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American Journal of Obstetrics and... Aug 2010The purpose of this study was to estimate the association of parity with pelvic girdle syndrome (PGS; pain in anterior and bilateral posterior pelvis).
OBJECTIVE
The purpose of this study was to estimate the association of parity with pelvic girdle syndrome (PGS; pain in anterior and bilateral posterior pelvis).
STUDY DESIGN
We included 75,939 pregnant women in the Norwegian Mother and Child Cohort Study. Data were obtained by self-administered questionnaires.
RESULTS
By pregnancy week 30, 15% of the women had developed PGS. Among first-time mothers, 11% of the women reported PGS, compared with 18% of the women with 1 previous delivery and 21% of women with 2 previous deliveries. The odds ratios for PGS of having had 1 or 2 previous deliveries were 1.9 (95% confidence interval [CI], 1.9-2.0) and 2.4 (95% CI, 2.3-2.6), respectively, after adjustment for other study factors. For PGS with severe pain, the corresponding odds ratios were 2.6 (95% CI, 2.3-2.9) and 3.8 (95% CI, 3.3-4.3).
CONCLUSION
The risk of the development of PGS increased with number of previous deliveries, which suggests that parity-related factors play a causal role.
Topics: Adolescent; Adult; Body Mass Index; Cohort Studies; Confidence Intervals; Delivery, Obstetric; Educational Status; Female; Gestational Age; Humans; Logistic Models; Norway; Odds Ratio; Pain Measurement; Parity; Pelvic Bones; Pelvic Pain; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Risk Assessment; Severity of Illness Index; Surveys and Questionnaires; Young Adult
PubMed: 20510180
DOI: 10.1016/j.ajog.2010.03.040 -
Musculoskeletal Science & Practice Dec 2018Due to biological immaturity and unfavorable psychosocial conditions, it is conjectured that teenage pregnancy may be associated with disorders such as pelvic girdle... (Comparative Study)
Comparative Study
BACKGROUND
Due to biological immaturity and unfavorable psychosocial conditions, it is conjectured that teenage pregnancy may be associated with disorders such as pelvic girdle pain. The evidence for risk factors for pelvic girdle pain in pregnant adolescents remains unclear.
OBJECTIVES
To evaluate the factors associated with pelvic girdle pain related to pregnancy in adolescents.
DESIGN
Case-control study.
METHOD
Seventy three pregnant women with presence of pelvic girdle pain (case group) and 331 pregnant women without pelvic girdle pain (control group) aged between 10 and 19 years, with gestational age between 28 and 40 weeks were included.
RESULTS/FINDINGS
A logistic regression model was used to identify factors associated with the occurrence of pelvic girdle pain. The following aspects were considered for the model: sociodemographic, anthropometric, gynecological and obstetrical, related to lifestyle, musculoskeletal and psychosocial factors. The results showed that suspected common mental disorder (OR: 2.27; 95% CI: 1.23 to 4.18), low back pain during menstruation (OR: 2.10; 95% CI: 1.16 to 3.80) and strenuous work (OR: 1.95; 95% CI: 1.13 to 3.35) were associated with pelvic girdle pain among pregnant adolescents.
CONCLUSIONS
Attention must be given to pregnant adolescents with suspected common mental disorder, low back pain during menstruation and strenuous work in order to ensure referral to the appropriate healthcare professional for early prevention of pelvic girdle pain.
Topics: Adolescent; Adult; Case-Control Studies; Child; Exercise Therapy; Female; Humans; Low Back Pain; Pelvic Girdle Pain; Pregnancy; Pregnancy Complications; Pregnant Women; Risk Factors; Young Adult
PubMed: 30423525
DOI: 10.1016/j.msksp.2018.09.011 -
Tidsskrift For Den Norske Laegeforening... Jun 1990Pelvic girdle relaxation is physiologic during pregnancy and is caused by hormonal and biomechanical factors. When a pregnant women presents herself as a patient with...
Pelvic girdle relaxation is physiologic during pregnancy and is caused by hormonal and biomechanical factors. When a pregnant women presents herself as a patient with low back- and pelvic pain, walking dysfunction, and when the pain is reproduced by sacroiliac provocation tests, the diagnosis "symptom-giving pelvic girdle relaxation" may be justified. If the same symptoms and signs continue after delivery, we suggest the term "pelvic joint syndrome". Studies of selected patients indicate an incidence of 1.5 to 16%. In a random Norwegian population comprising 1,045 women, 25% claimed to have had pelvic girdle relaxation pre- and/or post partum. Four months post partum a point prevalence of 26.5% was found to have pelvic and low back pain. One of three was diagnosed as pelvic joint syndrome on the basis of special criteria after having excluded other diagnoses by clinical examination, X-ray and laboratory controls. Symptomatic lowback pain may be a difficult differential diagnosis. Risk factors for pelvic joint syndrome seem to be previous pelvic girdle relaxation or pelvic girdle relaxation in mother and sisters.
Topics: Back Pain; Diagnosis, Differential; Female; Humans; Norway; Pregnancy; Pregnancy Complications; Pubic Symphysis; Risk Factors; Sacroiliac Joint
PubMed: 2142835
DOI: No ID Found -
Clinical Biomechanics (Bristol, Avon) Jun 2016The relationship between activation of the stabilizing muscles of the lumbopelvic region during the Active Straight Leg Raise test and pelvic girdle pain remains...
Response of the muscles in the pelvic floor and the lower lateral abdominal wall during the Active Straight Leg Raise in women with and without pelvic girdle pain: An experimental study.
BACKGROUND
The relationship between activation of the stabilizing muscles of the lumbopelvic region during the Active Straight Leg Raise test and pelvic girdle pain remains unknown. Therefore, the aim was to examine automatic contractions in relation to pre-activation in the muscles of the pelvic floor and the lower lateral abdominal wall during leg lifts, performed as the Active Straight Leg Raise test, in women with and without persistent postpartum pelvic girdle pain.
METHODS
Sixteen women with pelvic girdle pain and eleven pain-free women performed contralateral and ipsilateral leg lifts, while surface electromyographic activity was recorded from the pelvic floor and unilaterally from the lower lateral abdominal wall. As participants performed leg lifts onset time was calculated as the time from increased muscle activity to leg lift initiation.
FINDINGS
No significant differences were observed between the groups during the contralateral leg lift. During the subsequent ipsilateral leg lift, pre-activation in the pelvic floor muscles was observed in 36% of women with pelvic girdle pain and in 91% of pain-free women (P=0.01). Compared to pain-free women, women with pelvic girdle pain also showed significantly later onset time in both the pelvic floor muscles (P=0.01) and the muscles of the lower lateral abdominal wall (P<0.01).
INTERPRETATION
We suggest that disturbed motor activation patterns influence women's ability to stabilize the pelvis during leg lifts. This could be linked to provocation of pain during repeated movements.
Topics: Abdominal Muscles; Abdominal Wall; Adult; Case-Control Studies; Electromyography; Female; Humans; Leg; Motor Activity; Movement; Muscle Contraction; Pelvic Floor; Pelvic Girdle Pain; Postpartum Period
PubMed: 27128765
DOI: 10.1016/j.clinbiomech.2016.04.007 -
Scientific Reports Mar 2016Fishes have adapted a number of different behaviors to move out of the water, but none have been described as being able to walk on land with a tetrapod-like gait. Here...
Fishes have adapted a number of different behaviors to move out of the water, but none have been described as being able to walk on land with a tetrapod-like gait. Here we show that the blind cavefish Cryptotora thamicola walks and climbs waterfalls with a salamander-like diagonal-couplets lateral sequence gait and has evolved a robust pelvic girdle that shares morphological features associated with terrestrial vertebrates. In all other fishes, the pelvic bones are suspended in a muscular sling or loosely attached to the pectoral girdle anteriorly. In contrast, the pelvic girdle of Cryptotora is a large, broad puboischiadic plate that is joined to the iliac process of a hypertrophied sacral rib; fusion of these bones in tetrapods creates an acetabulum. The vertebral column in the sacral area has large anterior and posterior zygapophyses, transverse processes, and broad neural spines, all of which are associated with terrestrial organisms. The diagonal-couplet lateral sequence gait was accomplished by rotation of the pectoral and pelvic girdles creating a standing wave of the axial body. These findings are significant because they represent the first example of behavioural and morphological adaptation in an extant fish that converges on the tetrapodal walking behaviour and morphology.
Topics: Animals; Biomechanical Phenomena; Fishes; Walking
PubMed: 27010864
DOI: 10.1038/srep23711 -
European Journal of Physical and... Aug 2017The cause of non-specific lumbopelvic pain is unknown. Pregnancy-related pelvic girdle pain seems to be a subgroup that deserves a specific treatment. One of the options...
BACKGROUND
The cause of non-specific lumbopelvic pain is unknown. Pregnancy-related pelvic girdle pain seems to be a subgroup that deserves a specific treatment. One of the options is the use of a pelvic belt.
AIM
To objectify the influence of a pelvic belt in patients with pelvic girdle pain.
DESIGN
Case-control study.
SETTING
Outpatient clinic.
POPULATION
A total of 49 women with long-lasting posterior pelvic girdle pain and 37 parous women of the same age group without pelvic girdle pain.
METHODS
Hip adduction force was measured by asking the participant to squeeze a hand-held dynamometer between the knees. This was firstly performed without a pelvic belt and then with a pelvic belt. The increase of hip adduction force after applying the pelvic belt was expressed in percentages.
RESULTS
After tightening a pelvic belt hip adduction force increased 25.9±33.9% in patients with pelvic girdle pain (P<0.0001) and 1.0±8.6% in participants without (P=0.67). The difference between groups was significant (P<0.00001).
CONCLUSIONS
A pelvic belt has a positive influence on hip adduction force in pregnancy-related posterior pelvic girdle pain.
CLINICAL REHABILITATION IMPACT
The results show an objective positive effect of the pelvic belt in women with long-lasting pregnancy-related posterior pelvic girdle pain in a test-situation. The results support the idea that the use of a belt could be part of a multidisciplinary rehabilitation of those patients.
Topics: Adult; Case-Control Studies; Female; Hip Joint; Humans; Orthotic Devices; Pain Measurement; Pelvic Girdle Pain; Pregnancy; Prognosis; Range of Motion, Articular; Reference Values; Severity of Illness Index; Statistics, Nonparametric; Treatment Outcome
PubMed: 28251846
DOI: 10.23736/S1973-9087.17.04442-2 -
Anatomical Record (Hoboken, N.J. : 2007) Apr 2017The human pelvis has evolved over time into a remarkable structure, optimised into an intricate architecture that transfers the entire load of the upper body into the... (Review)
Review
The human pelvis has evolved over time into a remarkable structure, optimised into an intricate architecture that transfers the entire load of the upper body into the lower limbs, while also facilitating bipedal movement. The pelvic girdle is composed of two hip bones, os coxae, themselves each formed from the gradual fusion of the ischium, ilium and pubis bones. Unlike the development of the classical long bones, a complex timeline of events must occur in order for the pelvis to arise from the embryonic limb buds. An initial blastemal structure forms from the mesenchyme, with chondrification of this mass leading to the first recognisable elements of the pelvis. Primary ossification centres initiate in utero, followed post-natally by secondary ossification at a range of locations, with these processes not complete until adulthood. This cascade of events can vary between individuals, with recent evidence suggesting that fetal activity can affect the normal development of the pelvis. This review surveys the current literature on the ontogeny of the human pelvis. Anat Rec, 300:643-652, 2017. © 2017 Wiley Periodicals, Inc.
Topics: Humans; Osteogenesis; Pelvic Bones; Pelvis
PubMed: 28297183
DOI: 10.1002/ar.23541 -
Chiropractic & Manual Therapies 2019Pelvic girdle pain is a common problem during pregnancy and postpartum with significant personal and societal impact and costs. Studies examining the effectiveness of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Pelvic girdle pain is a common problem during pregnancy and postpartum with significant personal and societal impact and costs. Studies examining the effectiveness of interventions for pelvic girdle pain measure different outcomes, making it difficult to pool data in meta-analysis in a meaningful and interpretable way to increase the certainty of effect measures. A consensus-based core outcome set for pelvic girdle pain can address this issue. As a first step in developing a core outcome set, it is essential to systematically examine the outcomes measured in existing studies.
OBJECTIVE
The objective of this systematic review was to identify, examine and compare what outcomes are measured and reported, and how outcomes are measured, in intervention studies and systematic reviews of interventions for pelvic girdle pain and for lumbopelvic pain (which includes pelvic girdle pain).
METHODS
We searched PubMed, Cochrane Library, PEDro and Embase from inception to the 11th May 2018. Two reviewers independently selected studies by title/abstract and by full text screening. Disagreement was resolved through discussion. Outcomes reported and their outcome measurement instruments were extracted and recorded by two reviewers independently. We assessed the quality of reporting with two independent reviewers. The outcomes were grouped into core domains using the OMERACT filter 2.0 framework.
RESULTS
A total of 107 studies were included, including 33 studies on pelvic girdle pain and 74 studies on lumbopelvic pain. Forty-six outcomes were reported across all studies, with the highest amount (26/46) in the 'life impact' domain. 'Pain' was the most commonly reported outcome in both pelvic girdle pain and lumbopelvic pain studies. Studies used different instruments to measure the same outcomes, particularly for the outcomes pain, function, disability and quality of life.
CONCLUSIONS
A wide variety of outcomes and outcome measurements are used in studies on pelvic girdle pain and lumbopelvic pain. The findings of this review will be included in a Delphi survey to reach consensus on a pelvic girdle pain - core outcome set. This core outcome set will allow for more effective comparison between future studies on pelvic girdle pain, allowing for more effective translation of findings to clinical practice.
SUPPLEMENTARY INFORMATION
accompanies this paper at 10.1186/s12998-019-0279-2.
Topics: Adult; Back Pain; Female; Humans; Outcome Assessment, Health Care; Pelvic Girdle Pain; Postpartum Period; Pregnancy; Pregnancy Complications; Quality of Life; Young Adult
PubMed: 31700607
DOI: 10.1186/s12998-019-0279-2 -
Nature Dec 2005One of the most marked transformations in the vertebrate transition to land was that of fins to limbs. This transformation involved not only the generation of...
One of the most marked transformations in the vertebrate transition to land was that of fins to limbs. This transformation involved not only the generation of morphological novelties (digits, sacrum) but also a shift in locomotory dominance from the pectoral to the pelvic appendage. Despite its importance, the transformation from pelvic fin to hindlimb is the least studied and least well-documented part of this transformation, which is bracketed by the osteolepiform Eusthenopteron and the early tetrapods Ichthyostega and Acanthostega, but is not directly illuminated by any intermediate form. Panderichthys is the closest tetrapod relative currently represented by complete fossils, but its pelvic fin skeleton has not been described. Here, I present the only known articulated pelvic fin endoskeleton and associated partial pelvis of Panderichthys. The pelvic girdle is even less tetrapod-like than that of the osteolepiform Eusthenopteron, but the pelvic fin endoskeleton shares derived characteristics with basal tetrapods despite being more primitive than the pectoral fin of Panderichthys. The evolution of tetrapod locomotion appears to have passed through a stage of body-flexion propulsion, in which the pelvic fins played a relatively minor anchoring part, before the emergence of hindlimb-powered propulsion in the interval between Panderichthys and Acanthostega.
Topics: Animals; Biological Evolution; Extremities; Fishes; Fossils; Locomotion; Models, Biological; Pelvis; Skeleton
PubMed: 16372007
DOI: 10.1038/nature04119 -
Ortopedia, Traumatologia, Rehabilitacja Jun 2022Pelvic asymmetry and accompanying postural defects tend to become more common with age. The school period, which is associated with spending more time in a sitting...
BACKGROUND
Pelvic asymmetry and accompanying postural defects tend to become more common with age. The school period, which is associated with spending more time in a sitting position and daily activities performed with the dominant limb, may contribute to this.
MATERIAL AND METHODS
We examined 22 children (12 girls, 10 boys) aged 7 years. The same group was re-examined two years later. Pelvic asymmetry was identified by assessing the position of the iliac spines. The indicator of trunk asymmetry was the trunk rotation angle (TRA) measured with a Bunnel scoliometer within the spinous processes on the upper thoracic vertebra, apex of thoracic kyphosis, thoracolumbar junction, lumbar spine, and (if present in patients) the greatest deformity (rib hump, hump in the lumbar region).
RESULTS
Pelvic asymmetry was detected in 14 children at the age of 7 years compared to 16 in the same group of patients aged 9 years. During these two years, the prevalence of trunk asymmetry in children with an oblique/rotated pelvis had increased. The progression of trunk asymmetry with an oblique position of the pelvis was most marked in the lumbar region. In children with symmetrical pelvis, the most marked increase in TRA was recorded in the thoracic segment.
CONCLUSIONS
1. The development of pelvic girdle asymmetry is influenced by the increasing number of asymmetrically performed movements and asymmetric body positions assumed, which increase in number with age. 2. The most marked increase in asymmetry of the spine in subjects with an oblique/rotated pelvis was seen in the lumbar spine, which proves an association of the former with tilting of the pelvic girdle. 3. Asymmetry is a dynamic process. When ignored, this postural defect progresses significantly and there may be compensatory changes in neighbouring systems.
Topics: Male; Female; Humans; Child; Lumbar Vertebrae; Thoracic Vertebrae; Movement; Posture; Pelvis; Scoliosis
PubMed: 36888644
DOI: 10.5604/01.3001.0015.9056