra Hospital, Chennai, Tamil Nadu, India from November 2019 to March 2020. Total 250 mothers were screened and finally 150 participants were selected. They were asked to fill-up the Pregnancy Physical Activity Questionnaire (PPAQ), Pregnancy Musculoskeletal Dysfunction Scale (PMDS) to assess the PA level and musculoskeletal dysfunction. Mothers who complaints of PGP were clinically diagnosed and were asked to fill the Pelvic Girdle Questionnaire (PGQ). Data was analysed using Statistical Package for the Social Sciences (SPSS) version 20.0. Results: A total of 26 (17.33%) pregnant women in this study had PGP. The association between the total PA and PGP showed that the risk of PGP decreased as the PA increased which was statistically significant (p-value=0.03). PGP was also significantly associated with increased body weight (p-value=0.014). Conclusion: It was found that there was an association between total PA and PGP in pregnancy. Increased PA is associated with reduction in PGP. Hence, moderate PA is recommended during pregnancy.

Abstract Background Many women develop pelvic girdle pain (PGP) during pregnancy and about 10% have chronic pain several years after delivery. Self-administered pain provocation tests are one way to diagnose and evaluate this pain. Their validity in post-partum women is not yet studied. The purpose of this study was to evaluate the validity of self-administered test for assessment of chronic pregnancy-related PGP several years after delivery. Methods Women who previously have had PGP during pregnancy and who participated in one of three RCT studies were invited to a postal follow up of symptoms including performance of self-administered tests after two, 6 or 11 years later, respectively. In total, 289 women returned the questionnaire and the test-results. Of these, a sub-group of 44 women with current PGP underwent an in-person clinical examination. Comparisons were made between test results in women with versus without PGP but also, in the sub-group, between the self-administered tests and those performed during the clinical examination. Results Fifty-one women reported PGP affecting daily life during the last 4 weeks, and 181 reported pain when performing at least one of the tests at home. Those with chronic PGP reported more positive tests (p

Study Design Two-group, pretest–posttest randomized clinical trial. Purpose To evaluate the efficacy of the muscle energy technique (MET) and Kinesiotaping (KT) in addition to conventional physiotherapy among patients with mechanical sacroiliac joint dysfunction (SIJD). Overview of Literature Patients with SIJD suffer from lower back and gluteal pain, as well as stiffness, due to restricted pelvic joint movement. To restore function and reduce pain among individuals with mechanical SIJD, the MET and KT may be helpful. However, a limited number of studies have compared MET and KT in mechanical SIJD. Methods A total of 40 male and female participants aging between 30 and 50 years experiencing unilateral pain around the gluteal area, groin area, and lower limbs for more than 4 weeks but less than 1 year will be selected. Patients will then be randomized into two groups: METCp (n=20) and KTCp groups (n=20). The METCp group will receive MET along with conventional physiotherapy, while the KTCp group will receive conventional physiotherapy with KT. Both groups will receive three alternating days of treatment per week that will continue for 4 weeks. The modified Oswestry Disability Index, a digital pressure algometer, and sacroiliac joint motion testing will be used for evaluation. Between- and within-group pre- and post-intervention results for mechanical SIJD were compared using the Wilcoxon signed-rank test/paired t-test and Mann-Whitney U -test/independent t -test. Results Modified Oswestry Disability Index, digital pressure algometer, and sacroiliac joint motion will be measured at baseline, 2nd week during intervention, and 4th week at the end of intervention Conclusions The present study will provide data regarding the effects of MET and KT among patients with mechanical SIJD.

A decline in musculoskeletal health during pregnancy is an underappreciated adverse outcome of pregnancy that can have immediate and long-term health consequences. High physical job demands are known risk factors for nontraumatic musculoskeletal disorders in the general working population. Evidence from meta-analyses suggest that occupational lifting and prolonged standing during pregnancy may increase risk of adverse pregnancy outcomes. This systematic review examined associations between occupational lifting or postural load in pregnancy and associated musculoskeletal disorders and related sequalae. Five electronic databases (Medline, Embase, CINAHL, NIOSHTIC-2, and Ergonomic Abstracts) were searched from 1990 to July 2022 for studies in any language. A Web of Science snowball search was performed in December 2022. Reference lists were manually reviewed. Eligible studies reported associations between occupational lifting or postural load and musculoskeletal health or sequelae (eg, employment outcomes) among pregnant and postpartum workers. Data were extracted using a customized form to document study and sample characteristics; and details of exposures, outcomes, covariates, and analyses. Investigators independently assessed study quality for 7 risk-of-bias domains and overall utility, with discrepant ratings resolved through discussion. A narrative synthesis was conducted due to heterogeneity. Sixteen studies (11 cohort studies, 2 nested case-control studies, and 3 cross-sectional studies) from 8 countries were included (N=142,320 pregnant and N=1744 postpartum workers). Limited but consistent evidence with variable quality ratings, ranging from critical concern to high, suggests that pregnant workers exposed to heavy lifting (usually defined as ≥22 lbs or ≥10 kg) may be at increased risk of functionally limiting pelvic girdle pain and antenatal leave. Moreover, reports of dose-response relationships suggest graded risk levels according to lifting frequency, ranging from 21% to 45% for pelvic girdle pain and 58% to 202% for antenatal leave. Limited but consistent evidence also suggests that postural load increases the risk of employment cessation. Limited but consistent evidence suggests that pregnant workers exposed to heavy lifting and postural load are at increased risk of pelvic girdle pain and employment cessation. Job accommodations to reduce exposure levels may promote safe sustainable employment for pregnant workers. [Display omitted] [ABSTRACT FROM AUTHOR]

Objective. Pregnancy-related pelvic girdle pain (PGP) may persist or occur postpartum and negatively affects women's lives. There is uncertainty regarding the association between the structures of the bony pelvis, diastasis recti abdominis (DRA), pain processing, and PGP and to what extent these factors should be considered during physical therapy. This study aimed to evaluate the differences between women with and without PGP shortly after delivery regarding the separation of a pubic symphysis, DRA, and pain catastrophizing. Methods. Women diagnosed with PGP 24 to 72 hours after vaginal delivery were matched to pain-free controls according to age and parity. Ultrasound evaluations of diastasis recti (interrecti distance [IRD]) during rest and curl-up task and pubic symphysis (interpubic width)were performed. The Pain Catastrophizing Scale was used to assess the level of catastrophizing. A special Cox regression model was used to fit a conditional logistic regression for a 1:2 matched case--control study. Results. Thirty-five women with clinically diagnosed PGP and 70 matched controls were included in the study. The PGP group had a significantly higher pre-pregnancy body mass index than the control group. After adjusting for body mass index in multiple conditional logistic regression, the interpubic distance (odds ratio =1.64; 95% CI=1.22 to 2.20) and IRD during curl-up (odds ratio =2.01; 95% CI=1.08 to 3.74) were significantly associated with PGP. Pain catastrophizing and IRD at rest were not associated with PGP in univariable or multivariable analysis. Conclusions. Pain catastrophizing is similar for women with and without PGP early postpartum. However, the degree of the pubic symphysis and rectus abdominis separation during the curl-up task are positively associated with PGP shortly after delivery. Impact. This study indicates that a reconsideration of the way we look at DRA is warranted. The development of a more comprehensive assessment including objective measurements and a biopsychosocial understanding is needed to inform directions for further postpartum physical therapy. [ABSTRACT FROM AUTHOR]

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 . [ABSTRACT FROM AUTHOR]

Abstract Background As the development of core outcome sets (COS) increases, guidance for developing and reporting high-quality COS continues to evolve; however, a number of methodological uncertainties still remain. The objectives of this study were: (1) to explore the impact of including patient interviews in developing a COS, (2) to examine the impact of using a 5-point versus a 9-point rating scale during Delphi consensus methods on outcome selection and (3) to inform and contribute to COS development methodology by advancing the evidence base on COS development techniques. Methods Semi-structured patient interviews and a nested randomised controlled parallel group trial as part of the Pelvic Girdle Pain Core Outcome Set project (PGP-COS). Patient interviews, as an adjunct to a systematic review of outcomes reported in previous studies, were undertaken to identify preliminary outcomes for including in a Delphi consensus survey. In the Delphi survey, participants were randomised (1:1) to a 5-point or 9-point rating scale for rating the importance of the list of preliminary outcomes. Results Four of the eight patient interview derived outcomes were included in the preliminary COS, however, none of these outcomes were included in the final PGP-COS. The 5-point rating scale resulted in twice as many outcomes reaching consensus after the 3-round Delphi survey compared to the 9-point scale. Consensus on all five outcomes included in the final PGP-COS was achieved by participants allocated the 5-point rating scale, whereas consensus on four of these was achieved by those using the 9-point scale. Conclusions Using patient interviews to identify preliminary outcomes as an adjunct to conducting a systematic review of outcomes measured in the literature did not appear to influence outcome selection in developing the COS in this study. The use of different rating scales in a Delphi survey, however, did appear to impact on outcome selection. The 5-point scale demonstrated greater congruency than the 9-point scale with the outcomes included in the final PGP-COS. Future research to substantiate our findings and to explore the impact of other rating scales on outcome selection during COS development, however, is warranted.

Abstract Background Pregnancy-related Pelvic Girdle Pain (PPGP) is a common complaint. The aetiology remains unclear and reports on risk factors for PPGP provide conflicting accounts. The aim of this scoping review was to map the body of literature on risk factors for experiencing PPGP. Methods We searched the databases PubMed, Embase, CINAHL, PsycINFO, MIDIRS, and ClinicalTrial.gov (3 August 2020). We selected studies with two reviewers independently. Observational studies assessing risk factors for PPGP were included. Studies examining specific diagnostic tests or interventions were excluded. Results We identified 5090 records from databases and 1077 from ClinicalTrial.gov. Twenty-four records met the inclusion criteria. A total of 148 factors were examined of which only 14 factors were examined in more than one study. Factors that were positively associated with PPGP included a history of low back or pelvic girdle pain, being overweight/obese, already having a child, younger age, lower educational level, no pre-pregnancy exercise, physically demanding work, previous back trauma/disease, progestin-intrauterine device use, stress, depression and anxiety. Conclusions A large number of factors have been examined as potential risk factors for PPGP, but there is a lack of repetition to be able to draw stronger conclusions and pool studies in systematic reviews. Factors that have been examined in more than five studies include age, body mass index, parity and smoking. We suggest a systematic review be conducted to assess the role of these factors further in the development of PPGP.

Background: Coccygodynia is one of the chronic, refractory painful musculoskeletal disorders. Interventional procedures are applied to patients unresponsive to initial treatment in coccygodynia. This study aims to compare the treatment outcomes of ganglion impar block (GIB) and caudal epidural steroid injection (CESI) in patients with chronic coccygodynia. Methods: This study was a prospective randomized comparison study conducted between June 2019 and January 2021. Patients diagnosed with chronic coccygodynia were randomly divided into two groups: the GIB group and the CESI group. The severity of pain, presence of neuropathic pain, and quality of life were evaluated using the Numeric Rating Scale, Leeds Assessment of the Neuropathic Symptoms and Signs Scale, and Short Form-12 Health Survey (SF-12), respectively. Results: A total of 34 patients in each group were included in the final analyses. While there was a significant decrease in pain intensity in both groups in the 3-month follow-up, this decrease was more significant in the GIB group at the 3rd week. There was a significant improvement in the SF-12 physical score and the number of patients with neuropathic pain in both groups in the 3rd week, but this improvement was not observed in the 3rd month. Conclusions: Although GIB may provide more pain relief in short term, both GIB and CESI are useful treatment methods in coccygodynia unresponsive to more conservative treatments. [ABSTRACT FROM AUTHOR]