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BACKGROUND: During pregnancy, many pregnant women experience lumbopelvic pain due to mechanical, systemic, and hormonal reasons and this pain and fear of movement (kinesiophobia) causes daily life limitations. OBJECTIVE: To examine low back pain (LBP), kinesiophobia, disability, and related conditions that develop together during pregnancy. METHODS: The was a cross-sectional and analytical study. The presence, severity, and duration of pain in the lumbopelvic region were questioned. Postpartum LBP was evaluated using a self-administered questionnaire, disability using the Oswestry Disability Index (ODI), pain intensity using a visual analog scale (VAS), physical activity levels using the physical activity level during pregnancy questionnaire and the international physical activity questionnaire short form, and kinesiophobia was evaluated using the Tampa Scale for Kinesiophobia. RESULTS: The study comprised 120 pregnant women with a mean age of 27.4 ± 6.1 years. It was observed that 42.3% of the pregnant had LBP (n = 69). The mean body mass index (BMI) was 73.6 ± 16.2 kg/m2, and the mean VAS score was 5.5 ± 2 cm. When we divided the group according to the presence of LBP, age (p = 0.49), gestational week (p = 0.75), and gravida (p = 0.81) were similar. BMI (p = 0.038) and ODI scores (p < 0.001) were higher in the group with LBP. CONCLUSION: LBP in pregnant women has a higher frequency than in the normal population, regardless of age, gestational week, and gravida. Obesity appears to be a risk factor for LBP and increases disability. Kinesiophobia in pregnant women is significantly associated with obesity and disability. Unless there are contraindications, a physically active pregnancy process and regular exercise should be recommend. [ABSTRACT FROM AUTHOR] more...

Introduction: Lumbopelvic pain (LPP) is common in pregnant women and has a significant negative effect on physical and psychological health. In this study, for the first time, we conduct a meta‐analysis to estimate the overall prevalence of LPP among pregnant women and clarify the reasons for the differences in the estimated results. Material and methods: A systematic search of four databases (PubMed, Embase, Web of Science and Cochrane Central Register of Controlled Trials) was conducted from inception until October 2022. Two reviewers conducted a methodological quality assessment. Random‐effects model analysis was used to estimate the pooled prevalence and the 95% confidence interval. Chi‐square tests and I2‐values were used to assess the heterogeneity. Subgroup analysis (according to the participants' continent, age, body mass index [BMI], gestational age and study risk of bias), sensitivity analysis and random‐effects meta‐regression were used to explore the the sources of heterogeneity. Results: Of the 1661 unique citations, 38 studies (21 533 pregnant participants) were included in this systematic review and meta‐analysis. The overall pooled prevalence of LPP during pregnancy was 63% (95% CI: 0.57 to 0.69), with significant heterogeneity (I2 = 99.1%, P < 0.001). The prevalence differed by participants' continents, 71% (North America), 74% (South America), 63% (Asia), 64% (Europe), 59% (Africa) and 45% (Oceania). The prevalence differed by BMI, 64% (BMI <25), 64% (25 ≤ BMI ≤ 28), and 71% (BMI >28). The prevalence differed by age, 72% (age <25 years), 58% (25 ≤ age ≤ 30 years), and 69% (age >30 years). The prevalence were the same differed by study risk of bias, 63% (both low and moderate risk of bias studies). The prevalence were similar by gestational age, 62% (second trimester) and 63% (third trimester). Conclusions: Lumbopelvic pain during pregnancy is common; about three‐fifths of pregnant women experience LPP. More prevention and intervention research for lumbopelvic should be conducted in pregnant women with different clinical characteristics. [ABSTRACT FROM AUTHOR] more...

Introduction and hypothesis: Postpartum lumbopelvic pain (PLPP) is common among women. Abdominal, diaphragm, and pelvic floor muscles (PFMs) modulate intraabdominal pressure as a part of the force closure mechanism. These muscles are exposed to changes during pregnancy that compromise the force closure mechanism. It was hypothesized that abdominal and PFMs activity, the direction of bladder base displacement, diaphragm thickness, and excursion might differ between women with and without PLPP during respiratory and postural tasks. Methods: Thirty women with and 30 women without PLPP participated in this case–control study. Ultrasound imaging was used to assess the abdominal, diaphragm, and PFMs during rest, active straight leg raising (ASLR) with and without a pelvic belt, and deep respiration. Results: The bladder base descent was significantly greater in the PLPP group than in the controls during deep respiration and ASLR without a belt (p = 0.026; Chi-squared = 6.40). No significant differences were observed between the groups in the abdominal muscles activity and diaphragm muscle thickness. There was a significant interaction effect of the group and the task for diaphragm excursion (F (2, 116) = 6.08; p = 0.00) and PFM activity (F (2, 116) = 5.22; p = 0.00). In the PLPP group, wearing a belt compromised altered PFM activation and direction of bladder base displacement. Conclusion: The PFM activity, direction of bladder base displacement, and diaphragm excursion differed between groups during postural and respiratory tasks. Therefore, it is recommended to involve retraining of the PFMs and diaphragm muscle in the rehabilitation of women with PLPP. [ABSTRACT FROM AUTHOR] more...

Objectives: Lumbopelvic pain (LPP) is a very common cause of discomfort during pregnancy, but its etiology remains unclear. The association between abdominal muscle thickness and LPP in pregnant women has not been studied extensively, despite the significant abdominal changes that occur during pregnancy. This study aimed to examine the relationship between abdominal muscle thickness and LPP in pregnant women. Methods: In this study, 49 pregnant women in their second trimester participated. The intensity of LPP was assessed using a numerical rating scale. Ultrasound imaging was used to measure the thickness of abdominal muscles, including the rectus abdominis, external oblique, internal oblique, and transversus abdominis muscles. Participants were classified into two groups, the LPP group and non‐LPP group, and the abdominal muscle thickness was compared between the two groups. The statistical significance level was set at P <.05. Results: There were 24 and 25 participants in the LPP and non‐LPP groups, respectively. Internal oblique (IO) thickness was significantly thinner in the LPP group than in the non‐LPP group (5.4 ± 0.2 mm versus 6.1 ± 0.2 mm; P =.042). Multivariate logistic regression analysis showed that IO thickness was significantly associated with LPP (odds ratio, 0.516; 95% confidence interval, 0.284–0.935; P =.019). Conclusions: This study suggested that LPP in second trimester pregnancy might be related to IO thickness. Further longitudinal studies are needed to understand the role of this muscle as an LPP risk factor for pregnant women. [ABSTRACT FROM AUTHOR] more...

Globally, musculoskeletal lumbopelvic pain (LPP) predominates among women. This high predominance of LPP is attributed to the complex interaction of biomechanical, psychological, and social factors among women. The deleterious effect of LPP has increased the likelihood of LPP-care seeking among women. The need for care seeking is influenced by a person's perception, beliefs, and attitude toward pain; which in turn, is framed by his/her culture and community. Thus, this qualitative research aimed to seek insights into LPP-care seeking behaviors among women from Indian cultural background. Semi-structured interviews were administered among 18 women living in urban as well as semi-urban areas of North India. Analysis of interview scripts lead to generation of three themes: LPP-care seeking behavior, non-adherence to LPP rehabilitation and barriers to LPP rehabilitation. LPP-care seeking behavior was influenced by unawareness about physiotherapy (PT), self-help practices and beliefs about LPP. We also found that lack or incomplete knowledge incite false assumptions, resulted in non-adherence in LPP rehabilitation. In addition, unsupportive family, lack of time, and difficulty in memorizing LPP exercises were the cultural, work, and old age-related barriers to LPP-care seeking, respectively. [ABSTRACT FROM AUTHOR] more...

Objectives: In this study, we aimed to clarify the impact of a Pilates-based therapeutic exercise on disability, pain, mood, and sleep quality in patients with pregnancy-related lumbopelvic pain (LPP), Patients and methods: In the single-blinded randomized controlled study conducted between January 2018 and June 2018, 34 pregnant women (mean age: 29.7±6.2 years; range, 18 to 40 years) in the second trimester (week 14-24) with LPP were randomly assigned to a control group and a Pilates group. All patients underwent usual prenatal care. In addition, the selected Pilates exercise was carried out twice a week for 60-min per session for 12 weeks in the Pilates group. The control group was not prescribed an exercise regimen; however, they were not discouraged from exercising. The primary outcome was disability; secondary outcomes were LPP, mood, and sleep quality. Disability [Roland-Morris Disability Questionnaire (RMDQ)], LPP [Visual Analog Scale (VAS)], mood [Hospital Anxiety and Depression Scale, Anxiety (HADS-A) and Depression (HADS-D) subscales], and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were measured before and after 12 weeks. Adverse effects and adherence were recorded to determine exercise safety and compliance. The intention-to-treat analysis was applied. Results: The between-group effect sizes were moderate for the RMDQ and VAS scales (d=0.4 and d=0.7, respectively) and small for the HADS-A and HADS-D scales (both d=0.2). The intention-to-treat analysis demonstrated that there was a statistically significant difference in disability, pain, and mood in favor of the Pilates group (p<0.05). There was no significant difference between the two groups in terms of the PSQI (p>0.05). Conclusion: Adding Pilates to usual prenatal care should be considered a promising treatment option for pregnancy-related LPP. [ABSTRACT FROM AUTHOR] more...

Copyright of Journal of Nursology is the property of Ataturk University Coordinatorship of Scientific Journals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Copyright of Istanbul Gelisim University Journal of Health Sciences / İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi is the property of Istanbul Gelisim Universitesi Saglik Bilimleri Yuksekokulu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) more...

Background: Although lumbopelvic muscle stiffness is commonly clinically assessed in women with chronic pelvic pain (CPP), it has not been objectively quantified in this population, and its association with other pain-related impairments has not yet been established. Objective: To compare superficial lumbopelvic muscle stiffness in women with and without CPP. In addition, pressure pain threshold (PPT) was compared between groups and the associations between muscle stiffness and PPT were assessed in women with CPP. Study Design: Case-control. Methods: Muscle stiffness and PPT of 11 lumbopelvic muscles were assessed in 149 women with CPP and 48 asymptomatic women. Subjective outcome measures, including pelvic floor function, health history, and psychosocial outcomes, were collected before muscle stiffness and PPT measurements. Analysis of covariance was used to compare muscle stiffness differences between groups, and independent t-tests were used to compare PPT between groups. Associations between measurements of PPT and muscle stiffness were calculated using correlation analysis. Results: Five of the 11 muscles measured were significantly stiffer in women with CPP than those without CPP (p < 0.05). PPT was significantly decreased in all muscles measured in women with CPP; however, there was not a significant association between muscle stiffness and PPT in women with CPP. Conclusion: The study identified the abdominal lumbopelvic muscles that have increased stiffness in women with CPP compared to asymptomatic women. In addition, muscle stiffness and PPT are two distinct impairments within this population. The results suggest that women with CPP have peripheral muscle impairments, which may be addressed without intravaginal or intrarectal intervention. Clinical Trial Registration: NCT04851730. [ABSTRACT FROM AUTHOR] more...

Abstract Background About 50% of women experience lumbopelvic pain (LBPP) during their pregnancy. LBPP has negative repercussions on sleep, social and sexual life, physical and work capacity, and psychological health and contributes to physical inactivity. The benefits of LBPP prevention or treatment in pregnant women through specific exercises should therefore be further investigated. This study protocol has been designed to establish the feasibility of implementing motor control exercise program with pregnant women presenting with a history of LBPP. Methods/design Forty pregnant women with a history of LBPP will be recruited and randomly allocated to a control (20 participants) or intervention (20 participants) group. The control group will receive standard prenatal care, including basic information on what to do when suffering from LBPP. The intervention group will participate in three 40-min exercise sessions per week from < 20 weeks until 34–36 weeks of gestation: one supervised group session via the Zoom platform (once a month, this session will take place at the Université du Québec à Trois-Rivières) and two unsupervised sessions at home. A motor control exercise program will be developed to target strengthening of the lumbo-pelvic-hip core muscles and improve spinal and pelvic stabilization. Participants of this group will also receive standard prenatal care. Women of the control group will receive after 6 weeks postpartum an exercise program designed to reduce LBPP they may have developed during pregnancy and that may persist after delivery. Primary outcomes will be participants’ recruitment, retention and adherence rates, safety, and acceptability of the intervention. Secondary outcomes will include LBPP incidence, frequency, and intensity, as well as self-reported functional disability, physical activity levels, fear avoidance behavior, anxiety, and depression. Discussion This study will inform the feasibility of conducting a full-scale randomized controlled study to test the effectiveness of a motor control exercise program on the prevention and treatment of LBPP in women with a history of LBPP. Adequate prevention and treatment of pregnant women with a history of LBPP should help limit the recurrences of LBPP or the aggravation of its intensity during pregnancy. Trial registration US National Institutes of Health Clinical Trials registry NCT04253717 April 27, 2021. more...

Abstract Background Postpartum septic symphysitis (PPSS) is defined as acute onset of severe pain around the symphysis, restricted movement, fever, and elevated inflammatory parameters. It is a rare but serious condition requiring urgent diagnosis and treatment. The aim of this study was to describe the incidence, symptoms, diagnosis, treatment, and long-term follow-up of PPSS. Methods This follow-up study included 19 out of 21 women diagnosed with PPSS from 1989 to 2017 at one tertiary care hospital in Sweden. Clinical data were retrieved from hospital records and compared to those retrieved from a regional registry. Women completed a postal questionnaire, and those who reported lumbopelvic pain (LPP) were offered a clinical examination. Results 1) PPSS was diagnosed after a normal postpartum period of 24 to 50 h by blood tests (n = 19/19), ultrasonography (n = 9 /19), computer tomography (n = 8/19) or magnetic resonance imaging (n = 16/19) Treatment included aspiration of symphyseal abscesses, i.v. antibiotics and different physiotherapeutic interventions. Women with PPSS more frequently were primiparous (n = 14/19, p = 0.001), had an instrumental delivery (n = 14/19, p = 0.003), longer time of active labour (p = 0.01) and second stage of labour (p = 0.001) than women in the regional registry. 2) Ten out of 19 (52%) women reported LPP at follow-up. These women more often suffered impaired function related to LPP (Pelvic Girdle Questionnaire, 27 versus 0, p more...

Background: Countless women experience lumbopelvic pain (LBPP) after pregnancy. Physical activity is revealed as a beneficial procedure to alleviate LBPP, yet it appears that individual investigations report mixed conclusions about its effectiveness. Objective: This systematic review and meta-analysis examined the impact of stabilizing exercises on pain intensity, disability, and quality of life (QoL) in postpartum women. Data sources : A systematic search was conducted in PubMed, MEDLINE, Google Scholar, Scopus, and reference lists of included studies up to September, 2021. Study selection: Eleven studies comprising 623 participants were included and analyzed using a random-effects model. Results: Data displayed that stabilizing exercises significantly reduced pain (standard mean difference; SMD: −0.76, 95% confidence interval (CI): −1.26 to −0.27, p =.002), and disability (SMD: −1.19, 95% CI: −1.7 to −0.68, p <.001). However, our study found no significant change in QoL following stabilizing exercises (MD: 4.42, 95% CI: −5.73, 14.57, p =.39). Conclusion: Our systematic review and meta-analysis demonstrated that stabilizing interventions had some benefits in postpartum women. While there is some evidence to display the efficacy of stabilizing exercises for relieving LBPP, additional longer-term and high-quality studies are required to confirm the current findings. [ABSTRACT FROM AUTHOR] more...

ABSTRACT BACKGROUND: Back pain is a normal symptom during pregnancy and is expected to become worse beyond the first three months after childbirth. OBJECTIVES: To determine the effectiveness of wearing unstable shoes instead of conventional shoes, regarding pain intensity, low back mobility and stability, among women with lumbopelvic pain (LPP) during the postpartum period. DESIGN AND SETTING: Prospective, single-blinded, randomized clinical trial conducted at a podiatry and physiotherapy clinical center. METHODS: A nine-week program of wearing either unstable shoes (A) or conventional shoes (B) was implemented. The following outcomes were measured in three assessments: pain intensity, using a visual analogue scale (VAS); low-back mobility, using a modified Schober test; and stability, using a pressure platform. RESULTS: The lateral stability speed, anterior stability speed and anterior center of pressure (COP) showed significant (P < 0.05) decreases in the unstable shoes group after nine weeks, in relation to the conventional group. Intra-group measurements showed significant differences (P < 0.05) in VAS between the second and third assessments and between the first and third assessments in both groups. Intra-group evaluations also showed statistically significant differences (P < 0.05) in the lateral stability speed and anterior stability speed. CONCLUSIONS: Unstable shoes were effective in decreasing the pain intensity at five and nine weeks in women with postpartum LPP. In addition, their use produced decreases in lateral stability speed, anterior stability speed and anterior COP at nine weeks. more...

Abstract Background Lumbopelvic pain (LPP) is common during pregnancy and can have long-lasting negative consequences in terms of disability and reduced quality of life. Therefore, it is crucial to identify women at risk of having pregnancy-related LPP after childbirth. This study aimed to investigate the association between body perception, pain intensity, and disability in women with pregnancy-related LPP during late pregnancy and postpartum, and to study whether a disturbed body perception during late pregnancy predicted having postpartum LPP. Methods A prospective cohort study in 130 primiparous women (median age = 30 years) was performed. Pain intensity, disability, and lumbopelvic body perception during the last month of pregnancy and 6 weeks postpartum were assessed with the Numerical Pain Rating Scale (NPRS), Oswestry Disability Index, and Fremantle Back Awareness Questionnaire, respectively. Having pregnancy-related LPP was defined as an NPRS score ≥ 1/10. At both timepoints, women were categorized into three groups; pain-free, LPP with low disability, and LPP with high disability (based on Oswestry Disability Index scores). At each timepoint, body perception was compared between groups, and correlations between body perception, pain intensity, and disability were evaluated in women with LPP by using non-parametric tests. Logistic regression analysis was used to determine whether body perception during the last month of pregnancy predicted the presence of LPP 6 weeks postpartum. Results Women with LPP at the end of pregnancy, and 6 weeks postpartum reported a more disturbed body perception compared to pain-free women (p ≤ 0.005). Greater body perception disturbance correlated with higher pain intensity (σ = 0.266, p = 0.008) and disability (σ = 0.472, p more...

Background: About 50% of women experience lumbopelvic pain (LBPP) during their pregnancy. LBPP has negative repercussions on sleep, social and sexual life, physical and work capacity, and psychological health and contributes to physical inactivity. The benefits of LBPP prevention or treatment in pregnant women through specific exercises should therefore be further investigated. This study protocol has been designed to establish the feasibility of implementing motor control exercise program with pregnant women presenting with a history of LBPP. Methods/design: Forty pregnant women with a history of LBPP will be recruited and randomly allocated to a control (20 participants) or intervention (20 participants) group. The control group will receive standard prenatal care, including basic information on what to do when suffering from LBPP. The intervention group will participate in three 40-min exercise sessions per week from < 20 weeks until 34–36 weeks of gestation: one supervised group session via the Zoom platform (once a month, this session will take place at the Université du Québec à Trois-Rivières) and two unsupervised sessions at home. A motor control exercise program will be developed to target strengthening of the lumbo-pelvic-hip core muscles and improve spinal and pelvic stabilization. Participants of this group will also receive standard prenatal care. Women of the control group will receive after 6 weeks postpartum an exercise program designed to reduce LBPP they may have developed during pregnancy and that may persist after delivery. Primary outcomes will be participants' recruitment, retention and adherence rates, safety, and acceptability of the intervention. Secondary outcomes will include LBPP incidence, frequency, and intensity, as well as self-reported functional disability, physical activity levels, fear avoidance behavior, anxiety, and depression. Discussion: This study will inform the feasibility of conducting a full-scale randomized controlled study to test the effectiveness of a motor control exercise program on the prevention and treatment of LBPP in women with a history of LBPP. Adequate prevention and treatment of pregnant women with a history of LBPP should help limit the recurrences of LBPP or the aggravation of its intensity during pregnancy. Trial registration: US National Institutes of Health Clinical Trials registry NCT04253717 April 27, 2021. [ABSTRACT FROM AUTHOR] more...

Background: Pregnancy leads to some physiological changes and anatomical changes within maternal and developmental fetus. Posterior pelvic pain usually arises in 20% of the pregnant ladies which may become a cause of adductor tightness during third trimester. Objective: The objective of the study was to find out the impact of pelvic pain on hip adductors in pregnant females during third trimester. Study type, settings & duration: A cross sectional study was conducted at Arif Memorial Teaching Hospital, General Hospital Lahore and Dr. Sadia Khan Clinic, Lahore from March to October 2019. Methodology: Total 206 pregnant women were enrolled. A non-probability convenient sampling method was used. Keeping the margin of error 0.05% and level of significance equal to 5%. Pain was measured by pelvic girdle questionnaire and hip adduction was measured by hip adduction test using goniometer. The standard normal range of hip adduction was 25. Results: Pelvic Pain during pregnancy was reported by 66 % of multigravida patients which was 135 out of 206. Data collector and data analyzer were blinded and main methodological problems were avoided by careful study planning to avoid biasness. Hip adduction tightness was up to 16 degree and found in the pregnant ladies; whereas normal range of hip adduction is 20 to 30 degree. Hip adductors tightness mostly found in multigravida patient with the mean age of 29 years. Conclusion: Study concluded that pregnant ladies who suffered from posterior pelvic pain during third trimester can also have hip adductor tightness. more...

Background: Postpartum septic symphysitis (PPSS) is defined as acute onset of severe pain around the symphysis, restricted movement, fever, and elevated inflammatory parameters. It is a rare but serious condition requiring urgent diagnosis and treatment. The aim of this study was to describe the incidence, symptoms, diagnosis, treatment, and long-term follow-up of PPSS.Methods: This follow-up study included 19 out of 21 women diagnosed with PPSS from 1989 to 2017 at one tertiary care hospital in Sweden. Clinical data were retrieved from hospital records and compared to those retrieved from a regional registry. Women completed a postal questionnaire, and those who reported lumbopelvic pain (LPP) were offered a clinical examination.Results: 1) PPSS was diagnosed after a normal postpartum period of 24 to 50 h by blood tests (n = 19/19), ultrasonography (n = 9 /19), computer tomography (n = 8/19) or magnetic resonance imaging (n = 16/19) Treatment included aspiration of symphyseal abscesses, i.v. antibiotics and different physiotherapeutic interventions. Women with PPSS more frequently were primiparous (n = 14/19, p = 0.001), had an instrumental delivery (n = 14/19, p = 0.003), longer time of active labour (p = 0.01) and second stage of labour (p = 0.001) than women in the regional registry. 2) Ten out of 19 (52%) women reported LPP at follow-up. These women more often suffered impaired function related to LPP (Pelvic Girdle Questionnaire, 27 versus 0, p < 0.0001), a poorer health-related quality of life (EuroQol-5 dimensions p = 0.001 and EuroQol-visual analogue scale, 65 mm versus 84 mm, p = 0.022) and higher levels of anxiety and depression (Hospital Anxiety Depression Scale (HADS) HADS-Anxiety, 7 versus 2, p = 0.010; and HADS-Depression, 1 versus 0, p = 0.028) than women with no pain. 3). Of the eight women who were clinically assessed, one had lumbar pain and seven had pelvic girdle pain (PGP).Conclusions: In the largest cohort of patients with PPSS to date, primiparas and women with instrumental vaginal delivery were overrepresented, indicating that first and complicated deliveries might be risk factors. Approximately half of the women reported PGP at follow-up, with considerable consequences affecting health-related quality of life and function decades after delivery. Prospective multicentre studies are needed to establish risk factors, long-term consequences, and adequate treatment for this rare pregnancy complication. [ABSTRACT FROM AUTHOR] more...

Pain syndromes affecting women have a significant global impact. There is increasing evidence that chronic pain affects a higher proportion of women than men around the world; unfortunately, women are less likely to receive treatment. Moreover, women generally experience more recurrent pain, more severe pain and longer-lasting pain than men. Pain conditions are more prevalent in women such as fibromyalgia, chronic pelvic pain and lumbopelvic pain during pregnancy and postpartum. Gender differences in pain sensitivity, pharmacological therapy, and nonpharmacological pain interventions have also been reported. It is becoming evident that gender differences in pain and its relief arise from an interaction of genetic, anatomical, physiological, neuronal, hormonal, psychological and social factors that modulate pain differently. more...

Resumen en Español Introducción El dolor de la cintura pélvica es un problema común durante el embarazo y el posparto con un impacto personal y social significativo. Los estudios que examinan la efectividad de intervenciones para el dolor de la cintura pélvica miden diferentes resultados, lo que dificulta el agrupamiento de los datos en un metanálisis para aumentar la certeza de las medidas del efecto. Un conjunto de resultados principales basado en un consenso puede abordar este problema. Primero, para desarrollar un conjunto de resultados principales, es esencial examinar sistemáticamente los resultados utilizados en los estudios existentes. Objetivo El objetivo de esta revisión sistemática fue identificar, examinar y comparar qué resultados se miden y reportan, y cómo se los miden, en estudios de intervención y revisiones sistemáticas de intervenciones para el dolor de la cintura pélvica y para el dolor lumbopélvico. Método Se realizaron búsquedas en PubMed, Cochrane Library, PEDro y Embase desde el inicio hasta el 11 mayo 2018. Dos revisores seleccionaron independientemente los estudios por título/resumen y texto completo. El desacuerdo se resolvió por discusión. Los resultados reportados y sus instrumentos de medición fueron extraídos por dos revisores independiente. Se evaluó la calidad de informe con dos revisores independientes. Los resultados se agruparon en dominios principales utilizando el filtro OMERACT 2.0. Resultados Se incluyeron 107 artículos: 33 artículos sobre el dolor de la cintura pélvica y 74 artículos sobre el dolor lumbopélvico. Se informaron 46 resultados, principalmente (26/46) en el dominio “Impacto en la vida”. “El Dolor” fue el resultado más frecuente. Los estudios utilizaron diferentes instrumentos para medir los mismos resultados, particularmente para los resultados dolor, función, discapacidad y calidad de vida. Conclusiones Se utiliza una amplia variedad de resultados y mediciones de resultados en estudios sobre el dolor de la cintura pélvica y el dolor lumbopélvico. Los resultados de esta revisión se incluirán en una encuesta Delphi, obtener para llegar a un consenso sobre un conjunto de resultados principales. Este conjunto de resultados principales permitirá una comparación más efectiva entre estudios sobre el dolor de la cintura pélvica, lo que permitirá un análisis más efectivo en la práctica clínica. more...

Objective: To identify factors associated with sick leave due to lumbopelvic pain (LPP) in pregnancy. Design: Prospective cohort study using participants from a randomized controlled trial (RCT) designed to study the effect of exercise during pregnancy on pregnancy related diseases. Setting: St. Olavs Hospital, Trondheim University Hospital and Stavanger University Hospital, April 2007 to December 2009. Subjects: Healthy pregnant women. Main outcome measures: Self-reported sick leave due to LPP in late pregnancy (gestation week 32–36). Results: In total, 532/716 (74%) women reported LPP at 32–36 weeks of pregnancy, and 197/716 (28%) reported sick leave due to LPP. Not receiving job adjustments when needed (Odds ratio, OR with 95% confidence interval, CI, was 3.0 (1.7–5.4)) and having any pain in the pelvic girdle versus no pain (OR 2.7 (1.3–5.6), OR 2.7 (1.4–5.2) and OR 2.2 (1.04–4.8)) for anterior, posterior and combined anterior and posterior pain in the pelvis respectively, were associated with sick leave due to LPP in late pregnancy. Also higher disability, sick listed due to LPP at inclusion and lower education, were significant explanatory variables. There was a trend of reduced risk for sick leave due to LPP when allocated to the exercise group in the original RCT (OR 0.7 (0.4–1.0)). Conclusion: Facilitating job adjustments when required might keep more pregnant women in employment. Furthermore, pain locations in pelvic area, disability, lower education and being sick listed due to LPP in mid pregnancy are important risk factors for sick leave in late pregnancy.Key points Current awareness: More than half of pregnant women are on sick leave during pregnancy and the most frequently reported cause is lumbopelvic pain. This paper adds:Inability to make job adjustments, pain locations in pelvic area, disability and lower education level were the most important risk factors for sick leave in late pregnancy. Facilitating early job adjustment might be a precaution to keep more pregnant women in work. Allocation to an exercise group tended to reduce the risk of sick leave in late pregnancy.Registration number: Clinical trial gov (NCT 00476567). more...

Background: Pregnancy leads to some physiological changes and anatomical changes within maternal and developmental fetus. Posterior pelvic pain usually arises in 20% of the pregnant ladies which may become a cause of adductor tightness during third trimester. Objective: The objective of the study was to find out the impact of pelvic pain on hip adductors in pregnant females during third trimester. Study type, settings & duration: A cross sectional study was conducted at Arif Memorial Teaching Hospital, General Hospital Lahore and Dr. Sadia Khan Clinic, Lahore from March to October 2019. Methodology: Total 206 pregnant women were enrolled. A non-probability convenient sampling method was used. Keeping the margin of error 0.05% and level of significance equal to 5%. Pain was measured by pelvic girdle questionnaire and hip adduction was measured by hip adduction test using goniometer. The standard normal range of hip adduction was 25. Results: Pelvic Pain during pregnancy was reported by 66 % of multigravida patients which was 135 out of 206. Data collector and data analyzer were blinded and main methodological problems were avoided by careful study planning to avoid biasness. Hip adduction tightness was up to 16 degree and found in the pregnant ladies; whereas normal range of hip adduction is 20 to 30 degree. Hip adductors tightness mostly found in multigravida patient with the mean age of 29 years. Conclusion: Study concluded that pregnant ladies who suffered from posterior pelvic pain during third trimester can also have hip adductor tightness. [ABSTRACT FROM AUTHOR] more...

Introduction: Lumbopelvic pain (LPP) is clinically diverse and difficult to treat medical problem. Changes during pregnancy and confinement conduce the appearance of pain complaints. LPP proper differential diagnosis and education constitute the basis of properly selected treatment. The aim of the study was to establish the LPP frequency in pregnant women. Additionally, the daily living activities limitations level was defined. Materials and methods: 211 pregnant women took part in the study. The study was performed with the use of advanced online questionnaire. The research tool consisted of: original questionnaire, International Physical Activity Questionnaire - IPAQ (shortened Polish version) and Oswestry Disability Index (ODI). Results: On the basis of conducted studies, the LPP was diagnosed in majority (80.1%) of tested women. There were statistically significant correlations between the pain intensity and age (p = 0.023, r = -0.16) and education (p = 0.013, r = -0.17). It has been proven that there is a statistically significant correlation between the pain intensity, BMI (p = 0.002, r = 0.22) and physical activity level (p = 0.048, r = 0.14). It has been stated that 65.4% research subjects had no significant limitations in performing daily living activities. Conclusions: The lumbopelvic pain applies to majority of pregnant women in the study. The risk of LPP increases with BMI growth. LPP occurs less frequently in women with higher education and in older ones. In majority of cases LPP does not cause limitations in daily living activities. [ABSTRACT FROM AUTHOR] more...

Objective: To evaluate the effects of a rehabilitation programme for lumbopelvic pain after childbirth. Methods: Women with lumbopelvic pain 3 months postpartum were included in a randomized controlled trial. Patients in the intervention group (n = 48) received pelvic floor muscle training combined with neuromuscular electrical stimulation of the paraspinal muscles for 12 weeks, while patients in the control group (n = 48) received neuromuscular electrical stimulation for 12 weeks. Outcomes were measured with the Triple Numerical Pain Rating Scale (NPRS), Modified Oswestry Disability Questionnaire (MODQ) and Short-Form Health Survey-36 (SF-36). Results: The NPRS score was significantly better in the intervention group at 12 weeks compared with the control group (p = 0.000). The MODQ score was significantly better at 6 and 12 weeks compared with the control group (p = 0.009 and p = 0.015, respectively). The mean value of the Physical Components Summary of the SF-36, was significantly better in the intervention group at 6 weeks (p = 0.000) and 12 weeks (p = 0.000) compared with the control group, but there was no significant improvement in Mental Components Summary of the SF-36. Conclusion: A postpartum programme for women with lumbopelvic pain is feasible and improves the physical domain of quality of life. more...

Background: More than half of the pregnant women are affected by lumbopelvic pain (LPP) in their daily lives. Physical activity (PA) contributes to LPP relief. There are several reports on exercise habits, including the recommended activity intensity (moderate) and time spent (at least three times a week); however, only a few detailed reports on household/child-rearing and occupational activity are available. Therefore, this study explored the relationships between housework/child-rearing, occupational hours, and LPP. Methods: This study included 95 pregnant females who attended an obstetrics and gynecology hospital. The participants were divided into two groups based on the results of an interview on the presence of LPP and classified by intensity or category using the Pregnancy Physical Activity Questionnaire (PPAQ-J). The Wilcoxon signed-rank test was used to compare PA between the two groups. When a significant difference was observed, we performed logistic regression analysis using body mass index (BMI) as an adjustment variable. Results: There were 16 females with LPP and 17 women without LPP in the third trimester. There were significant associations between the PPAQ scores of housework/child-rearing activities and LPP in the third trimester. No significant differences in any category of PPAQ scores were observed between the groups with and without LPP in the first and second trimester of pregnancy. Conclusions: Our study showed the association between PA and LPP in the third pregnancy. Pregnant females with LPP tended to spend more time on housework and child-rearing necessary for their lives. The duration of housework and child rearing should be reduced because of prolonged standing and the burden on the lumbar area. more...

• Convergent validity between PFM tenderness and central pain mechanisms. • Poor agreement between pelvic floor muscle tenderness and self-reported symptoms. • When PFM tenderness on digital palpation is present, screen for central pain mechanisms. Tenderness on palpation of the pelvic floor muscles (PFMs) is a clinical assessment tool used alongside other tests to identify PFM involvement in pelvic complaints including pelvic pain. Although reliability of PFM tenderness has been determined, validity has yet to be established. To assess convergent validity of PFM tenderness on digital palpation with the presence of central pain mechanism, as determined by a score of greater than 40 on the Central Sensitization Inventory (CSI). A secondary objective was to assess the agreement between PFM tenderness and self-reported symptoms of PFM sensitivity. Participants completed a battery of self-report questions, the CSI, and various physical assessments (blinded assessors). Convergent validity was assessed between tenderness on palpation and the CSI. Kappa statistics were used to determine agreement between tenderness on palpation and self-reported perineal pain, urinary urgency, dyspareunia, and dysmenorrhea. Ninety-nine female participants with hip or back pain and at least one self-reported symptom of pelvic floor dysfunction were included in the study (mean age 40.56 ± 12.72 years). Convergent validity was found between PFM tenderness on palpation and scores greater than 40 on the CSI (X 1 2 = 4.2 , p = 0.04). There was poor agreement between tenderness on palpation with dyspareunia (agreement 62.83%, Kappa = 0.27), dysmenorrhea (agreement 55.75%, Kappa = 0.14), or perineal pain (agreement 53.04%, Kappa = 0.10). PFM tenderness on digital palpation confirmed convergent validity with CSI scores, suggesting central pain mechanisms. Clinicians may need to consider the role of central pain mechanisms in their clinical decision making when treating PFM dysfunction. [ABSTRACT FROM AUTHOR] more...

Background: Lumbopelvic pain (LPP) is common during pregnancy and can have long-lasting negative consequences in terms of disability and reduced quality of life. Therefore, it is crucial to identify women at risk of having pregnancy-related LPP after childbirth. This study aimed to investigate the association between body perception, pain intensity, and disability in women with pregnancy-related LPP during late pregnancy and postpartum, and to study whether a disturbed body perception during late pregnancy predicted having postpartum LPP. Methods: A prospective cohort study in 130 primiparous women (median age = 30 years) was performed. Pain intensity, disability, and lumbopelvic body perception during the last month of pregnancy and 6 weeks postpartum were assessed with the Numerical Pain Rating Scale (NPRS), Oswestry Disability Index, and Fremantle Back Awareness Questionnaire, respectively. Having pregnancy-related LPP was defined as an NPRS score ≥ 1/10. At both timepoints, women were categorized into three groups; pain-free, LPP with low disability, and LPP with high disability (based on Oswestry Disability Index scores). At each timepoint, body perception was compared between groups, and correlations between body perception, pain intensity, and disability were evaluated in women with LPP by using non-parametric tests. Logistic regression analysis was used to determine whether body perception during the last month of pregnancy predicted the presence of LPP 6 weeks postpartum. Results: Women with LPP at the end of pregnancy, and 6 weeks postpartum reported a more disturbed body perception compared to pain-free women (p ≤ 0.005). Greater body perception disturbance correlated with higher pain intensity (σ = 0.266, p = 0.008) and disability (σ = 0.472, p < 0.001) during late pregnancy, and with pain intensity 6 weeks postpartum (σ = 0.403, p = 0.015). A disturbed body perception during late pregnancy nearly significantly predicted having postpartum LPP (Odds Ratio = 1.231, p = 0.052). Conclusions: Body perception disturbance was greater in women experiencing LPP during late pregnancy and postpartum compared to pain-free women, and correlated with pain intensity and disability. Though non-significant (p = 0.052), the results of the regression analysis suggest that greater body perception disturbance during late pregnancy might predict having LPP postpartum. However, future studies should follow up on this. [ABSTRACT FROM AUTHOR] more...

Abstract Background Low back pain (LBP) during pregnancy might be strongly related to posture and movements of the body, and its management is a clinically important issue. The purpose of this study was to investigate the activities related to LBP during pregnancy. Methods Participants included 275 women before 12 weeks of pregnancy. The women were evaluated at 12, 24, 30, and 36 weeks of pregnancy. The intensity of LBP was assessed using the Numerical Rating Scale (NRS). Movements related to LBP were investigated by free descriptive answers. Descriptive statistics were used to compile the movements that pregnant women thought induced LBP at each evaluation. Subsequently, a linear regression analysis was performed to evaluate the degree of association of certain movements with LBP using the data of participants who had LBP. The intensity of LBP (NRS score) was specified as the dependent variable, the movements that were related to pain were specified as the independent variables at the analysis. A significance threshold was set at 0.05. Results The final sample used in the analyses was 254, 249, 258, and 245 women at 12, 24, 30, and 36 weeks of pregnancy, respectively. There were 16 kinds of movements that induced LBP and all of them were daily activities rather than special movements that require extra task or effort. As pregnancy progressed, less number of participants attributed pain to a specific movement. At all evaluations, movements, especially sitting up, standing up from a chair, and tossing and turning were thought to be related to LBP. Furthermore, standing up from a chair and tossing and turning were significantly related to LBP throughout the pregnancy. In contrast, lying down and sitting up were significantly related to LBP but the relationship did not continue till late pregnancy. Conclusions Daily routine activity is related to LBP during pregnancy. These results suggest that recommendations for pregnant women about basic physical movements, such as ways of standing up that reduce the load on the body might be useful in the management of LBP. more...

Purpose: The impact of pregnancy on the anterior-posterior sacral orientation and its relation to lumbopelvic pain and weight gain has not been fully recognized. This longitudinal study aimed to compare the sacral inclination angle in women between their early and advanced pregnancy and at 6 months postpartum. The authors also searched for a correlation between the sacral inclination and lumbopelvic pain, BMI and change in body mass. Methods: Thirteen healthy women participated in the study. Data were collected at 8-16 and 35-38 weeks of gestation, and at 27-31.5 postpartum weeks. At each session, the women's sacral inclination angles were measured using the Saunders digital inclinometer. Data were also collected on lumbopelvic pain, BMI and body mass gain/loss. Results: There was no effect of the evaluation period on the sacral inclination (p > 0.05); however, various individual values of the sacral inclination in pregnancy and postpartum were noted. In advanced pregnancy, 61.5% of the women had recurrent pain in the lumbopelvic region. The sacral inclination did not correlate with the lumbopelvic pain, BMI and body mass change (p > 0.05) in the pregnancy and postpartum periods. Conclusions: Advanced pregnancy did not influence sacral inclination. However, individuals varied in their responses. Therefore, we suggest that an individually-based physical therapy approach concerning proper posture during and after pregnancy should be emphasized. The sacral inclination had no impact on the occurrence of recurrent lumbopelvic pain. BMI and changes in body mass did not influence the sacral inclination in advanced pregnancy and at 6 months postpartum. [ABSTRACT FROM AUTHOR] more...

An increased density of ligaments in the lumbopelvic region, that is typical for ligamentopathy, causes redistribution of the stressstrain state of structures in the biomechanical system «lumbar spine - sacrum - sacroiliac joint - pelvis», thereby provoking development of degenerative-dystrophic changes. Proceeding from the above, the concept of conservative treatment for ligamentogenic lumbopelvic pain (LLPP) should provide restoration of the natural density of the ligament and use of structuremodifying medicines. Objective: to develop a biomechanically and pathogenetically based technology for the conservative treatment of LLPP and assess of the efficacy of its use. Methods: 45 patients with LLPP were divided into three groups: I -- extracorporeal shock-wave therapy, II -- dietary supplement «Protecta», III -- integrated treatment with dietary supplement «Protecta» in combination with shock-wave therapy. The patients' condition was assessed before the treatment, after 1 and 3 months following its finishing. Results: reduction of the pain and functional limitations was registered in patients from all the groups. Nevertheless the pain, stiffness and functional insufficiency decreased most significantly in cases from group III. Following 1 and 3 months after the end of their treatment course, these patients' blood serum revealed lower values of destruction in their cartilaginous and osseous tissues as well as a reduced activity of marker enzymes. Biochemical marker values after 1 month following the end of their treatment course in patients from groups I and III were better versus group II, but after 3 months the dynamics of the examined indices were more expressed in groups II and III. Conclusion: the developed technology for conservative treatment of LLPP with use of extracorporeal shock-wave therapy and dietary supplement «Protecta» is effective, as it is confirmed by results of clinical and biochemical studies. [ABSTRACT FROM AUTHOR] more...

Background: Pregnancy related non-specific low back pain (PNSLBP) and pelvic girdle pain (PGP) affect almost half of pregnant women, causing substantial disability for some. These diagnoses, which may represent several possible individual or co-occurring conditions, lack the specificity required to guide personalized treatment decisions. A reliable and valid classification is needed to direct effectiveness research and inform treatment strategies. Objectives: To describe the psychometric properties of pathoanatomic classifications of PNSLBP and PGP as well as to assess the risk of bias of supporting evidence. Methods: Two independent reviewers systematically searched PubMed, Embase, Cochrane and PEDro databases and conducted a manual search of reference list of eligible articles reporting office-based examination for classifying PNSLBP/PGP. QUADAS-2 tool was used to assess the risk of bias and applicability of reviewed studies. Results: Ten studies were eligible. Inter-rater reliability was 87% for PNSLBP and 84.6% for PGP. Major sources of potential bias included the lack of reference standard diagnostic tests, insufficient blinding, non-systematic order of index test application, and unclear participant selection procedures. Patient flow throughout studies and the interval between testing (flow and timing) showed the lowest risk of bias. The applicability of the reference standard had the highest concern, while participant selection and index test had the lowest. Conclusion: Although acceptable inter-rater reliability has been demonstrated, there is no current evidence to support the validity of PNSLBP and PGP classification systems. Future studies should consider including reference standard diagnostic tests, random order sequencing of index tests, rigorous selection criteria, and blinded assessors. [ABSTRACT FROM AUTHOR] more...

Objective: To identify factors associated with sick leave due to lumbopelvic pain (LPP) in pregnancy. Design: Prospective cohort study using participants from a randomized controlled trial (RCT) designed to study the effect of exercise during pregnancy on pregnancy related diseases. Setting: St. Olavs Hospital, Trondheim University Hospital and Stavanger University Hospital, April 2007 to December 2009. Subjects: Healthy pregnant women. Main outcome measures: Self-reported sick leave due to LPP in late pregnancy (gestation week 32–36). Results: In total, 532/716 (74%) women reported LPP at 32–36 weeks of pregnancy, and 197/716 (28%) reported sick leave due to LPP. Not receiving job adjustments when needed (Odds ratio, OR with 95% confidence interval, CI, was 3.0 (1.7–5.4)) and having any pain in the pelvic girdle versus no pain (OR 2.7 (1.3–5.6), OR 2.7 (1.4–5.2) and OR 2.2 (1.04–4.8)) for anterior, posterior and combined anterior and posterior pain in the pelvis respectively, were associated with sick leave due to LPP in late pregnancy. Also higher disability, sick listed due to LPP at inclusion and lower education, were significant explanatory variables. There was a trend of reduced risk for sick leave due to LPP when allocated to the exercise group in the original RCT (OR 0.7 (0.4–1.0)). Conclusion: Facilitating job adjustments when required might keep more pregnant women in employment. Furthermore, pain locations in pelvic area, disability, lower education and being sick listed due to LPP in mid pregnancy are important risk factors for sick leave in late pregnancy. Current awareness: More than half of pregnant women are on sick leave during pregnancy and the most frequently reported cause is lumbopelvic pain. This paper adds: Inability to make job adjustments, pain locations in pelvic area, disability and lower education level were the most important risk factors for sick leave in late pregnancy. Facilitating early job adjustment might be a precaution to keep more pregnant women in work. Allocation to an exercise group tended to reduce the risk of sick leave in late pregnancy.Registration number: Clinical trial gov (NCT 00476567). [ABSTRACT FROM AUTHOR] more...

Background: Lumbopelvic pain (LPP) is one of the most common discomforts during pregnancy. However, few studies have evaluated relation between LPP and gait in pregnancy quantitatively.Research Question: This study aimed to investigate the relation between the LPP and gait characteristics such as symmetry, stability, and the degree of motion during pregnancy.Methods: Gait data were collected for fifty-two pregnant women between the third and tenth month of pregnancy on smooth, horizontal walkway by using inertial measurement sensor units attached to the participants' lumbar. The degrees of trunk movement, movement symmetry, gait variability, and symmetry of rotation were expressed as the root mean square (RMS), autocorrelation peak (AC), coefficient of variance (CV), and the degree of asymmetry at the approximate amount of angular variation (DA) respectively, which were calculated from measured acceleration data and angular velocity data. An independent t-test was performed to investigate differences in these gait parameters between LPP group and pain free group classified according to the presence or absence of the pain, which is evaluated by using a questionnaire. In addition, LPP group was divided into 5 subgroups based on the types of pain, and the differences between the groups were also investigated by using a one way ANOVA.Results: Rotational asymmetry was observed in movement of the roll direction of the LPP patients. The DA of the roll angle of the LPP group was significantly greater than that in the pain free group (0.140 ± 0.093 vs. 0.077 ± 0.053, respectively; p =  0.004). In the analysis of pain complications, the significant difference in DA of roll angle, and CV of yaw angle were observed.Significance: The results indicated that motion asymmetry of both rotation and translation increased significantly in LPP patients' gait. [ABSTRACT FROM AUTHOR] more...

Many women undergo lumbopelvic pain (LPP) during pregnancy. The main factors for LPP are the physical stress related with change of posture and muscle relaxing around pelvis. Also it is thought that movement patterns during daily activity are associated with LPP. Therefore, this paper attempts to investigate the characteristic of movement patterns that have affect LPP during pregnancy. For this purpose, an experiment was conducted to measure standing up and sitting down of pregnant women using inertial sensor unit (IMU), which is simple device and is able to measure motions such as vibration or rotation quantitatively. Then movement evaluation parameters were calculated from measured data of lumber angular velocity. As the movement evaluation parameters, Maximum peak, Minimum peak, Peak to peak (PP: Range between Maximum peak and Minimum peak), Time of PP, PP divided by Time of PP, Root mean square of each parameter, and each parameter divided by Body mass index variation (BMIV) were calculated during both of standing up and sitting down for each of roll, pitch, and yaw angles. Finally, we consider whether there is any relevance between LPP and movement characteristics by comparing the movement evaluation parameters of LPP group with these of non-LPP group. As a result, it appears that Maximum peak, PP and PP/Time of PP of pitch angle during standing up have some relevance to LPP. Additionally, particular features of LPP group in roll and yaw angles and during sitting down were founded by accounting for BMIV to the proposed parameters. more...

Background and aims: Matrix metalloproteinase 9 (MMP9) is an enzyme that may affect degradation of several extracellular matrix (ECM) components in the pelvic ligaments during pregnancy. Previous studies indicate that genetic variations in the gene encoding MMP9 may affect the enzymatic activity. One such genetic variant is a single nucleotide polymorphism (SNP), rs17576 A>G. In this study we investigated whether the MMP9 SNP rs17576 A>G may be associated with increased lumbopelvic pain in 838 pregnant woman. The study was registered with ClinicalTrials.gov (NCT 00476567) on May 21, 2007. Methods: Lumbopelvic pain-intensity was measured by visual analog scale (VAS) at two time points during pregnancy, T1 (18-22 weeks), T2 (32-36 weeks) and 3 months after delivery. Blood samples were collected at each point and SNP genotyping was carried out using predesigned TaqMan SNP genotyping assays. Results: The results showed a significant association between the number of G alleles and pain-intensity in the evening at T2. The pain among G/G carriers was higher than among A/G carriers, which in turn was higher than among the A/A carriers. The most pronounced association between the G allele and pain-intensity was observed in primiparae. Conclusions: We conclude that the MMP9 rs17576 A>G polymorphism is associated with increased lumbopelvic pain-intensity during pregnancy. The present data support the hypothesis that lumbopelvic pain during pregnancy may be related to a relaxin -- MMP9 -- tissue remodeling mechanism. Implications: The present findings may be important for future mechanistic studies on how MMP9 rs17576 A>G may affect changes in the ECM components in pelvic ligaments and lumbopelvic pain-intensity during pregnancy. [ABSTRACT FROM AUTHOR] more...

A treatment program focusing on stabilising exercises for women with pelvic girdle pain after pregnancy showed a very good and long-lasting effect. Stabilising exercises are a common exercise and treatment modality. The aim of this article is to briefly present the treatment program and to review our knowledge concerning stabilising exercises for lumbopelvic pain, further to discuss aspects that may have a positive effect on the outcome. The treatment program consisted of following elements; joint mobilisation, motor control, muscle force, body and emotional awareness. The main focus was on exercises for control and stability of the pelvis. Stabilising exercises should not be at the expense of neuromuscular control and should not cause unnecessary compression forces which could result in increased pain. How the exercises is performed is equally as important as which exercise is chosen. The treatment program should be implemented in clinical practise, but not be limited to one exercise apparatus, one technique, one method, or only to stabilising exercises. more...

Pregnancy is the period when, due to hormonal and structural changes connected with fetal growth, temporary musculoskeletal dysfunctions occur. Pregnancy-related fatigue fractures may be a rare cause of persistent or increasing pain in the sacrum region. [ABSTRACT FROM AUTHOR] more...

STUDY DESIGN: Randomized Clinical Trial. OBJECTIVES: To check the effects of ITB stretching versus the effects of hamstring and abdominal activation on pain levels and ipsilateral hip ROM in people with lumbopelvic pain. BACKGROUND: previous studies have shown the effectiveness of Hot moist pack and Stretching to reduce pain and improve range of motion. Also abdominal and hamstring stretching has shown reduction in lumbopelvic pain. However no studies are available that compare the effects of hamstring and abdominal activation on pain levels and ipsilateral hip ROM and stretching in lumbopelvic pain. METHODS: Thirty individuals with lumbopelvic pain were randomized to intervention group (Group B) and control group (Group A). Patients attended a baseline session, followed by 6 days intervention, and were reassessed at the end of the intervention. Assessment measures used were hip adduction range of motion using smartphone inclinometer app, Visual Analogue Scale and Modified Oswestry Disability Questionnaire (MODQ). RESULTS: Both the groups showed significant improvements in hip addcution range of motion, Pain and on MODQ. When compared, the intervention group showed better results than control group. The results also showed significant differences within the groups post intervention. [ABSTRACT FROM AUTHOR] more...

In general, women appear to report lumbopelvic pain (LPP) more frequently. In addition to the biomechanical risks, this systematic review aimed to identify the add-on biopsychosocial implications of LPP among women in the Indian community. PubMed, ScienceDirect, Web of Science, PEDro, and Google Scholar were searched twice from inception to a final systematic literature search in December 2022. All studies addressing Indian women with LPP were selected. Studies on non-musculoskeletal LPP were excluded. Qualities of non-experimental and experimental research articles were assessed through the Critical Appraisal Skills Programme (CASP) checklist and Cochrane risk of bias criteria for Effective Practice and Organization of Care reviewsrespectively. Data synthesis was narrative as the selected studies differed substantially. Habitual squatting, kneeling, and continuous sitting were identified as ergonomic risks to LPP. Menopause, cesarean, and multiple deliveries influence the onset of LPP among women. There is a severe deficit in data about the musculoskeletal implications of LPP. There are insufficient data present to summarize the biopsychosocial risks of LPP. Even the exact anatomical sites of LPP were not described in most articles. Due to the severe scarcity of data, there is an alarming need to explore the musculoskeletal as well as psychosocial consequences of LPP in Indian women. Among rural women, LPP was common in those working as laborers; which are physically robust jobs with respect to strength and anthropometrics of women. Domestic chores in India involve a lot of manual work; placing unequal loads on the lumbar spine, eventually resulting in LPP. Therefore ergonomic strategies for women should be designed to meet the needs and demands of their respective occupations as well as domestic chores., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Sushil et al.) more...

Abstract: The aims were to study: prevalence of pelvic girdle pain (PGP) one year postpartum; clinical course of PGP, physical functioning (PF) and bodily pain (BP) (from SF-36, 0 (worst) to 100 (best)) from gestation week (GW) 30 to one year postpartum; and whether findings at GW30 were associated with development of PF and BP from GW30 to one year postpartum. 215 pregnant women were followed from GW30 to one year postpartum. Clinical examination and questionnaire were used at GW30, questionnaire only were used at 12 weeks and one year postpartum. The women were categorised by GW30 clinical variables: self-reported PGP, pain locations in the pelvis and response to two clinical tests. Linear mixed models for repeated measures were used to study PF and BP during follow-up, within the categories of clinical variables. PGP prevalence remained unchanged from 12 weeks to one year postpartum (31–30%). PF and BP scores improved markedly from GW30 to 12 weeks postpartum, and marginally thereafter. Median PF scores were 70, 95 and 100 at GW30, 12 weeks and one year postpartum, respectively. Corresponding median BP scores were 52, 84 and 84. We found significant interactions between each clinical variable and time (P ≤ 0.01) for PF and BP. The most afflicted women at GW30 experienced largest improvement. Despite high PGP prevalence one year postpartum, most women recovered in terms of PF and BP scores. Unfavourable clinical course postpartum did not appear to depend on self-reported PGP, pain locations in the pelvis, or response to clinical tests at GW30. [Copyright &y& Elsevier] more...