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Erschienen in: European Spine Journal 8/2009

01.08.2009 | Original Article

Self-administered tests as a screening procedure for pregnancy-related pelvic girdle pain

verfasst von: Monika Fagevik Olsén, Annelie Gutke, Helen Elden, Charlotte Nordenman, Lina Fabricius, Melissa Gravesen, Anette Lind, Gunilla Kjellby-Wendt

Erschienen in: European Spine Journal | Ausgabe 8/2009

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Abstract

The aim of this study was to investigate sensitivity and specificity of self-administrated tests aimed at pain provocation of posterior and/or anterior pelvis pain and to investigate pain intensity during and after palpation of the symphysis. A total of 175 women participated in the study, 100 pregnant women with and 25 pregnant women without lumbopelvic back pain and 50 non-pregnant women. Standard pain provocation tests were compared with self assessed tests. All women were asked to estimate pain during and after palpation of the symphysis. For posterior pelvic pain, the self-test of P4 and Bridging test had the highest sensitivity of 0.90 versus 0.97 and specificity of 0.92 and 0.87. Highest sensitivity for self-test for anterior pelvic pain was pulling a mat 0.85. Palpation of symphysis was painful and persistency of pain was the longest among women who fulfilled the criteria for symphyseal pain. There were overall significant differences between the groups concerning intensity and persistency of pain (P < 0.001). Our results indicate that pregnant women can perform a screening by provocation of posterior pelvic pain by self-tests with the new P4 self-test and the Bridging test. Palpation of the symphysis is painful and should only be used as a complement to history taking, pain drawing and pulling a MAT-test.
Literatur
1.
Zurück zum Zitat Albert H, Godskesen M, Westergaard J (2000) Evaluation of clinical tests used in classification procedures in pregnancy-related pelvic joint pain. Eur Spine J 9:161–166PubMedCrossRef Albert H, Godskesen M, Westergaard J (2000) Evaluation of clinical tests used in classification procedures in pregnancy-related pelvic joint pain. Eur Spine J 9:161–166PubMedCrossRef
2.
Zurück zum Zitat Albert H, Godskesen M, Westergaard J (2001) Prognosis in four syndromes of pregnancy-related pelvic pain. Acta Obstet Gynecol Scand 80:505–510PubMedCrossRef Albert H, Godskesen M, Westergaard J (2001) Prognosis in four syndromes of pregnancy-related pelvic pain. Acta Obstet Gynecol Scand 80:505–510PubMedCrossRef
3.
Zurück zum Zitat Albert HB, Godskesen M, Westergaard JG (2002) Incidence of four syndromes of pregnancy-related pelvic joint pain. Spine 27:2831–2834PubMedCrossRef Albert HB, Godskesen M, Westergaard JG (2002) Incidence of four syndromes of pregnancy-related pelvic joint pain. Spine 27:2831–2834PubMedCrossRef
4.
Zurück zum Zitat Brynhildsen J, Hansson A, Persson A, Hammar M (1998) Follow-up of patients with low back pain during pregnancy. Obstet Gynecol 91:182–186PubMedCrossRef Brynhildsen J, Hansson A, Persson A, Hammar M (1998) Follow-up of patients with low back pain during pregnancy. Obstet Gynecol 91:182–186PubMedCrossRef
5.
Zurück zum Zitat Cook C, Massa L, Harm-Ernandes I, Segneri R, Adcock J, Kennedy C, Figuers C (2007) Interrater reliability and diagnostic accuracy of pelvic girdle pain classification. J Manipulative Physiol Ther 30:252–258PubMedCrossRef Cook C, Massa L, Harm-Ernandes I, Segneri R, Adcock J, Kennedy C, Figuers C (2007) Interrater reliability and diagnostic accuracy of pelvic girdle pain classification. J Manipulative Physiol Ther 30:252–258PubMedCrossRef
6.
Zurück zum Zitat Gutke A, Ostgaard HC, Oberg B (2006) Pelvic girdle pain and lumbar pain in pregnancy: a cohort study of the consequences in terms of health and functioning. Spine 31:E149–E155PubMedCrossRef Gutke A, Ostgaard HC, Oberg B (2006) Pelvic girdle pain and lumbar pain in pregnancy: a cohort study of the consequences in terms of health and functioning. Spine 31:E149–E155PubMedCrossRef
7.
Zurück zum Zitat Gutke A, Ostgaard HC, Oberg B (2008) Predicting persistent pregnancy-related low back pain. Spine 33:E386–E393PubMedCrossRef Gutke A, Ostgaard HC, Oberg B (2008) Predicting persistent pregnancy-related low back pain. Spine 33:E386–E393PubMedCrossRef
8.
Zurück zum Zitat Hansen A, Jensen DV, Larsen EC, Wilken-Jensen C, Kaae BE, Frolich S, Thomsen HS, Hansen TM (2005) Postpartum pelvic pain––the “pelvic joint syndrome”: a follow-up study with special reference to diagnostic methods. Acta Obstet Gynecol Scand 84:170–176PubMedCrossRef Hansen A, Jensen DV, Larsen EC, Wilken-Jensen C, Kaae BE, Frolich S, Thomsen HS, Hansen TM (2005) Postpartum pelvic pain––the “pelvic joint syndrome”: a follow-up study with special reference to diagnostic methods. Acta Obstet Gynecol Scand 84:170–176PubMedCrossRef
9.
Zurück zum Zitat Hansen A, Jensen DV, Wormslev M, Minck H, Johansen S, Larsen EC, Wilken-Jensen C, Davidsen M, Hansen TM (1999) Symptom-giving pelvic girdle relaxation in pregnancy. II: symptoms and clinical signs. Acta Obstet Gynecol Scand 78:111–115PubMedCrossRef Hansen A, Jensen DV, Wormslev M, Minck H, Johansen S, Larsen EC, Wilken-Jensen C, Davidsen M, Hansen TM (1999) Symptom-giving pelvic girdle relaxation in pregnancy. II: symptoms and clinical signs. Acta Obstet Gynecol Scand 78:111–115PubMedCrossRef
11.
Zurück zum Zitat Kristiansson P, Svardsudd K, von Schoultz B (1996) Serum relaxin, symphyseal pain, and back pain during pregnancy. Am J Obstet Gynecol 175:1342–1347PubMedCrossRef Kristiansson P, Svardsudd K, von Schoultz B (1996) Serum relaxin, symphyseal pain, and back pain during pregnancy. Am J Obstet Gynecol 175:1342–1347PubMedCrossRef
12.
Zurück zum Zitat Laslett M, Young SB, Aprill CN, McDonald B (2003) Diagnosing painful sacroiliac joints: a validity study of a McKenzie evaluation and sacroiliac provocation tests. Aust J Physiother 49:89–97PubMed Laslett M, Young SB, Aprill CN, McDonald B (2003) Diagnosing painful sacroiliac joints: a validity study of a McKenzie evaluation and sacroiliac provocation tests. Aust J Physiother 49:89–97PubMed
13.
Zurück zum Zitat Mens JM, Vleeming A, Stoeckart R, Stam HJ, Snijders CJ (1996) Understanding peripartum pelvic pain. Implications of a patient survey. Spine 21:1363–1369 discussion 1369–1370PubMedCrossRef Mens JM, Vleeming A, Stoeckart R, Stam HJ, Snijders CJ (1996) Understanding peripartum pelvic pain. Implications of a patient survey. Spine 21:1363–1369 discussion 1369–1370PubMedCrossRef
14.
Zurück zum Zitat Mogren IM (2006) BMI, pain and hyper-mobility are determinants of long-term outcome for women with low back pain and pelvic pain during pregnancy. Eur Spine J 15:1–10CrossRef Mogren IM (2006) BMI, pain and hyper-mobility are determinants of long-term outcome for women with low back pain and pelvic pain during pregnancy. Eur Spine J 15:1–10CrossRef
15.
Zurück zum Zitat Nilsson-Wikmar L, Holm K, Oijerstedt R, Harms-Ringdahl K (2005) Effect of three different physical therapy treatments on pain and activity in pregnant women with pelvic girdle pain: a randomized clinical trial with 3, 6, and 12 months follow-up postpartum. Spine 30:850–856PubMedCrossRef Nilsson-Wikmar L, Holm K, Oijerstedt R, Harms-Ringdahl K (2005) Effect of three different physical therapy treatments on pain and activity in pregnant women with pelvic girdle pain: a randomized clinical trial with 3, 6, and 12 months follow-up postpartum. Spine 30:850–856PubMedCrossRef
16.
Zurück zum Zitat Noren L, Ostgaard S, Johansson G, Ostgaard HC (2002) Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up. Eur Spine J 11:267–271PubMedCrossRef Noren L, Ostgaard S, Johansson G, Ostgaard HC (2002) Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up. Eur Spine J 11:267–271PubMedCrossRef
17.
Zurück zum Zitat Ostgaard HC, Roos-Hansson E, Zetherstrom G (1996) Regression of back and posterior pelvic pain after pregnancy. Spine 21:2777–2780PubMedCrossRef Ostgaard HC, Roos-Hansson E, Zetherstrom G (1996) Regression of back and posterior pelvic pain after pregnancy. Spine 21:2777–2780PubMedCrossRef
18.
Zurück zum Zitat Ostgaard HC, Zetherstrom G, Roos-Hansson E (1994) The posterior pelvic pain provocation test in pregnant women. Eur Spine J 3:258–260PubMedCrossRef Ostgaard HC, Zetherstrom G, Roos-Hansson E (1994) The posterior pelvic pain provocation test in pregnant women. Eur Spine J 3:258–260PubMedCrossRef
19.
Zurück zum Zitat Ostgaard HC, Zetherstrom G, Roos-Hansson E, Svanberg B (1994) Reduction of back and posterior pelvic pain in pregnancy. Spine 19:894–900PubMedCrossRef Ostgaard HC, Zetherstrom G, Roos-Hansson E, Svanberg B (1994) Reduction of back and posterior pelvic pain in pregnancy. Spine 19:894–900PubMedCrossRef
20.
Zurück zum Zitat Ransford A, Cairns D, Mooney V (1976) The pain drawing as an aid to the psychological evaluation of patients with low-back pain. Spine 1:127–134CrossRef Ransford A, Cairns D, Mooney V (1976) The pain drawing as an aid to the psychological evaluation of patients with low-back pain. Spine 1:127–134CrossRef
21.
Zurück zum Zitat Rost CC, Jacqueline J, Kaiser A, Verhagen AP, Koes BW (2006) Prognosis of women with pelvic pain during pregnancy: a long-term follow-up study. Acta Obstet Gynecol Scand 85:771–777PubMedCrossRef Rost CC, Jacqueline J, Kaiser A, Verhagen AP, Koes BW (2006) Prognosis of women with pelvic pain during pregnancy: a long-term follow-up study. Acta Obstet Gynecol Scand 85:771–777PubMedCrossRef
22.
Zurück zum Zitat Sturesson B, Uden G, Uden A (1997) Pain pattern in pregnancy and “catching” of the leg in pregnant women with posterior pelvic pain. Spine 22:1880–1883PubMedCrossRef Sturesson B, Uden G, Uden A (1997) Pain pattern in pregnancy and “catching” of the leg in pregnant women with posterior pelvic pain. Spine 22:1880–1883PubMedCrossRef
23.
Zurück zum Zitat To WW, Wong MW (2003) Factors associated with back pain symptoms in pregnancy and the persistence of pain 2 years after pregnancy. Acta Obstet Gynecol Scand 82:1086–1091PubMedCrossRef To WW, Wong MW (2003) Factors associated with back pain symptoms in pregnancy and the persistence of pain 2 years after pregnancy. Acta Obstet Gynecol Scand 82:1086–1091PubMedCrossRef
24.
Zurück zum Zitat Turgut F, Turgut M, Cetinsahin M (1998) A prospective study of persistent back pain after pregnancy. Eur J Obstet Gynecol Reprod Biol 80:45–48PubMedCrossRef Turgut F, Turgut M, Cetinsahin M (1998) A prospective study of persistent back pain after pregnancy. Eur J Obstet Gynecol Reprod Biol 80:45–48PubMedCrossRef
25.
Zurück zum Zitat Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B (2008) European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J 17:794–819PubMedCrossRef Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B (2008) European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J 17:794–819PubMedCrossRef
Metadaten
Titel
Self-administered tests as a screening procedure for pregnancy-related pelvic girdle pain
verfasst von
Monika Fagevik Olsén
Annelie Gutke
Helen Elden
Charlotte Nordenman
Lina Fabricius
Melissa Gravesen
Anette Lind
Gunilla Kjellby-Wendt
Publikationsdatum
01.08.2009
Verlag
Springer-Verlag
Erschienen in
European Spine Journal / Ausgabe 8/2009
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-009-0948-2

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