-
International Journal of Women's Health 2021To evaluate the efficacy of a memory-foam mattress and pillow plus standard treatment for nightly pelvic girdle pain (PGP) during pregnancy.
OBJECTIVE
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.
PubMed: 34938126
DOI: 10.2147/IJWH.S335977 -
Health and Quality of Life Outcomes Feb 2017The Pelvic Girdle Questionnaire is the only instrument designed to assess pain and disability specifically in pregnant or postpartum women with pelvic girdle pain. The...
BACKGROUND
The Pelvic Girdle Questionnaire is the only instrument designed to assess pain and disability specifically in pregnant or postpartum women with pelvic girdle pain. The objective of this study was the adaptation to the Spanish language and analysis of the psychometric properties of the Pelvic Girdle Questionnaire.
METHODS
This is a descriptive cross-sectional study divided into two phases. In the first phase, a translation and adaptation process was performed according to international guidelines. Secondly, the analysis of the properties of the Spanish version was conducted using a sample of 125 pregnant or postpartum women suffering from pelvic girdle pain. Participants completed the Spanish version along with five other measurement instruments through an online platform. Internal consistency, construct validity, test-retest reliability, the ceiling and floor effects, responsiveness and discriminatory ability of the Spanish version were analysed.
RESULTS
The Spanish version of the Pelvic Girdle Questionnaire showed high internal consistency with Cronbach's alpha = 0.961, and an intraclass correlation coefficient of 0.962. The convergent validity showed high positive correlation with other questionnaires used. ROC curves showed no discriminatory capacity for number of sites of pain or pregnancy/post-partum state.
CONCLUSIONS
This article presents the translation, validation and psychometric properties of the Spanish version of the Pelvic Girdle Questionnaire, that has proved to be an appropriate and valid assessment tool of disability due to pelvic girdle pain in pregnant and postpartum women.
Topics: Adolescent; Adult; Cross-Cultural Comparison; Cross-Sectional Studies; Female; Humans; Middle Aged; Pelvic Girdle Pain; Pregnancy; Pregnancy Complications; Puerperal Disorders; Spain; Surveys and Questionnaires; Translating; Young Adult
PubMed: 28143502
DOI: 10.1186/s12955-017-0605-0 -
The British Journal of Surgery Nov 2023Resection of pelvic bone tumors and the subsequent reconstruction of the pelvic girdle pose challenges due to complex anatomy, load-bearing demands, and significant...
Resection of pelvic bone tumors and the subsequent reconstruction of the pelvic girdle pose challenges due to complex anatomy, load-bearing demands, and significant defects. 3D-printed implants have revolutionized pelvic girdle reconstruction by offering customized solutions, porous surface structures for precise resection with custom guides, and improved integration. Many tertiary medical centers have adopted 3Dprinted hemipelvic endoprostheses, leading to enhanced outcomes. However, most studies are limited to single centers, with a small number of cases and short follow-up periods. Additionally, the design of these implants often relies heavily on individual experience, resulting in a lack of uniformity and significant variation. To provide a comprehensive assessment of this technology, we conducted an analysis of existing literature, encompassing tumor resection classification, various types of prosthesis design, reconstruction concepts, and post-reconstruction functional outcomes.
Topics: Humans; Printing, Three-Dimensional; Prosthesis Design; Sarcoma; Plastic Surgery Procedures; Pelvic Bones; Pelvic Neoplasms; Bone Neoplasms; Retrospective Studies; Treatment Outcome
PubMed: 37824784
DOI: 10.1093/bjs/znad310 -
Physical Therapy Apr 2024The objective of this study was to evaluate whether early postpartum exercise is associated with changes in pelvic symptom severity, pelvic floor muscle strength, and...
OBJECTIVE
The objective of this study was to evaluate whether early postpartum exercise is associated with changes in pelvic symptom severity, pelvic floor muscle strength, and diastasis recti abdominis (DRA) from 3 to 12 months postpartum.
METHODS
In this prospective cohort study, 504 participants with and without pelvic symptoms (pelvic girdle pain, stress urinary incontinence, vaginal heaviness) were followed. At 3, 6, 9, and 12 months postpartum, we assessed pelvic symptoms, exercise behavior (by questionnaires), pelvic floor muscle strength (by vaginal palpation), and DRA (by caliper measurement). Based on the 3-months questionnaire, participants were categorized as nonexercisers (n = 105), minimal low-impact exercisers (n = 249), regular low-impact exercisers (n = 117), and high-impact exercisers (n = 32). Between-group differences and within-group changes from 3 to 12 months were calculated using Chi-square tests, Kruskal-Wallis tests, and Friedman analysis of variance.
RESULTS
At 3 months, no differences in symptom prevalence were seen between the groups. Nonexercisers reported higher pelvic girdle pain severity and had weaker pelvic floor muscles. The within-group analysis showed that pelvic girdle pain severity did not change in nonexercisers or high-impact exercisers, but decreased in minimal and regular low-impact exercisers. Stress urinary incontinence increased in nonexercisers from 3 to 12 months, while it remained unchanged in regular low-impact and high-impact exercisers, and decreased in minimal low-impact exercisers. Across all groups, vaginal heaviness and DRA decreased, and pelvic floor strength increased from 3 to 12 months.
CONCLUSION
The study indicates that early low-impact exercising is associated with reduced pelvic girdle pain severity during the first postpartum year. Minimal low-impact exercisers also showed a slight reduction in stress urinary incontinence. Conversely, nonexercisers reported an increase in stress urinary incontinence between 3 and 12 months postpartum.
IMPACT
Physical therapists should encourage women to start with low-impact exercise early after pregnancy.
LAY SUMMARY
This study highlights the positive effects of starting gentle, low-impact exercise early after childbirth to reduce pelvic girdle pain and urinary incontinence.
Topics: Female; Humans; Pregnancy; Diastasis, Muscle; Muscle Strength; Pelvic Floor; Pelvic Girdle Pain; Prospective Studies; Rectus Abdominis; Urinary Incontinence, Stress; Exercise; Longitudinal Studies
PubMed: 38109793
DOI: 10.1093/ptj/pzad171 -
Journal of Rehabilitation Research and... 2015Symphysis pubis diastasis (SPD) is an infrequent complication of labor that can impair womens' general health through failure of the passive stability of the pelvic... (Review)
Review
Symphysis pubis diastasis (SPD) is an infrequent complication of labor that can impair womens' general health through failure of the passive stability of the pelvic girdle. Although conservative approaches are often used to decrease symptoms and interpubic separation, notably few studies have analyzed the effect of these methods on managing the symptoms of women with SPD. The purpose of this study was to review the available literature on the conservative treatment of SPD during pregnancy and labor. A computer-based search using PubMed, PEDro, and CINAHL was performed up to November 2014. We selected all studies that considered women with SPD during pregnancy or labor and treated them with conservative methods and excluded those that included surgical intervention. Eighteen studies were selected, most of which were case reports. Although the overall results of conservative treatment were unclear because of the type and design of the obtained studies, most of the studies reported bed rest in the lateral decubitus position and a pelvic girdle as basic treatments. Additionally, the few clinical trials reported recommended additional physiotherapy, including strengthening and stabilizing exercises, to reduce SPD symptoms.
Topics: Analgesics; Bed Rest; Braces; Female; Humans; Patient Positioning; Physical Therapy Modalities; Pregnancy; Pubic Symphysis Diastasis
PubMed: 26560443
DOI: 10.1682/JRRD.2014.12.0302 -
Hippokratia Jul 2011Pregnancy related low back pain is a common complaint among pregnant women. It can potentially have a negative impact on their quality of life. The aim of this article...
Pregnancy related low back pain is a common complaint among pregnant women. It can potentially have a negative impact on their quality of life. The aim of this article is to present a current review of the literature concerning this issue.By using PubMed database and low back pain, pelvic girdle pain, pregnancy as keywords, abstracts and original articles in English investigating the diagnosis treatment of back pain during pregnancy were searched and analyzedLow back pain could present as either a pelvic girdle pain between the posterior iliac crest and the gluteal fold or as a lumbar pain over and around the lumbar spine. The source of the pain should be diagnosed and differentiated early.The appropriate treatment aims to reduce the discomfort and the impact on the pregnant womans quality of life. This article reveals the most common risk factors, as well as treatment methods, which may help to alleviate the pain. Some suggestions for additional research are also discussed.
PubMed: 22435016
DOI: No ID Found -
Anatomical Record (Hoboken, N.J. : 2007) Apr 2017Asymmetry of the human axial skeleton has received much less attention that of the limb skeleton. Pelvic morphology is subject to multiple selective factors, including...
Asymmetry of the human axial skeleton has received much less attention that of the limb skeleton. Pelvic morphology is subject to multiple selective factors, including bipedal locomotion and obstetrics, among others, as well as environmental factors such as biomechanical loading. How these various factors influence or restrict asymmetry of the pelvis is unknown and few studies have investigated levels and patterns of pelvic asymmetry. This study examines percentage directional (%DA) and absolute (%AA) asymmetry in 14 bilaterally paired dimensions of the pelvic canal, non-canal pelvis, and femur in female (n = 111) and male (n = 126) skeletons from nine geographically dispersed skeletal samples. Directional asymmetries were uniformly low for all measures and lacked any consistent patterning across the variables, while %AA was highest in the pelvic canal, particularly the posterior aspects. Few sex differences and no population differences were found for %DA and %AA; however the latter was correlated with coefficients of variation across the 14 variables in both sexes. While sample mean %DA were low, standard deviations of the canal variables were high and the majority of individuals in both sexes displayed %DA values >±0.5, suggesting asymmetry is common, if not directionally consistent. Biomechanical loading of the pelvic girdle may influence asymmetry of both the canal and non-canal aspects of the pelvis; however it is unlikely that these asymmetries negatively affect obstetric function, given the prevalence for %DA found in this study. Anat Rec, 300:653-665, 2017. © 2017 Wiley Periodicals, Inc.
Topics: Adult; Anthropology, Physical; Female; Femur; Humans; Male; Pelvic Bones; Pelvis; Sex Characteristics
PubMed: 28297182
DOI: 10.1002/ar.23546 -
BMC Musculoskeletal Disorders Jan 2024Pelvic girdle pain (PGP) is common during and after pregnancy. It has been assumed that Scandinavian women report more PGP than women of other ethnicities. However,...
BACKGROUND
Pelvic girdle pain (PGP) is common during and after pregnancy. It has been assumed that Scandinavian women report more PGP than women of other ethnicities. However, there are few population-based studies on ethnic differences and few with ethnicity as risk factor for PGP. The purposes of the present study were: To examine the prevalence of self-reported PGP through pregnancy and early postpartum in a multi-ethnic cohort. To investigate how ethnicity and patient characteristics were associated with risk of PGP during pregnancy and early postpartum. To investigate if clinical and personal factors obtained in gestation week (GW) 15 were associated with PGP in GW28 and postpartum week (PPW) 14.
METHODS
This study analyzed questionnaire data from 823 women from the Stork - Groruddalen mult-iethnic cohort study in Norway. Chi-square tests were used to investigate ethnic differences in prevalence of self-reported PGP, and logistic regression analyses to identify factors associated with self-reported PGP.
RESULTS
Women from South-Asia and Middle East reported 10-20% higher prevalence of self-reported PGP at all time points compared with Western women. Ethnicity was associated with PGP in GW15 and PPW14, adjusted for parity. Pain locations in pelvic area (PGP locations) in GW15, especially combined symphysis and posterior PGP, gave the highest risk (OR=7.4) for PGP in GW28 and in PPW14 (OR = 3.9). Being multiparous was a risk for PGP in PPW14 (OR=1.9).
CONCLUSIONS
Women of South Asian and Middle Eastern background had higher risk of self-reported PGP than Western women. Ethnicity was associated with PGP in GW15 and PPW14, after adjustments for parity. PGP locations in GW15 was the most prominent risk factor for PGP in GW28 and PPW14, whilst ethnicity was not significant in multivariable analyses.
Topics: Pregnancy; Female; Humans; Pelvic Girdle Pain; Cohort Studies; Prevalence; Pain Measurement; Pregnancy Complications; Postpartum Period; Risk Factors
PubMed: 38166902
DOI: 10.1186/s12891-023-07135-w -
Brazilian Journal of Physical Therapy 2020There are a limited number of tests for the assessment of shoulder and pelvic girdle stability. Reliable instruments are important to evaluate movement dysfunction at...
BACKGROUND
There are a limited number of tests for the assessment of shoulder and pelvic girdle stability. Reliable instruments are important to evaluate movement dysfunction at these joints in order to provide more objective parameters.
OBJECTIVE
To evaluate the inter-day reliability of the Upper Body Test in young adults.
METHODS
A reliability study was carried out with three assessments of the shoulder and pelvic girdle stability within 48-h intervals (Monday, Wednesday, and Friday). The OctoBalance® platform was used to perform the Upper Body Test in 31 active young adults (24.5±8 years). Intraclass Correlation Coefficient (ICC) two-way mixed model, Coefficient of Variation, and Bland-Altman plots were used to verify the reliability of the test. The standard error of measurement (SEM) and the minimum detectable difference (MDD) were calculated for clinical applicability.
RESULTS
The Intraclass Correlation Coefficient ranged from 0.87 to 0.94 - Featuring a mean difference of 0.89 (95%CI=-0.19-1.97) to left and 0.95 (95%CI=-0.38-2.27) for the right side, with a low variation coefficient (3.31-5.91%) between the second and third days of assessment. There was a statistically significant difference between the first assessment day and the other test sessions. The Bland-Altman analyses revealed low bias with scores within the limits of agreement. Minimum detectable difference scores were between 4.02 and 5.10, and standard error of measurement between 1.75 and 2.72, depending on the movement side.
CONCLUSION
The Upper Body Test presented good inter-day reliability for assessing the stability of the shoulder and pelvic girdle in young active healthy adults.
Topics: Humans; Lower Extremity; Movement; Pelvic Girdle Pain; Reproducibility of Results; Shoulder; Young Adult
PubMed: 30872005
DOI: 10.1016/j.bjpt.2019.02.009 -
Clinical Biomechanics (Bristol, Avon) Aug 2019Walking difficulties are common among pregnant women with pelvic girdle pain. This cross-sectional study investigated the influence of pelvic girdle pain, pregnancy and...
BACKGROUND
Walking difficulties are common among pregnant women with pelvic girdle pain. This cross-sectional study investigated the influence of pelvic girdle pain, pregnancy and speed on spatiotemporal and trunk, pelvic and hip kinematics during gait in the 2nd trimester of pregnancy.
METHODS
Three-dimensional gait analysis at self-selected speed was performed in 25 pregnant women with pelvic girdle pain, 24 asymptomatic pregnant and 24 non-pregnant women. Linear mixed models were used to investigate between-group differences in gait variables. Adjustment for gait speed was included in the analysis. Correlations between speed and fear of movement, disability and pain were examined using Spearman correlation coefficient (r).
FINDINGS
Pregnant women with pelvic girdle pain walked 18% slower (estimated marginal means (95% confidence intervals) 1.18 (1.22, 1.24) meter/s) compared to asymptomatic pregnant women (1.44 (1.38, 1.50) meter/s) (P < 0.001). Moreover, with longer double limb support (5%, P = 0.04), shorter contralateral step length (3%, P = 0.03) and more restricted pelvic and hip kinematics (0.001 ≤ P ≤ 0.01) adjusted for speed. Only stance, double limb support and thoracic rotation (0.001 ≤ P ≤ 0.04) differed between asymptomatic pregnant and non-pregnant women. Speed was negatively correlated with fear of movement (r = -0.63, P = 0.01) and disability (r = -0.46, P = 0.03) in the pelvic girdle pain group.
INTERPRETATION
Gait is primarily influenced by pelvic girdle pain and less by pregnancy. Pregnant women with pelvic girdle pain walked slower and with a more rigid gait pattern compared to asymptomatic pregnant women, presumably related to altered load transfer. Our results may assist clinical evaluation of pelvic girdle pain, as well as direct future research.
Topics: Adult; Analysis of Variance; Biomechanical Phenomena; Cross-Sectional Studies; Female; Gait; Humans; Pelvic Girdle Pain; Pregnancy; Walking; Walking Speed
PubMed: 31158589
DOI: 10.1016/j.clinbiomech.2019.05.030