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British Journal of Sports Medicine Nov 2022
Topics: Pregnancy; Female; Humans; Pelvic Girdle Pain; Pregnancy Complications
PubMed: 35948414
DOI: 10.1136/bjsports-2022-105724 -
International Journal of Environmental... May 2022There is uncertainty regarding the association between abdominal morphology, pelvic floor function, and psychological factors in women with postpartum pelvic girdle pain...
There is uncertainty regarding the association between abdominal morphology, pelvic floor function, and psychological factors in women with postpartum pelvic girdle pain (PGP). The aim of this case-control study was to evaluate the differences between women with and without persistent PGP regarding pelvic floor function, diastasis recti, and psychological factors 6−24 weeks postpartum. Pelvic floor manometry, palpation examination of abdominal muscles, the International Consultation on Incontinence Questionnaire Short Form, The Depression, Anxiety and Stress Scale—21, and the Pain Catastrophizing Scale were used. The PGP group presented with lower vaginal resting pressure (p < 0.001), more tenderness (p = 0.018) and impaired voluntary activation of pelvic floor muscles (p ≤ 0.001). Women with pain also had more distortion on the level of the anterior abdominal wall (p = 0.001) and more severe diastasis recti (p = 0.046) when compared to pain-free controls. Lower vaginal resting pressure was the strongest factor explaining PGP (OR 0.702, 95%CI 0.502−0.981). There were no differences in terms of the pelvic floor strength, endurance, severity of urinary incontinence and reported distress between the groups. Women with PGP 6−24 weeks postpartum differ in pelvic floor and abdominal muscle function from the pain-free controls. Vaginal resting pressure may be an important factor in pelvic girdle pain shortly postpartum. Further studies are needed to see a trend in changes over time.
Topics: Case-Control Studies; Female; Humans; Muscle Contraction; Pelvic Floor; Pelvic Girdle Pain; Postpartum Period; Urinary Incontinence
PubMed: 35627771
DOI: 10.3390/ijerph19106236 -
Journal of Clinical Nursing Jan 2018To analyse pain and functional capacity in women with pelvic girdle pain and to evaluate the effect of pelvic belt on these parameters. Two types of belts were to... (Randomized Controlled Trial)
Randomized Controlled Trial
AIMS AND OBJECTIVES
To analyse pain and functional capacity in women with pelvic girdle pain and to evaluate the effect of pelvic belt on these parameters. Two types of belts were to compare.
BACKGROUND
Pelvic girdle pain is very common during pregnancy. To prevent and relieve pelvic pain, women can use a set of techniques and tools such as a pelvic belt. While scientific evidence is lacking, commercial industries suggest the effectiveness of pelvic belts.
DESIGN
Randomised control trial.
METHODS
Forty-six pregnant women with pelvic girdle pain were evaluated. Pain analysis included a quantitative and a qualitative assessment. A daily activities questionnaire was used for functional capacity evaluation. Women were tested at two times during the pregnancy for a longitudinal evaluation, and they used one of the two belt models during their pregnancy.
RESULTS
Pelvic pain started between the 14th-21st week of pregnancy. Pain intensity was 60 ± 20 mm. Daily activities could increase pain. The use of belts reduced pain. The intensity of pain decreased by 20 mm on a visual analogue scale. The daily activities were also easier. However, all these conclusions are valid only if pregnant women used belts regularly on short periods.
CONCLUSIONS
The belts appear to be interesting tools to reduce pelvic pain and improve comfort of pregnant women. This effect might be explained by an analgesic effect with proprioceptive and biomechanical effect. The different types of belts could have differential effects on global, sacroiliac joint and back pain during pregnancy, but this hypothesis requires confirmation.
RELEVANCE TO CLINICAL PRACTICE
Relevant for patient: to use an easy and validated tool. Relevant for clinical practice: to suggest a tool scientifically validated for patient. Relevant to economic issues: belts decrease pelvic pain and increase comfort of pregnant women. Sick leave could decrease.
Topics: Adult; Female; Humans; Longitudinal Studies; Orthotic Devices; Pain Measurement; Pelvic Girdle Pain; Pregnancy; Pregnancy Complications; Qualitative Research
PubMed: 28544276
DOI: 10.1111/jocn.13888 -
The Journal of the American Academy of... Apr 2014Pelvic resection is a technique that involves surgical resection of portions of the pelvic girdle. Historically, this procedure was known as internal hemipelvectomy.... (Review)
Review
Pelvic resection is a technique that involves surgical resection of portions of the pelvic girdle. Historically, this procedure was known as internal hemipelvectomy. Hemipelvectomy is a resection that includes the ipsilateral limb. The main indication for these procedures is primary malignant tumors of the pelvis, but in rare cases they are indicated for metastatic lesions, infection, or trauma. Reconstruction is dictated by the extent of the resection and the remaining structures. Surgical technique is dictated by histology of the tumor and location of the lesion. A multidisciplinary team is required. The patient and family should undergo counseling preoperatively to discuss morbidity and mortality, the extensive rehabilitation process, and life expectancy.
Topics: Arthroplasty; Bone Neoplasms; Hemipelvectomy; Humans; Pelvic Bones; Prostheses and Implants; Recovery of Function; Surgical Flaps
PubMed: 24668351
DOI: 10.5435/JAAOS-22-04-214 -
Disability and Rehabilitation Apr 2020The aims of this study were to translate and culturally adapt The Pelvic Girdle Questionnaire to Swedish, and to evaluate the construct and discriminative validity. A...
The aims of this study were to translate and culturally adapt The Pelvic Girdle Questionnaire to Swedish, and to evaluate the construct and discriminative validity. A translation and cultural adaptation process was performed according to international guidelines. Pilot tests were conducted among 16 women during pregnancy and post-partum. Analysis of the construct and discriminative validity of the Swedish version of the Pelvic Girdle Questionnaire was performed in a sample of 177 pregnant women suffering from pain in the lumbo-pelvic area. Participants completed the Pelvic Girdle Questionnaire along with Oswestry Disability Index, numeric rating scales for pain intensity and for pelvic girdle pain concerns. The Swedish version of the Pelvic Girdle Questionnaire showed high internal consistency with Cronbach's alphas between 0.82 and 0.96, good convergent validity with high correlations with the Oswestry Disability Index and the pain intensity numeric rating scale, whereas moderate correlation was shown between the concerns numeric rating scale and the other instruments as hypothesized. Receiver operating characteristic curves showed good discriminatory capacity for women in need of treatment. The Swedish version of the Pelvic Girdle Questionnaire has patient acceptability. It has good construct and discriminative validity for measurements of consequences of pregnancy-related pelvic girdle pain among Swedish speaking women.IMPLICATIONS FOR REHABILITATIONPregnancy-related pelvic girdle pain may be disabling and long-lasting, however treatable when identified.The Pelvic Girdle Questionnaire is the only condition-specific, reliability tested and validated questionnaire for pelvic girdle pain.The Swedish version of the Pelvic Girdle Questionnaire has patient acceptability, good construct validity for pelvic girdle pain among Swedish speaking women, and shows good discriminative capacity for women in need of treatment.
Topics: Cross-Cultural Comparison; Disability Evaluation; Female; Humans; Pelvic Girdle Pain; Pregnancy; Psychometrics; Reproducibility of Results; Surveys and Questionnaires; Sweden
PubMed: 30707631
DOI: 10.1080/09638288.2018.1515991 -
European Journal of Obstetrics,... May 2005The growing interest in pregnancy-related low back and/or pelvic girdle pain has invoked research projects to this subject. Although it seems a modern syndrome,... (Review)
Review
The growing interest in pregnancy-related low back and/or pelvic girdle pain has invoked research projects to this subject. Although it seems a modern syndrome, historical articles show that pregnancy-related pelvic girdle pain (PPGP) was already known centuries ago. The purpose of the present article is to provide a summary review of performed studies on pregnancy-related pelvic girdle pain. Remarkably, these studies show large differences in results with regard to, for example, incidence rates and relevant etiologic factors of pregnancy-related pelvic girdle pain. These differences can be explained by the use of different definitions and descriptions of pregnancy-related pelvic girdle pain between studies. In conclusion, it is necessary to search for an evidence-based overall definition of pregnancy-related pelvic girdle pain in order to provide more knowledge about incidence rates, etiologic factors and other related subjects.
Topics: Back Pain; Female; History, 17th Century; History, 19th Century; History, 20th Century; History, Ancient; Humans; Pelvic Pain; Pregnancy; Pregnancy Complications; Risk Factors
PubMed: 15866079
DOI: 10.1016/j.ejogrb.2004.11.021 -
International Urogynecology Journal Jul 2023The relationship between external lumbar, hip, and/or pelvic girdle pain and internal vaginal pelvic floor myofascial pain is not well described. We assessed this...
INTRODUCTION AND HYPOTHESIS
The relationship between external lumbar, hip, and/or pelvic girdle pain and internal vaginal pelvic floor myofascial pain is not well described. We assessed this relationship in a cohort of adult women.
METHODS
The cohort included women ≥ 18 years old who received care for external lumbar, hip, and/or pelvic girdle pain (reported or elicited on physical examination) who then underwent internal vaginal myofascial levator ani pain assessments, in a tertiary care Female Pelvic Medicine and Reconstructive Surgery pelvic pain clinic over a 2-year period (2013 and 2014).
RESULTS
The cohort of 177 women had an average age of 44.9±16.0 years, an average body mass index of 27.2±7.0 kg/m, and the majority (79.2%) were white. Most patients presented with a chief complaint of pelvic (51.4%), vulvovaginal (18.6%), and/or lumbar (15.3%) pain. Women who reported symptoms of lumbar, hip, or pelvic girdle pain were more likely to have pain on vaginal pelvic floor muscle examination than women without this history (OR, 7.24; 95% CI, 1.95-26.93, p=0.003). The majority (85.9%) of women had bilateral internal vaginal pelvic floor myofascial pain on examination.
CONCLUSIONS
Although participants did not describe "vaginal pelvic floor myofascial pain," the high detection rate for internal vaginal pelvic floor myofascial pain on clinical examination highlights an opportunity to improve treatment planning. These findings suggest that the vaginal pelvic floor muscle examination should be part of the assessment of all women with lumbar, hip, and/or pelvic girdle pain. The relationship between this finding and clinical outcomes following directed treatment warrants additional study.
Topics: Adult; Female; Humans; Middle Aged; Adolescent; Male; Pelvic Girdle Pain; Pelvic Floor; Pelvic Pain; Gynecological Examination; Pelvic Floor Disorders; Myofascial Pain Syndromes
PubMed: 36308537
DOI: 10.1007/s00192-022-05390-4 -
Proceedings of the National Academy of... Jan 2014A major challenge in understanding the origin of terrestrial vertebrates has been knowledge of the pelvis and hind appendage of their closest fish relatives. The pelvic...
A major challenge in understanding the origin of terrestrial vertebrates has been knowledge of the pelvis and hind appendage of their closest fish relatives. The pelvic girdle and appendage of tetrapods is dramatically larger and more robust than that of fish and contains a number of structures that provide greater musculoskeletal support for posture and locomotion. The discovery of pelvic material of the finned elpistostegalian, Tiktaalik roseae, bridges some of these differences. Multiple isolated pelves have been recovered, each of which has been prepared in three dimensions. Likewise, a complete pelvis and partial pelvic fin have been recovered in association with the type specimen. The pelves of Tiktaalik are paired and have broad iliac processes, flat and elongate pubes, and acetabulae that form a deep socket rimmed by a robust lip of bone. The pelvis is greatly enlarged relative to other finned tetrapodomorphs. Despite the enlargement and robusticity of the pelvis of Tiktaalik, it retains primitive features such as the lack of both an attachment for the sacral rib and an ischium. The pelvic fin of Tiktaalik (NUFV 108) is represented by fin rays and three endochondral elements: other elements are not preserved. The mosaic of primitive and derived features in Tiktaalik reveals that the enhancement of the pelvic appendage of tetrapods and, indeed, a trend toward hind limb-based propulsion have antecedents in the fins of their closest relatives.
Topics: Amphibians; Animal Fins; Animals; Biological Evolution; Canada; Fishes; Fossils; Paleontology; Pelvis; Species Specificity; Vertebrates
PubMed: 24449831
DOI: 10.1073/pnas.1322559111 -
Journal of Bodywork and Movement... Jul 2021Secondary dysmenorrhea is frequently associated with dyspareunia. When the diagnostic workup is negative, its clinical management could be complex and a cause for... (Review)
Review
Secondary dysmenorrhea is frequently associated with dyspareunia. When the diagnostic workup is negative, its clinical management could be complex and a cause for concerned for the patient. We reported a case of a young woman who suffered from dyspareunia, dysmenorrhea and chronic pelvic pain. After symptoms progression and pharmacological therapy unresponsiveness, the gynaecologist referred the patient to an osteopath for the functional evaluation of the abdominal pevic area. The examination revealed the presence of pelvic, lumbosacral, and sacrococcygeal dysfunctions which, once treated, significatively reduced the severity of dysmenorrhea and dyspareunia. A multidisciplinary approach might be considered in case of suspected functional impairment. This should be carefully evaluated, considering the previous trauma history and the somatic dysfunctions on abdominal-pelvic fascia.
Topics: Chronic Pain; Dysmenorrhea; Dyspareunia; Endometriosis; Female; Humans; Pelvic Pain; Pelvis
PubMed: 34391229
DOI: 10.1016/j.jbmt.2021.03.013 -
Obstetrics and Gynecology Clinics of... Sep 2014Several musculoskeletal diagnoses are frequently concomitant with pelvic floor pathology and pain. The definition of pelvic pain itself often depends on the medical... (Review)
Review
Several musculoskeletal diagnoses are frequently concomitant with pelvic floor pathology and pain. The definition of pelvic pain itself often depends on the medical specialist evaluating the patient. Because there is variability among disorders associated with pelvic pain, patients may seek treatment for extended periods as various treatment options are attempted. Further, health care providers should recognize that there may not be a single source of dysfunction. This article discusses the musculoskeletal disorders of the pelvic girdle (structures within the bony pelvis) and their association with lumbar spine and hip disorders.
Topics: Humans; Lumbar Vertebrae; Musculoskeletal Diseases; Osteitis; Pain Measurement; Pelvic Floor; Pelvic Pain; Pelvis; Physical Examination
PubMed: 25155123
DOI: 10.1016/j.ogc.2014.04.004