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Journal of Rehabilitation Medicine Mar 2015To determine whether participation in a group fitness class for pregnant women can prevent and treat pelvic girdle pain and low back pain. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To determine whether participation in a group fitness class for pregnant women can prevent and treat pelvic girdle pain and low back pain.
DESIGN
An observer-blinded randomized controlled trial.
PARTICIPANTS
A total of 105 sedentary, nulliparous pregnant women, mean age 30.7 years (standard deviation (SD) 4.0), mean pre-pregnancy body mass index (BMI) 23.8 (SD 4.3), were assigned to either control or exercise groups at mean gestation week 17.7 (SD 4.2).
METHODS
The exercise intervention followed the guidelines of American College of Obstetricians and Gynecologists and included a 60 min general fitness class, with 40 min of endurance training and 20 min of strength training including stretching, performed at least twice per week for a minimum of 12 weeks. Outcome measures were number of women reporting pelvic girdle pain and low back pain after the intervention (mean pregnancy week 36.6 (SD 0.9)) and postpartum (mean 7.7 (SD 1.7)).
RESULTS
There were no statistically significant differences between the exercisers and controls in numbers reporting the 2 conditions after the intervention (pelvic girdle pain: odds ratio (OR) = 1.34, CI = 0.56-3.20 or low back pain: OR = 1.10, CI = 0.47-2.60) or postpartum (pelvic girdle pain: OR = 0.38, CI = 0.13-1.10 or low back pain: OR = 1.45, CI = 0.54-3.94). A comparison of the women who had attended at least 80% of the weekly exercise classes with the control participants did not change the results.
CONCLUSION
Participation in regular group fitness classes during pregnancy did not alter the proportion of women reporting pelvic girdle pain or low back pain during pregnancy or after childbirth.
Topics: Adult; Body Mass Index; Exercise; Exercise Therapy; Female; Humans; Low Back Pain; Pelvic Girdle Pain; Pregnancy; Pregnancy Complications; Single-Blind Method; Young Adult
PubMed: 25385408
DOI: 10.2340/16501977-1906 -
Acta Obstetricia Et Gynecologica... Oct 2019Ear acupuncture carried out in primary care by trained midwives, with no specialist training in acupuncture, may be effective in alleviating pregnancy-related lower back... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Ear acupuncture carried out in primary care by trained midwives, with no specialist training in acupuncture, may be effective in alleviating pregnancy-related lower back and/or posterior pelvic girdle pain (LBPGP). The objective of this study was to assess the effect of ear acupuncture associated with standard obstetric care, in the primary-care setting, on LBPGP experienced by pregnant women.
MATERIAL AND METHODS
This four-group, multicenter, randomized controlled trial was conducted at 18 public primary care centers in three regions in Spain, with the participation of 220 pregnant women at 24-36 weeks of gestation, aged 18 years or more, diagnosed with pregnancy-related LBPGP and who had not previously received ear acupuncture. The trial was conducted from March 2014 to December 2016. Participants were randomly assigned (1:1:1:1) to receive standard obstetric care plus two sessions (over 2 weeks) of verum ear acupuncture, or nonspecific ear acupuncture, or placebo ear acupuncture, or standard obstetric care alone. The primary outcome was change in pain intensity, assessed using a visual analog scale (0-100 mm) from baseline to the end of treatment (T2). Secondary outcomes included change or presence of pain at 3 months (T3) and at 1 year (T4) postpartum, and changes in responses to the Roland-Morris disability questionnaire (RMDQ) and Short Form-12 Health Survey (SF-12) at the end of treatment.
RESULTS
A total of 55 women were randomized to each group, and 205 completed the study. With respect to baseline values, the reduction in pain intensity among the verum ear acupuncture group vs standard obstetric care was significantly greater, both at T2 (65.8%, 95%CI 56.2-75.3 vs 25.1%, 95%CI 15.3-34.9) and at T3 (93.8%, 95%CI 88.7-99.0 vs 67.9%, 95%CI 55.3-80.5). Moreover, significant changes were found in the verum ear acupuncture group vs standard obstetric care at T2, in reduced RMDQ scores (70.9%, 95%CI 61.8-80.1 vs 21.2%, 95%CI 8.6-33.7) and in increased SF-12 scores on the physical scale (40.5%, 95%CI 31.5-49.4 vs 8.1%, 95%CI 0.8-15.5).
CONCLUSIONS
After 2 weeks of treatment, ear acupuncture applied by midwives and associated with standard obstetric care significantly reduces lumbar and pelvic pain in pregnant women, improves quality of life and reduces functional disability.
Topics: Acupuncture, Ear; Adult; Female; Humans; Low Back Pain; Pain Management; Pain Measurement; Pelvic Pain; Pregnancy; Spain
PubMed: 31034580
DOI: 10.1111/aogs.13635 -
Journal of Rehabilitation Medicine Mar 2017To investigate the effect of a supervised, structured exercise programme on the occurrence and severity of pregnancy-related lumbopelvic pain. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To investigate the effect of a supervised, structured exercise programme on the occurrence and severity of pregnancy-related lumbopelvic pain.
DESIGN
Randomized controlled trial.
SUBJECTS
A total of 45 pregnant women were randomly assigned to 2 groups: an experimental group (n = 20; mean age 32.8 (standard deviation (SD) 3.6) years) and a control group (n = 22; mean age 32.2 years (SD 4.9)).
METHODS
Exercise intervention for the experimental group consisted of aerobic and resistance exercises performed bi-weekly from the date of inclusion into the study until the end of pregnancy, together with at least 30 min of brisk daily walks. A numeric rating scale, Roland-Morris Disability Questionnaire (RMDQ), and Pelvic Girdle Questionnaire (PGQ) were used to measure outcomes. The control group received only standard antenatal care.
RESULTS
There were significant differences between the 2 groups on the numeric rating scale, PGQ and RMDQ scores in the 36th week of pregnancy (p = 0.017; p = 0.005; p < 0.001, respectively) in favour of the experimental group.
CONCLUSION
The exercise programme had a beneficial effect on the severity of lumbopelvic pain in pregnancy, reducing the intensity of pain and the level of disability experienced as a result.
Topics: Adult; Exercise Therapy; Female; Humans; Low Back Pain; Lower Extremity; Pain Measurement; Pelvic Girdle Pain; Pelvis; Pregnancy; Pregnancy Complications; Severity of Illness Index; Surveys and Questionnaires; Treatment Outcome
PubMed: 28233012
DOI: 10.2340/16501977-2196 -
The Journal of Manual & Manipulative... 2008Sacroiliac joint (SIJ) pain refers to the pain arising from the SIJ joint structures. SIJ dysfunction generally refers to aberrant position or movement of SIJ structures...
Sacroiliac joint (SIJ) pain refers to the pain arising from the SIJ joint structures. SIJ dysfunction generally refers to aberrant position or movement of SIJ structures that may or may not result in pain. This paper aims to clarify the difference between these clinical concepts and present current available evidence regarding diagnosis and treatment of SIJ disorders. Tests for SIJ dysfunction generally have poor inter-examiner reliability. A reference standard for SIJ dysfunction is not readily available, so validity of the tests for this disorder is unknown. Tests that stress the SIJ in order to provoke familiar pain have acceptable inter-examiner reliability and have clinically useful validity against an acceptable reference standard. It is unknown if provocation tests can reliably identify extra-articular SIJ sources of pain. Three or more positive pain provocation SIJ tests have sensitivity and specificity of 91% and 78%, respectively. Specificity of three or more positive tests increases to 87% in patients whose symptoms cannot be made to move towards the spinal midline, i.e., centralize. In chronic back pain populations, patients who have three or more positive provocation SIJ tests and whose symptoms cannot be made to centralize have a probability of having SIJ pain of 77%, and in pregnant populations with back pain, a probability of 89%. This combination of test findings could be used in research to evaluate the efficacy of specific treatments for SIJ pain. Treatments most likely to be effective are specific lumbopelvic stabilization training and injections of corticosteroid into the intra-articular space.
PubMed: 19119403
DOI: 10.1179/jmt.2008.16.3.142 -
Journal of Medical Genetics Sep 2005The limb girdle muscular dystrophies (LGMD) are a heterogeneous group of Mendelian disorders highlighted by weakness of the pelvic and shoulder girdle muscles. Seventeen...
BACKGROUND
The limb girdle muscular dystrophies (LGMD) are a heterogeneous group of Mendelian disorders highlighted by weakness of the pelvic and shoulder girdle muscles. Seventeen autosomal loci have been so far identified and genetic tests are mandatory to distinguish among the forms. Mutations at the calpain 3 locus (CAPN3) cause LGMD type 2A.
OBJECTIVE
To obtain unbiased information on the consequences of CAPN3 mutations.
PATIENTS
530 subjects with different grades of symptoms and 300 controls.
METHODS
High throughput denaturing HPLC analysis of DNA pools.
RESULTS
141 LGMD2A cases were identified, carrying 82 different CAPN3 mutations (45 novel), along with 18 novel polymorphisms/variants. Females had a more favourable course than males. In 94% of the more severely affected patient group, the defect was also discovered in the second allele. This proves the sensitivity of the approach. CAPN3 mutations were found in 35.1% of classical LGMD phenotypes. Mutations were also found in 18.4% of atypical patients and in 12.6% of subjects with high serum creatine kinase levels.
CONCLUSIONS
A non-invasive and cost-effective strategy, based on the high throughput denaturing HPLC analysis of DNA pools, was used to obtain unbiased information on the consequences of CAPN3 mutations in the largest genetic study ever undertaken. This broadens the spectrum of LGMD2A phenotypes and sets the carrier frequency at 1:103.
Topics: Adult; Calpain; Chromatography, High Pressure Liquid; Cohort Studies; DNA; Female; Genes, Recessive; Genetic Testing; Humans; Male; Muscle Proteins; Muscular Dystrophies, Limb-Girdle; Mutation; Phenotype; Polymorphism, Genetic
PubMed: 16141003
DOI: 10.1136/jmg.2004.028738 -
Reumatismo Mar 2018Polymyalgia rheumatica (PMR) is a chronic, inflammatory disorder of unknown cause clinically characterized by pain and prolonged morning stiffness affecting the... (Review)
Review
Polymyalgia rheumatica (PMR) is a chronic, inflammatory disorder of unknown cause clinically characterized by pain and prolonged morning stiffness affecting the shoulders and often the pelvic girdle and neck. Imaging has substantially contributed to defining PMR as a disease mainly involving extra-articular structures. This review article analyses the role of the different imaging techniques in the diagnosis and follow-up of patients with PMR with particular emphasis on the role of ultrasound, PET/CT and MRI.
Topics: Aged; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Polymyalgia Rheumatica; Positron Emission Tomography Computed Tomography; Predictive Value of Tests; Sensitivity and Specificity; Ultrasonography
PubMed: 29589403
DOI: 10.4081/reumatismo.2018.1040 -
Journal of Clinical Medicine Dec 2020Pelvic girdle pain (PGP) refers specifically to musculoskeletal pain localised to the pelvic ring and can be present at its anterior and/or posterior aspects. Causes... (Review)
Review
Pelvic girdle pain (PGP) refers specifically to musculoskeletal pain localised to the pelvic ring and can be present at its anterior and/or posterior aspects. Causes such as trauma, infection and pregnancy have been well-established, while patients with hypermobile joints are at greater risk of developing PGP. Research exploring this association is limited and of varying quality. In the present study we report on the incidence, pathophysiology, diagnostic and treatment modalities for PGP in patients suffering from Hypermobility Spectrum Disorder (HSD) and Hypermobility-Type Ehlers-Danlos Syndrome (hEDS). Recommendations are made for clinical practice by elaborating on screening, diagnosis and management of such patients to provide a holistic approach to their care. It appears that this cohort of patients are at greater risk particularly of mental health issues. Moreover over, they may require a multidisciplinary approach for their management. Ongoing research is still required to expand our understanding of the relationship between PGP, HSD and hEDS by appropriately diagnosing patients using the latest updated terminologies and by conducting randomised control trials to compare outcomes of interventions using standardised patient reported outcome measures.
PubMed: 33317183
DOI: 10.3390/jcm9123992 -
Ecology and Evolution Oct 2023Geometric morphometrics (GM) enable the quantification of morphological variation on various scales. Recent technical advances allow analyzing complex three-dimensional...
A landmark-free analysis of the pelvic girdle in Sulawesi ricefishes (Adrianichthyidae): How 2D and 3D geometric morphometrics can complement each other in the analysis of a complex structure.
Geometric morphometrics (GM) enable the quantification of morphological variation on various scales. Recent technical advances allow analyzing complex three-dimensional shapes also in cases where landmark-based approaches are not appropriate. Pelvic girdle bones (basipterygia) of Sulawesi ricefishes are 3D structures that challenge traditional morphometrics. We hypothesize that the pelvic girdle of ricefishes experienced sex-biased selection pressures in species where females provide brood care by carrying fertilized eggs supported by elongated pelvic fins ("pelvic brooding"). We test this by comparing pelvic bone shapes of both sexes in species exhibiting pelvic brooding and the more common reproductive strategy "transfer brooding," by using landmark-free 2D and 3D GM, as well as qualitative shape descriptions. Both landmark-free approaches revealed significant interspecific pelvic bone variation in the lateral process, medial facing side of the pelvic bone, and overall external and internal wing shape. Within pelvic brooders, the three analyzed species are clearly distinct, while pelvic bones of the genus are more similar to transfer brooding . Female pelvic brooding exhibit prominent, medially pointing tips extending from the internal wing and basipterygial plate that are reduced or absent in conspecific males, and transfer brooding , supporting our hypothesis that selection pressures affecting pelvic girdle shape are sex-biased in Sulawesi ricefishes. Furthermore, both sexes of pelvic brooding have overall larger pelvic bones than other investigated ricefishes. Based on these differences, we characterized two reproductive strategy- and sex-dependent pelvic girdle types for Sulawesi ricefishes. Morphological differences between the investigated pelvic brooding genera and provide additional evidence for two independent origins of pelvic brooding. Overall, our findings add to a better understanding on traits related to pelvic brooding in ricefishes and provide a basis for upcoming studies on pelvic girdle function and morphology.
PubMed: 37859830
DOI: 10.1002/ece3.10613