Background
Methods
Outcome measures
Assessment
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Pain experienced between the posterior iliac crest and the gluteal fold, particularly in the vicinity of the SIJ in conjunction with/or separately in the symphysis.
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Reports of duration and weight-bearing-related pain in the pelvic girdle.
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Diminished endurance in standing, walking and sitting.
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Positive clinical diagnostic tests, which reproduced pain in the pelvic girdle.
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No nerve root syndrome
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No reproducible pain and/or changed symptoms in the lumbar spine by repeated end range movement.
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Reported pain in the lumbar spine with or without radiation to the leg.
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Reproducible pain and/or changed symptoms in the lumbar spine by repeated end range motion [53].
Severity of PGP
Results
Variable | PGP or PGP + LBP (n = 37) | No PGP (n = 290) | p-value |
---|---|---|---|
Treatment in RCT | |||
Standard treatment | 11 (29.7 %) | 77 (26.6 %) | |
Standard treatment + Acupuncture | 14 (37.8 %) | 129 (44.5 %) | |
Standard treatment + Specific stabilising exercises | 4 (10.8 %) | 56 (19.3 %) | |
Standard treatment + Craniosacral therapy | 8 (21.6 %) | 28 (9.7 %) | 0.11 |
Age, years | 30.0 (23.0; 39.0) | 31.0 (20.0; 43.0) | 0.40 |
n = 37 | n = 289 | ||
BMI before pregnancy | 22.6 (19.7; 34.2) | 23.2 (18.0; 38.4) | 0.99 |
n = 23 | n = 115 | ||
Age at menarche, years | 13.0 (10.0; 15.0) | 13.0 (9.0; 16.0) | 0.63 |
n = 32 | n = 248 | ||
Previous LBP | 24 (64.9 %) | 127 (44.7 %) | 0.032 |
Women on sick-leave due to PGP | 13 (35.1 %) | 143 (50.0 %) | 0.13 |
Severity of PGP | |||
No complaints, PGP do not affect ability to work | 1 (2.7 %) | 5 (1.8 %) | |
Moderate complaints, PGP only affect ability to work sporadically | 5 (13.5 %) | 67 (23.8 %) | |
Not insignificant, cannot do some parts of my work | 15 (40.5 %) | 90 (32.0 %) | |
Severe, can almost not work | 12 (32.4 %) | 79 (28.1 %) | |
Severe, cannot work at all | 4 (10.8 %) | 40 (14.2 %) | 0.80 |
Tests for assessment of PGP before inclusion in the RCT | |||
Pain provocation tests | |||
P4 test | 37 (100.0 %) | 283 (97.6 %) | 0.86 |
Symphysis pressure test | 22 (59.5 %) | 121 (42.2 %) | 0.070 |
Patrick Faber test | 27 (73.0 %) | 159 (54.8 %) | 0.051 |
Modified Trendelenburg test | 22 (59.5 %) | 116 (40.0 %) | 0.039 |
Number of bilateral positive pain provocation tests | |||
0 | 0 (0.0 %) | 3 (1.0 %) | |
1 | 6 (16.2 %) | 58 (20.0 %) | |
2 | 6 (16.2 %) | 107 (36.9 %) | |
3 | 10 (27.0 %) | 81 (27.9 %) | |
4 | 15 (40.5 %) | 41 (14.1 %) | 0.0013 |
Functional test | |||
ASLR test (sum of scores) | 3.00 (0.00; 8.00) | 3.00 (0.00; 10.00) | 0.35 |
n = 23 | n = 116 | ||
Subgroups of pelvic girdle pain | |||
Solely symphysiolysis | 0 (0.0 %) | 5 (1.7 %) | 1.00 |
One sided sacroiliac pain | 3 (8.1 %) | 37 (12.8 %) | 0.61 |
One sided sacroiliac pain + symphyseal pain | 6 (16.2 %) | 39 (13.4 %) | 0.80 |
Double sided sacroiliac pain | 12 (32.4 %) | 118 (40.7 %) | 0.43 |
Pelvic girdle syndrome | 16 (43.2 %) | 91 (31.4 %) | 0.21 |
Pain related to motion | |||
In the morning, VAS | 31.0 (8.0; 92.0) | 26.5 (0.0; 96.0 | 0.089 |
In the evening, VAS | 62.0 (5.0; 93.0) | 62.8 (6.0; 100.0) | 0.30 |
n = 37 | n = 288 | ||
Unpleasantness of PGP, VAS | 63.0 (20.0; 100.0) | 73.0 (0.0; 100.0) | 0.068 |
n = 30 | n = 200 | ||
DRI | 50.0 (23.0; 100.0) | 59.0 (11.0; 100.0) | 0.11 |
n = 37 | n = 279 | ||
EQ-VAS | 40.0 (25.0; 100.0) | 50.0 (20.0; 99.0) | 0.37 |
n = 23 | n = 113 | ||
EQ-5D score | 0.620 (-0.016; 0.760) | 0.620 (-0.074; 0.796) | 0.23 |
n = 23 | n = 112 | ||
Education level | |||
Primary school | 0 (0.0 %) | 5 (2.0 %) | |
Secondary school | 11 (33.3 %) | 64 (25.3 %) | |
College | 5 (15.2 %) | 21 (8.3 %) | |
University degree | 17 (51.5 %) | 163 (64.4 %) | 0.37 |
No or rare ability to take rest breaks at work | 4 (13.8 %) | 68 (29.8 %) | 0.18 |
Physical activity ≥30 minutes during leisure before pregnancy, days/week | |||
0 | 3 (9.1 %) | 8 (3.2 %) | |
1 | 1 (3.0 %) | 20 (7.9 %) | |
2 | 3 (9.1 %) | 43 (17.1 %) | |
3 | 7 (21.2 %) | 57 (22.6 %) | |
4 | 5 (15.2 %) | 31 (12.3 %) | |
5 | 3 (9.1 %) | 37 (14.7 %) | |
6 | 2 (6.1 %) | 13 (5.2 %) | |
7 | 9 (27.3 %) | 43 (17.1 %) | 0.35 |
Variable | PGP or PGP + LBP (n = 37) | No PGP (n = 290) | p-value |
---|---|---|---|
Age, years | 37.7 (4.9) | 39.4 (5.7) | 0.059 |
38.0 (29.0; 49.0) | 40.0 (24.0; 54.0) | ||
n = 37 | n = 290 | ||
Time from randomisation to follow-up (years) | 7.35 (4.02) | 8.41 (3.80) | 0.27 |
5.00 (2.00; 12.00) | 11.00 (1.00; 13.00) | ||
Working hours/week | 35.7 (7.6) | 37.1 (6.5) | 0.032 |
38.0 (19.0; 60.0) | 40.0 (1.0; 49.0) | ||
n = 29 | n = 221 | ||
Marital status | |||
Single | 3 (8.6 %) | 24 (9.5 %) | |
Married/cohabitating | 32 (91.4 %) | 229 (90.5 %) | 1.00 |
Number of pregnancies | |||
1 | 4 (12.1 %) | 18 (7.2 %) | |
2 | 8 (24.2 %) | 89 (35.6 %) | |
3 | 15 (45.5 %) | 69 (27.6 %) | |
4 | 6 (18.2 %) | 73 (29.2 %) | |
5 | 0 (0.0 %) | 1 (0.4 %) | 0.56 |
Parity | |||
1 | 5 (14.7 %) | 30 (12.0 %) | |
2 | 20 (58.8 %) | 139 (55.4 %) | |
3 | 8 (23.5 %) | 75 (29.9 %) | |
4 | 1 (2.9 %) | 6 (2.4 %) | |
5 | 0 (0.0 %) | 1 (0.4 %) | 0.52 |
Caesarean section | 4 (14.3 %) | 48 (19.0 %) | 0.76 |
Birthweight last born baby, grams | 3633 (492) | 3692 (490) | 0.43 |
3548 (2995; 4615) | 3700 (2129; 5000) | ||
n = 30 | n = 274 | ||
Sex of last born baby, boy | 15 (50 %) | 140 (51 %) | 0.925 |
n = 30 | n = 275 |
Variable | PGP or PGP + LBP (n = 37) | No pain (n = 290) | p-value |
---|---|---|---|
ODI | 22.0 (6; 42) | 4.00 (0; 58) | <.001 |
n = 31 | n = 243 | ||
EQ-5D | 0.725 (0.414; 1) | 0.848 (0.222; 1) | <.001 |
n = 25 | n = 234 | ||
EQ -VAS | 76.5 (50; 100) | 86.0 (0; 100) | <.001 |
n = 30 | n = 230 | ||
HADS-A, sum of scores | 66 (0; 14) | 3 (0; 22) | <.001 |
n = 32 | n = 241 | ||
HADS-A > 8 | 10 (31.3 %) | 24 (10.0 %) | 0.0044 |
HADS-D, sum of scores | 2.50 (0; 12) | 1.00 (0; 12) | <.001 |
n = 32 | n = 241 | ||
HADS-D, >8 | 2 (6.3 %) | 4 (1.7 %) | 0.30 |
PCS score | 15.5 (0; 35) | 6 (0; 52) | <.001 |
n = 32 | n = 237 | ||
PCS magnification | 3.50 (0; 8) | 1 (0; 12) | <.001 |
n = 32 | n = 241 | ||
PCS helplessness | 6 (0; 17) | 2 (0; 24) | <.001 |
n = 32 | n = 241 | ||
PCS rumination | 5.50 (0; 11) | 2 (0; 16) | 0.0036 |
n = 32 | n = 241 | ||
GSE (half scale) | 33.0 (24.0; 40.0) | 35.0 (10.0; 40.0) | 0.046 |
n = 32 | n = 239 | ||
DRI index | 30.8 (2.8; 78.6) | 4.62 (0; 55.85) | <.001 |
n = 32 | n = 243 | ||
DRI, Dressing | 4 (0; 100) | 1 (0; 26) | <.001 |
n = 33 | n = 241 | ||
DRI, Outdoor walks | 11 (0; 90) | 1.50 (0; 71) | <.001 |
n = 33 | n = 242 | ||
DRI, Climbing stairs | 12 (0; 100) | 2 (0; 77) | <.001 |
n = 33 | n = 243 | ||
DRI, Sitting for a longer time | 30 (0; 80) | 3 (0; 90) | <.001 |
n = 33 | n = 243 | ||
DRI, Get up from chair | 13 (0; 100) | 2 (0; 77) | <.001 |
n = 33 | n = 243 | ||
DRI, Standing bent | 39 (0; 100) | 3 (0; 94) | <.001 |
n = 33 | n = 243 | ||
DRI, Carrying a bag | 22 (0; 97) | 2 (0; 69) | <.001 |
n = 33 | n = 242 | ||
DRI, Running | 38 (1; 100) | 3 (0; 100) | <.001 |
n = 33 | n = 243 | ||
DRI, Light work | 17 (0; 90) | 2 (0; 79) | <.001 |
n = 33 | n = 243 | ||
DRI, Turn in bed | 49 (2; 100) | 3 (0; 98) | <.001 |
n = 33 | n = 242 | ||
DRI, Heavy work | 47 (0; 98.) | 4 (0; 86) | <.001 |
n = 33 | n = 242 | ||
DRI, Lifting heavy | 26 (2; 100) | 3 (0; 75) | <.001 |
n = 33 | n = 243 | ||
DRI, Sports | 17 (0; 100) | 2 (0; 65) | <.001 |
n = 33 | n = 243 |