Girdle Pain Research Articles

Obese Patients With Polymyalgia Rheumatica Experience More Pain And Disability At Disease Onset And Require Higher Doses Of Glucocorticoids.

polymyalgia rheumatica (PMR) is an inflammatory disorder of the elderly characterized by girdle pain and stiffness. Obesity has an influence on disease activity and outcome in rheumatic diseases like osteoarthritis and rheumatoid arthritis, but its relationship to the severity and outcome of PMR is unknown. In a post-hoc analysis, 83 patients with recent-onset PMR were studied over six months with clinical examination, laboratory evaluation, and girdle ultrasound. MHAQ, Short Form 36 (SF36), and PMR-VAS, as well as prednisone (PDN) therapy were recorded. Patients were divided according to their body mass index (BMI). at baseline, the 12 obese patients had significantly more shoulder pain (p=0.03), global pain (p=0.03), PMR VAS (p<0.01), and fatigue (p=0.03), higher MHAQ (p=0.01), and lower physical component summary on SF36 (p=0.048), SF36 social functioning index (p=0.05) and SF36 pain index (p<0.001). The mean initial PDN dose was similar among groups, but obese patients received a lower dose per kg weight (1.9±0.7 mg vs. 2.2±0.7 mg; p<0.01). At six months, obese patients were being treated with higher mean daily PDN doses (8.5±3.2 mg/day vs. 6.2±5.2 mg/day, p=0.02); 40% of them were receiving higher daily PDN dose than per-protocol, vs. 14% non-obese patients (p=0.048). Clinical features, laboratory and ultrasound results were similar. obesity affects both symptoms severity and PDN utilization in patients with PMR. The reason thereof may relate to different subjective pain perception rather than increased inflammation in obese patients. BMI should be considered when interpreting symptoms in PMR patients and deciding their PDN doses.

Dynamometry for the Assessment of Trunk Muscle Strength in Postpartum Women with Pregnancy-Related Posterior Pelvic Girdle Pain: A Reliability Study

ObjectivesTo investigate the inter and intra-rater reliability of maximum isometric trunk muscular strength in postpartum women with pregnancy-related posterior pelvic girdle pain using a handheld dynamometer. MethodsThirty women (30.13 ± 3.67 years) with pregnancy-related posterior pelvic girdle pain (PPGP) had their trunk muscular strength assessed using a handheld dynamometer. Inter-rater reliability was estimated for measurements of two separate raters on the first day of the investigation. The tests were repeated with the first rater seven days later to determine the intra-rater reliability. A digital handheld dynamometer was used for testing, and a metal bar was used to secure it to a table. Participants were instructed to use maximal force to push the dynamometer in various trunk flexion, extension, lateral flexion, and rotational orientations. Each trial was repeated three times and averaged to obtain the representative assessment data. Analysis of variance, interclass correlation, absolute agreement, and standard error of measurements were used to evaluate the repeatability of measurements. ResultsExcellent inter and intra-rater reliability were demonstrated. The inter-rater reliability, computed with intraclass correlation coefficient (ICC), ranged from 0.979 to 0.992, and intra-rater reliability (ICC) ranged from 0.966 to 0.987. The standard error of measurement ranged from 0.35% to 1.26% for the different tests. Additionally, the dynamometer values in women with PPGP might be reported using just one trial after an instruction. ConclusionThe maximum isometric trunk muscular strength is reliable, and a quantitative assessment of the trunk strength in women with postpartum pregnancy-related posterior pelvic girdle pain and could be used to monitor the changes in postural stability between sessions.

Effect of home based tele pilates on pelvic girdle pain and lumbo pelvic stability among pregnant women – A randomized controlled trial

Introduction. Pelvic girdle pain is one of the common musculoskeletal problems in pregnancy, resulting from hormonal variations and biomechanical alterations in the muscles that support lumbo-pelvic stability. The Pilates method, which includes mind-body approaches and focuses on core strength, provides relief from pelvic pain. In recent years, tele-rehabilitation has emerged as one of the most popular solutions in clinical practice. Aim. To find out the effect of home-based Tele Pilates on pelvic girdle pain and lumbo-pelvic stability among pregnant women. Materials and methods. A randomized controlled trial was conducted in Sri Ramachandra Hospital, Chennai, from January 2023 to June 2023. Pregnant women with pelvic girdle pain from 20-30 weeks of gestation were screened and randomly divided into a Pilates exercise group (n = 19) and a control group (n = 19). Subjects in the Pilates group followed the exercise thrice a week for eight weeks. Subjects in the control group followed standardized antenatal exercises and education. The outcome measures used were Visual Analogue Scale (VAS) for pain level, Pelvic Girdle Questionnaire (PGQ) for functional disability, and Pressure Biofeedback for lumbo-pelvic stability. Mann-Whitney test, Wilcoxon signed rank test, and ‘t’ test were performed to examine the pain score, Pelvic Girdle Questionnaire, and the lumbo-pelvic stability. Results. Baseline parameters are similar and comparable. (p &lt; 0.05). Between-group analysis revealed that the experimental group showed improvement in the pain and disability with a significant difference (p ≤ 0.001). Both groups showed significant improvement in lumbo-pelvic stability in the within-group analysis (p &lt; 0.001). Conclusion. Home-based tele Pilates (HTPE) can be recommended as an effective and safe method for decreasing pain levels and improving lumbo-pelvic stability among pregnant women with pelvic girdle pain.

Investigating postural control as a predictor of low back and pelvic girdle pain during and after pregnancy

BackgroundFalls are common during pregnancy, posing risks to maternal and fetal health. Pregnant individuals also commonly experience low back and/or pelvic girdle pain. Other populations with pain, such as older adults with back pain demonstrate increased fall risk. This study assessed the relationship between standing balance control characteristics during single leg stance and low back/pelvic girdle pain scores during and after pregnancy with eyes open and closed. We hypothesized that standing balance control characteristics of smaller sway and sway velocity would be related to greater low back/pelvic girdle pain during the third trimester. MethodsDuring the second trimester, third trimester, and postpartum nineteen individuals performed single leg stance on a force platform with eyes open and closed and completed the Quebec Back Pain Disability Scale. Stepwise multiple linear regressions were used to investigate the variance of Quebec Back Pain Disability Scale scores that could be explained by postural control variables for each time point and condition. FindingsDuring the third trimester, decreased total sway and anterior/posterior sway range with eyes closed were significantly associated with higher low back/pelvic girdle pain disability scores (P = 0.005, R2 = 0.480). No significant relationships were found during the second trimester or postpartum nor for eyes open conditions. InterpretationThis study suggests a potential association between low back/pelvic girdle pain and postural control during pregnancy. Pregnant individuals with lumbopelvic pain may demonstrate postural stability deficits, particularly without visual input. Balance assessments and interventions should be considered during routine care for pregnant individuals, especially for those with pain.

Validity and reliability of the Polish version of the Pregnancy Mobility Index (PMI-PL).

Mobility, defined as active, controlled, multi-joint flexibility used in movement, is limited in pregnant women due to problems with low back pain (LBP) and pelvic girdle pain (PGP). The Pregnancy Mobility Index (PMI) is a tool for assessing mobility in relation to LBP/PGP. The lack of a Polish version of the PMI test prompted a transcultural adaptation to the Polish conditions. The aim of the study was to evaluate the measurement properties of the Polish adaptation of the Pregnancy Mobility Index. The study involved 121 pregnant women aged 18-44. The translation process was in accordance with the transcultural adaptation design. Reliability was assessed by intraclass correlation coefficient (ICC). Construct validity between the Polish version of the PMI (PMI-PL) and the Physical Activity Pregnancy Questionnaire (PPAQ-PL) was assessed by Spearman's rank correlation coefficient. The transcultural adaptation of the PMI test into Polish was satisfactory, with high internal consistency (Cronbach's alpha = 0.97-0.98, ICC = 0.989). Statistically significant inverse proportional correlations were found for total PA, total PA (light and above), light PA, moderate PA, and vigorous PA in the construct validity analysis between PMI-PL and PPAQ-PL. The Polish version of the PMI is a reliable instrument. The introduction of a questionnaire with a classification system will make it easier for health professionals to monitor the health status of pregnant women and encourage them to engage in physical activity appropriate for their current level of mobility.

Real-world outcomes of a dedicated fast-track polymyalgia rheumatica clinic.

To examine the clinical impact of a fast-track PMR clinic to enable early diagnosis and treatment, and to define both patient and disease characteristics in newly diagnosed PMR. Primary care physicians were invited to refer patients with new PMR to our fast-track clinic. Referral criteria included new onset shoulder or pelvic girdle pain and/or stiffness with elevated inflammatory markers in patients over 50 years. All patients were seen within 72 h of referral. Patients with a rheumatology diagnosis of PMR had an ultrasound (US) of their temporal and axillary arteries. 172 patients were referred from primary care over 12 months. 39% of patients referred with suspected PMR had an alternative diagnosis for which PMR regimen glucocorticoids was inappropriate. 55% of the non-PMR diagnoses were other inflammatory rheumatological conditions requiring follow-up. Only 20% of patients referred from primary care already on glucocorticoids were commenced on bone protection. PMR patients were co-morbid with a mean of 2.5 other conditions. 75% of PMR patients experienced a glucocorticoid-related adverse event in the first 12 months of treatment. 16% of patients with new PMR had ultrasound features of subclinical giant cell arteritis. The commencement of glucocorticoid therapy should be deferred until after specialist evaluation to enable an accurate clinical diagnosis. A delay in treatment can only realistically be avoided if GPs have access to a Fast-track PMR clinic. We believe that rheumatologists should consider establishing fast-track PMR clinics and this study provides a strong case for and a template to support this practice innovation.

Self-Report and Performance-Based Measures for Pelvic Girdle Pain During Pregnancy

Purpose: The purpose of this cross-sectional study was to quantify functional mobility in pregnant individuals during the second and third trimesters, both with and with no pelvic girdle pain, using performance-based measures as compared with self-report tools. Methods: Study participants included 58 individuals between 18 and 45 years of age in the second or third trimesters of pregnancy who were categorized by pelvic girdle pain ratings and positive screening results. Participants completed the Pelvic Girdle Questionnaire (PGQ) and the Pelvic Floor Impact Questionnaire (PFIQ), and were evaluated by accelerometry during quiet standing, straight-line walking, and the Timed Up and Go (TUG) test. Results: The majority of performance measures captured using accelerometry were not statistically different between the Pain and Control groups. However, turning velocities were lower in the third trimester group during turning phases of the TUG (P &lt; .006). Pain and No Pain groups differed in the distribution of PFIQ responses on Chores (P &lt; .001), Exercise (P &lt; .001), Travel (P = .012), and Frustration (P &lt; .001). A statistical difference was present between the Pain and Control groups in PGQ total score (P &lt; .001), and response distributions were statistically different on multiple PGQ items. Discussion: For pregnant individuals, accelerometry-based performance measures do not appear to detect difficulty with mobility, which may begin to be reported during the second trimester. Patient-report outcome tools may help clinicians capture movement difficulty and address biopsychosocial factors that impact pelvic girdle pain associated with pregnancy.

Altered Abdominal Muscle Recruitment and Declined Physical Function in Postpartum Individuals With Pregnancy-Related Pelvic Girdle Pain: A Matched Case-Control Study.

The influence of pregnancy-related pelvic girdle pain (PPGP) on lumbopelvic muscles has not been comprehensively examined in postpartum individuals. Previous research also presented self-reported activity limitations without objective measures. Thirty postpartum individuals with PPGP (PPGP group) and 30 age-, parity-, and postpartum duration-matched asymptomatic individuals (healthy group) were recruited. Transabdominal ultrasonography was used to measure muscle thickness or activation changes of the external oblique (EO), internal oblique (IO), transverse abdominals, lumbar multifidus, and pelvic floor muscles (PFMs) during rest and while performing the active straight leg raise (ASLR). Muscle changes were compared separately in the painful and nonpainful sides between the PPGP and health control group. Physical function was assessed using the ASLR fatigue (ASLRF), timed up-and-go, and 6-m walking (6MW) tests. The PPGP group had greater thickening changes in the bilateral IO during ASLR compared with the healthy group (nonpainful side, 16.34 vs 3.52 mm; P =.010; painful side, 18.83 vs 6.60 mm; P =.02) but became thinner in the EO (nonpainful side, -2.19 vs 19.97 mm; P <.001; painful side, -5.97 vs 21.43 mm; P <.001). Thicker IO and EO on the nonpainful side (IO, 6.60 vs 5.78 mm; P =.004; EO, 5.37 vs 4.54 mm; P =.011) and a lower bladder base (indication of PFMs) (91.87 vs 78.61 mm; P =.002) during rest were also observed in the PPGP group. Furthermore, the performance of the ASLRF and 6MW tests was poorer in the PPGP than in the healthy group (ASLRF nonpainful side, 82.36 vs 59.09 sec; P =.01; painful side, 75.73 vs 59.26 sec; P =.04; 6MW, 3.48 vs 3.17 sec; P =.02). Postpartum individuals with PPGP demonstrated altered abdominal muscle recruitment strategies during loading tasks, with objectively impaired physical functions. These findings are critical for developing effective muscle training interventions for PPGP.

Sexual Function of Women with and without Pregnancy-Related Pelvic Girdle Pain and its Relationship with Physical Activity, Kinesiophobia and Body Image: A Cross-Sectional Comparative Study

The aim of this study was to compare the sexual function of women with and without pregnancy-related PGP, and to investigate its relationship with physical activity (PA), kinesiophobia, and body image (BI). Demographic characteristics, sexual function (Pregnancy Sexual Response Inventory), PA (Pregnancy Physical Activity Questionnaire), kinesiophobia (Tampa Kinesiophobia Scale), and BI (Body Image in Pregnancy Scale) of 125 pregnant women were recorded. In the PGP group (n = 46), visual analogue scales were used to assess the pain intensity during resting and sexual activity, and Pelvic Girdle Questionnaire was used to evaluate the activity limitation. Although total sexual function and BI scores of the groups were similar (p > 0.05), dyspareunia during pregnancy and level of kinesiophobia were higher, and energy expenditure during moderate-intensity PA was lower in pregnant women with PGP (p < 0.05). The PGP group had moderate activity limitation and reported increased PGP intensity during sexual activities (p < 0.001). PA level was significantly correlated with sexual desire (r = 0.180), and overall sexual function was correlated with kinesiophobia (r = -0.344) and BI (r = -0.199) during pregnancy (p < 0.05). These findings suggest that pregnant women with PGP are more vulnerable to sexual dysfunctions, and there is a need to develop biopsychosocial framework-oriented management strategies which aim to improve PA level and to eliminate psychological factors such as kinesiophobia and negative BI.Clinical Trial Registration: NCT05990361

The Role of Non-rigid Pelvic Belts in Managing Pregnancy-related Pelvic Girdle Pain and Low Back Pain: A Systematic Review

The Role of Non-rigid Pelvic Belts in Managing Pregnancy-related Pelvic Girdle Pain and Low Back Pain: A Systematic Review

Physical Activity and Pain During Pregnancy

Low back and pelvic girdle pain are prevalent during pregnancy, impacting about 50% of pregnant women. Previous studies conducted on the general population have suggested that physical activity has been associated with reductions in pain levels. Purpose: To determine if women with higher levels of physical activity experience less low back and pelvic girdle pain and lower disability scores than women who are less physically active. Methods: Pregnant women (n=24, 32.2 ± 4.1 years) were recruited between 28- and 32-weeks gestation. Participants reported their weekly physical activity, responded to subjective pain surveys, and underwent a battery of objective pain testing. Spearman’s-rho was used to assess correlations between physical activity scores and each subjective pain measure. Results: Tests for correlation between pregnancy physical activity scores and pain domain measures were not significant (ps&gt;0.05), so no relationship could be determined between physical activity levels and low back/pelvic girdle pain based on this study. Conclusion: This study was not able to identify a significant correlation between physical activity levels and low back/pelvic girdle pain during pregnancy.

Characteristics and effects on daily lives of pelvic girdle pain during early postpartum in Beijing women, China

ABSTRACT Pelvic girdle pain (PGP) is a common problem during pregnancy and postpartum and negatively affects women’s well-being. Yet it is not well known in China. This study assessed PGP’s intensity, location, and quality and the status of daily activities on postpartum women with pain, and explored the relationship between pain and the prevalence of depressive symptoms. A cross-sectional study recruiting 1,038 eligible women at 6 weeks postpartum from the obstetric clinic of a hospital was conducted in Beijing, China. Data were collected using self-reported questionnaires, including Introductory information form, Body chart, Number Rating Scale, McGill Pain Questionnaire-2, Pelvic Girdle Questionnaire, and Edinburgh Postnatal Depression Scale. In this study, 32.2 percent women experienced pain. The mean (SD) pain intensity score was 3.07 ± 1.60. About 50.6 percent women experienced sacroiliac joint pain, and 25.5 percent women experienced pain in a combination of locations. About 73.1 percent women experienced aching pain, and 57.5 percent experienced more than one kind of pain quality. The mean total score, which assesses activity and symptom limitations, was 21.93 ± 17.35 (percent), of which a normal sex life (1.29 ± 0.94) was made more challenging due to pain. In mental health, the prevalence of depressive symptoms coincided with the prevalence of pain (p = 0.008). Postpartum PGP still needs to be taken seriously, and women with pain require further support. The above knowledge offers information to manage pain, daily lives and depressive symptoms, contributes to think about strategies to better promote postpartum women physical and mental health in the future.

Is Craniosacral Therapy Effective? A Systematic Review and Meta-Analysis.

The aim of this study was to evaluate the clinical effectiveness of craniosacral therapy (CST) in the management of any conditions. Two independent reviewers searched the PubMed, Physiotherapy Evidence Database, Cochrane Library, Web of Science, and Osteopathic Medicine Digital Library databases in August 2023, and extracted data from randomized controlled trials (RCT) evaluating the clinical effectiveness of CST. The PEDro scale and Cochrane Risk of Bias 2 tool were used to assess the potential risk of bias in the included studies. The certainty of the evidence of each outcome variable was determined using GRADEpro. Quantitative synthesis was carried out with RevMan 5.4 software using random effect models. Fifteen RCTs were included in the qualitative and seven in the quantitative synthesis. For musculoskeletal disorders, the qualitative and quantitative synthesis suggested that CST produces no statistically significant or clinically relevant changes in pain and/or disability/impact in patients with headache disorders, neck pain, low back pain, pelvic girdle pain, or fibromyalgia. For non-musculoskeletal disorders, the qualitative and quantitative synthesis showed that CST was not effective for managing infant colic, preterm infants, cerebral palsy, or visual function deficits. The qualitative and quantitative synthesis of the evidence suggest that CST produces no benefits in any of the musculoskeletal or non-musculoskeletal conditions assessed. Two RCTs suggested statistically significant benefits of CST in children. However, both studies are seriously flawed, and their findings are thus likely to be false positive.

The Potential Role of Wearable Inertial Sensors in Laboring Women with Walking Epidural Analgesia.

There is a growing interest in wearable inertial sensors to monitor and analyze the movements of pregnant women. The noninvasive and discrete nature of these sensors, integrated into devices accumulating large datasets, offers a unique opportunity to study the dynamic changes in movement patterns during the rapid physical transformations induced by pregnancy. However, the final cut of the third trimester of pregnancy, particularly the first stage of labor up to delivery, remains underexplored. The growing popularity of "walking epidural", a neuraxial analgesia method allowing motor function preservation, ambulation, and free movement throughout labor and during delivery, opens new opportunities to study the biomechanics of labor using inertial sensors. Critical research gaps exist in parturient fall prediction and detection during walking epidural and understanding pain dynamics during labor, particularly in the presence of pelvic girdle pain. The analysis of fetal descent, upright positions, and their relationship with dynamic pelvic movements facilitated by walking during labor is another area where inertial sensors can play an interesting role. Moreover, as contemporary obstetrics advocate for less restricted or non-restricted movements during labor, the role of inertial sensors in objectively measuring the quantity and quality of women's movements becomes increasingly important. This includes studying the impact of epidural analgesia on maternal mobility, walking patterns, and associated obstetrical outcomes. In this paper, the potential use of wearable inertial sensors for gait analysis in the first stage of labor is discussed.

Pregnancy-related pelvic girdle pain affects balance in the second and third trimesters of pregnancy.

During pregnancy, many changes in the musculoskeletal system and pregnancy-related disorders affect posture and postural stability. Pregnancy-related pelvic girdle pain (PPGP) is a common disorder in pregnancy; the cause remains unknown. The purpose of the present study was to determine if PPGP affects static postural stability and its relation to the stage of pregnancy. Sixty-three pregnant women between the ages of 18 and 45 and between the 12th and 38th weeks of gestation were included in the study. They were divided into four groups according on the trimester and the presence of PPGP. Static balance was assessed using a force plate on firm and compliant surfaces with eyes open and closed. Pregnant women with PPGP had significantly (p < 0.05) greater centre-of-pressure velocity and sway area compared to pregnant women without PPGP, especially in the third trimester of pregnancy. In the second trimester, only two significant differences in COP parameters were observed between pregnant women with and without PPGP. Pregnant women in the third trimester of pregnancy had significantly (p < 0.05) greater centre-of-pressure velocity and larger postural sway area compared to pregnant women in the second trimester of pregnancy, regardless of PPGP. Pregnant women with PPGP had poorer static stability when compared to pregnant women without pain, especially in the third trimester of pregnancy. The cause could be found in the poorer ability to stabilise the trunk and pelvis, poorer proprioception, and issues with automatic movement patterns.

Knowledge Mapping Analysis of Research on Pregnancy-Related Pelvic Girdle Pain (PPGP) from 2002 to 2022 Using Bibliometrics.

Pregnancy-related Pelvic Girdle Pain (PPGP) is a prevalent condition characterized by various physiological and pathological processes in the female body. The objective of this study is to offer a comprehensive understanding of the current research landscape, key areas of interest, and potential future directions in the field of PPGP. Using Web of Science, we explored PPGP literature from 2002 to 2022. VOSviewer and CiteSpace facilitated a quantitative analysis, revealing co-authorship patterns, co-occurring themes, citations, and co-citations. We identified, peaking at 99 publications in 2021. The United States led with 138 publications and the highest citation count (3160). The Karolinska Institute boasted the highest tally of publications (n = 21). Regarding the volume of publications, the esteemed journal of BMC Pregnancy and Childbirth attained the foremost position. Notably, Gutke, Annelie emerged as the most prolific and highly cited author. The analysis of keyword co-occurrence and co-citation clustering unveiled an intricate tapestry of PPGP studies, spanning various domains including risk factors, mechanistic intricacies, diagnostic benchmark, treatment modalities, and far-reaching ramifications on one's quality of life. Research endeavors exploring PPGP have unveiled an enduring trajectory of growth in contemporary times. The existing body of research primarily focuses on delving into the intricate interplay of epidemiological factors and the profound implications of interventions encompassing physical therapy, exercise protocols, and diverse modes of pain management within the domain of PPGP. Multidisciplinary integration encapsulates a prevailing trajectory of progress within this domain, while the focal point of future inquiries into PPGP may revolve around subjects pertaining to standardized outcome reporting.

Efficacy and safety of acupuncture in treating low back and pelvic girdle pain during pregnancy: a systematic review and meta-analysis of randomized controlled trials

Objectives: Low back and pelvic girdle pain (LBPGP) is common during pregnancy. Acupuncture is an effective and safe therapy for pain relief. However, further evidence is required to confirm the efficacy and safety of acupuncture in treating LBPGP during pregnancy. This study aimed to systematically review and investigate the clinical efficacy and safety of acupuncture for the treatment of pregnancy-related LBPGP. Methods: The PubMed, EMBASE, Cochrane Library, CNKI, VIP, and WanFang databases were searched from January 2000 to August 2023. Only the randomized controlled trials (RCTs) involving pregnant women between 16 and 34 weeks of gestation diagnosed with LBPGP were included in the study. A meta-analysis was conducted and pooled risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs) were compared. Results: Meta-analysis included 12 RCTs involving 1,641 participants. Eleven trials compared acupuncture alone or acupuncture combined with standard care (SC), of which three trials also used non-penetrating or placebo acupuncture as the control group. One trial compared acupuncture alone with non-penetrating acupuncture. Compared with SC, acupuncture combined with SC group significantly decreased visual analog scale score (mean difference (MD) = −2.83, 95% CI = −3.41 to −2.26, P &lt; 0.00001), cesarean section rate (RR = 0.69, 95% CI = 0.49–0.97, P = 0.03), preterm birth rate (RR = 0.42, 95% CI = 0.27–0.65, P &lt; 0.0001), labor duration (MD = −1.97, 95% CI = −2.73 to −1.20, P &lt; 0.0001), and Oswestry disability index score (MD = −9.14, 95% CI = −15.68 to −2.42, P = 0.008). In addition, acupuncture combined with SC significantly improved 12-Items Short Form Health Survey of physical component summaries (SF12-PCS). No significant differences were observed in the spontaneous delivery rate, newborn weight, drowsiness, and 12-Items Short Form Health Survey of mental component summaries (SF12-MCS) between the two groups. Adverse events such as needle pain and needle bleeding were aggravated in both the SC and acupuncture treatment groups but none were associated with acupuncture during or after the treatment period. Conclusions: Meta-analysis showed that acupuncture combined with SC had better efficacy than SC alone and could be a potential therapy for LBPGP during pregnancy. The safety results imply that acupuncture caused few adverse reactions; however, more evidence is required for further confirmation.

Effectiveness of Swiss Ball Exercise Compared to Mat Exercise on Pelvic Girdle Pain in Antenatal Women

Background: Pelvic girdle pain (PGP) is pain that occurs frequently in the sacroiliac joint (SIJ), which connects thegluteal fold and the posterior iliac crest, and can spread to the hips and thighs. Pubic symphysis discomfort andPGP can either occur simultaneously or separately. The symptoms of pelvic girdle pain (PGP) include pain andimpairment.Purpose: To assess the effectiveness of Swiss ball exercises against mat exercises in alleviating Pelvic Girdlepregnancy-related pain.Materials and Methods: After receiving a thorough description of the study’s objectives, 30 Women were chosenfrom Saveetha Medical College and Hospital based on the inclusion and exclusion criteria. Oswestry DisabilityIndex 2.0 (ODI) and Pelvic Girdle Questionnaire (PGQ) measurements of pain and disability were utilised asoutcome measures. Subjects were divided randomly into groups Swiss ball exercises (n=15) and Mat exercises(n=15).Results: The statistical evaluation of Swiss ball exercises and mat exercises yields the following results: Wediscovered a substantial decrease in Impairment and discomfort, ODI scores (p=0.0029), and PGQ scores (p=0.0001)in the Swiss ball exercise group.Conclusion: At the end of the study, it shows that Swiss ball exercises can be used to treat individuals who havepelvic girdle pain when pregnant.

The effect of exercise training and motivational counselling on physical activity behaviour and psychosocial factors in pregnant women: secondary analyses of the FitMum randomised controlled trial investigating prenatal physical activity

BackgroundA physically active lifestyle is beneficial during pregnancy. However, little is known about physical activity (PA) behaviour and psychosocial factors in women during and after pregnancy. This study examined exercise behavioural regulation, exercise self-efficacy, health-related quality of life, sickness absence and musculoskeletal pain in pregnant women offered either structured supervised exercise training, motivational counselling on PA, or standard prenatal care in the FitMum randomised controlled trial.MethodsTwo hundred and eighteen healthy inactive pregnant women were randomised to structured supervised exercise training (n = 87), motivational counselling on PA (n = 86) or standard prenatal care (n = 45). The women answered the Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2), the Pregnancy Exercise Self-Efficacy Scale (P-ESES-DK) and the Short Form 36 Health Survey Questionnaire (SF-36) at baseline (gestational age (GA) of max 15 weeks), GA 28 and 34 weeks, and one year after delivery. Sickness absence and low back and/or pelvic girdle pain were likewise reported in questionnaires at baseline and GA 28 weeks.ResultsParticipants offered structured supervised exercise training or motivational counselling on PA had higher autonomous motivation for exercise during pregnancy compared with participants receiving standard prenatal care (e.g., difference in intrinsic regulation at GA 28 weeks, structured supervised exercise training vs. standard prenatal care: mean difference in score 0.39 [0.16; 0.64], p < 0.001). Participants offered structured supervised exercise training also had higher exercise self-efficacy during pregnancy (e.g., GA 28 weeks, structured supervised exercise training vs. standard prenatal care: mean difference in score 6.97 [2.05; 12.02], p = 0.005). All participants reported high exercise self-efficacy at baseline and medium exercise self-efficacy during pregnancy and one year after delivery. No differences were found between groups in health-related quality of life, sickness absence or low back and/or pelvic girdle pain during pregnancy. No group differences were found one year after delivery.ConclusionStructured supervised exercise training and motivational counselling on PA had important effects on autonomous exercise motivation during pregnancy. Exercise self-efficacy was also increased with structured supervised exercise training compared to standard prenatal care. No group differences in health-related quality of life, sickness absence, or pain were found during and after pregnancy. No effects were found one year post-delivery after intervention cessation.Trial registrationThe study was approved by the Danish National Committee on Health Research Ethics (#H-18011067) and the Danish Data Protection Agency (#P-2019–512). The study adheres to the principles of the Helsinki declaration. Written informed consent was obtained at inclusion.

Pelvic girdle pain in pregnancy and early postpartum – prevalence and risk factors in a multi-ethnic cohort

BackgroundPelvic 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.MethodsThis 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.ResultsWomen 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).ConclusionsWomen 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.