Girdle Pain Research Articles

Best-Practice Recommendations for Chiropractic Care for Pregnant and Postpartum Patients: Results of a Consensus Process

ObjectiveThe purpose of this project was to develop a best-practices document on chiropractic care for pregnant and postpartum patients with low back pain (LBP), pelvic girdle pain (PGP), or a combination. MethodsA modified Delphi consensus process was conducted. A multidisciplinary steering committee of 11 health care professionals developed 71 seed statements based on their clinical experience and relevant literature. A total of 78 panelists from 7 countries were asked to rate the recommendations (70 chiropractors and representatives from 4 other health professions). Consensus was reached when at least 80% of the panelists deemed the statement to be appropriate along with a median response of at least 7 on a 9-point scale. ResultsConsensus was reached on 71 statements after 3 rounds of distribution. Statements included informed consent and risks, multidisciplinary care, key components regarding LBP during pregnancy, PGP during pregnancy and combined pain during pregnancy, as well as key components regarding postpartum LBP, PGP, and combined pain. Examination, diagnostic imaging, interventions, and lifestyle factors statements are included. ConclusionAn expert panel convened to develop the first best-practice consensus document on chiropractic care for pregnant and postpartum patients with LBP or PGP. The document consists of 71 statements on chiropractic care for pregnant and postpartum patients with LBP and PGP.

Lifestyle and Chronic Pain in the Pelvis: State of the Art and Future Directions.

During their lifespan, many women are exposed to pain in the pelvis in relation to menstruation and pregnancy. Such pelvic pain is often considered normal and inherently linked to being a woman, which in turn leads to insufficiently offered treatment for treatable aspects related to their pain experience. Nonetheless, severe dysmenorrhea (pain during menstruation) as seen in endometriosis and pregnancy-related pelvic girdle pain, have a high impact on daily activities, school attendance and work ability. In the context of any type of chronic pain, accumulating evidence shows that an unhealthy lifestyle is associated with pain development and pain severity. Furthermore, unhealthy lifestyle habits are a suggested perpetuating factor of chronic pain. This is of specific relevance during lifespan, since a low physical activity level, poor sleep, or periods of (di)stress are all common in challenging periods of women’s lives (e.g., during menstruation, during pregnancy, in the postpartum period). This state-of-the-art paper aims to review the role of lifestyle factors on pain in the pelvis, and the added value of a lifestyle intervention on pain in women with pelvic pain. Based on the current evidence, the benefits of physical activity and exercise for women with pain in the pelvis are supported to some extent. The available evidence on lifestyle factors such as sleep, (di)stress, diet, and tobacco/alcohol use is, however, inconclusive. Very few studies are available, and the studies which are available are of general low quality. Since the role of lifestyle on the development and maintenance of pain in the pelvis, and the value of lifestyle interventions for women with pain in the pelvis are currently poorly studied, a research agenda is presented. There are a number of rationales to study the effect of promoting a healthy lifestyle (early) in a woman’s life with regard to the prevention and management of pain in the pelvis. Indeed, lifestyle interventions might have, amongst others, anti-inflammatory, stress-reducing and/or sleep-improving effects, which might positively affect the experience of pain. Research to disentangle the relationship between lifestyle factors, such as physical activity level, sleep, diet, smoking, and psychological distress, and the experience of pain in the pelvis is, therefore, needed. Studies which address the development of management strategies for adapting lifestyles that are specifically tailored to women with pain in the pelvis, and as such take hormonal status, life events and context, into account, are required. Towards clinicians, we suggest making use of the window of opportunity to prevent a potential transition from localized or periodic pain in the pelvis (e.g., dysmenorrhea or pain during pregnancy and after delivery) towards persistent chronic pain, by promoting a healthy lifestyle and applying appropriate pain management.

Postpartum septic symphysitis, a rare condition with possible long-term consequences: a cohort study with long-term follow-up

BackgroundPostpartum 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.MethodsThis 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.Results1) 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).ConclusionsIn 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.

Symmetry in Paraspinal Muscles as a Predictor of the Development of Pregnancy-Related Low Back and Pelvic Pain: A Prospective Study.

ObjectiveTo determine the asymmetry in the paraspinal muscle before pregnancy and evaluate its association with pregnancy‐associated lumbopelvic pain (LPP).MethodsThis was a prospective case–control study conducted from January 2017 and December 2018. A total of 171 subjects (mean age ± SD, 27.4 ± 5.8 years) were finally divided into the LBP group, PGP group, and no LPP group. Each subject was asked to follow a standardized clinical imaging protocol before the pregnancy. The area of muscles (multifidus, erector spinae, and psoas muscles) on the axial slice at mid‐disc of L4–L5 and L5–S1 were segmented and then the cross‐sectional area (CSA) of a particular muscle was measured by outlining the innermost fascial border surrounding each muscle. The mean value of F‐CSA's ratio to T‐CSA (F/T CSA) was used to determine whether the bilateral paraspinal muscle was asymmetrical. Total muscle CSA (T‐CSA) represents the sum of CSA of interested three muscles. The signal intensity can distinguish fat and muscle tissue in a different range. Based on this, functional CSA (F‐CSA), represented by fat‐free area, was evaluated quantitively by excluding the signal of the deposits of intramuscular fat. Total muscle CSA (T‐CSA), functional CSA (F‐CSA), and the ratio of F‐CSA to T‐CSA (F/T CSA) were measured unilaterally and compared between groups. Logistic regression was performed to determine the risk factors for pregnancy‐associated LPP. The Pearson correlation coefficient was performed to test the relationship between asymmetry in F/T‐CSA and pain rating.ResultsA total of 124 subjects (72.5%) (28.5 ± 5.2 years) had LPP during pregnancy. Forty‐eight (38.7%) individuals had low back pain (LBP) and 76 (61.3%) had pelvic girdle pain (PGP). Seventy‐six women (44.4%) were determined to have asymmetry in paraspinal muscle according to the definition in this methods section. The duration of follow‐up was 24 months postpartum. A total of 39 (31.5%) women unrecovered from LPP. F/T‐CSA was significantly decreased for LBP in the PGP group than in the and control group (0.03 ± 0.02 vs 0.05 ± 0.03 vs 0.12 ± 0.05, P < 0.001). Meanwhile, significant differences were detected in both groups (all P < 0.001). In patients with LBP, the level of paraspinal asymmetry, represented by the difference in F/T‐CSA, was positively correlated with pain scores (r = 0.52, P < 0.01). However, no statistically significant correlation between pain scores and paraspinal asymmetry was found in PGP (r = 0.42, P > 0.05). Asymmetry in the paraspinal muscle (adjusted OR = 1.5), LBP (adjusted OR = 1.6), LPP in a previous pregnancy (adjusted OR = 1.4), sick leave ≥90 days (adjusted OR = 1.2), and heavy labor (adjusted OR = 1.2) were risk factors for the unrecovered LPP during pregnancy.ConclusionsAsymmetrical muscular compositions could lead to abnormal biomechanics for the segmental motions. Lateral‐directed physical training and stretching may help decrease the occurrence and severity of this condition.

Conceptual model of patho- and sanogenesis of the sacroiliac joint osteoarthritis

Objective. To develop a conceptual model of patho- and sanogene­sis of the sacroiliac joint (SIJ) osteoarthritis on base of the known data about the SIJ, the results of our own biomechanical studies of this joint, its ligaments and stabilizing muscles by finite element modelling, data of clinical verification of these results. Methods. The object of the model is the SIJ as a link, which connects the spine and pelvis. The proposed conceptual model is based on the M. Panjabi hypothesis of chronic lumbar pain in the case of partial dama­ge to ligaments, which leads to muscle dysfunction. Results. A new conceptual model of SIJ osteoarthritis was developed. In this model we tried to take into account the limitations of the existing SIJ stability hypotheses and models of the appearance of the pelvic girdle pain, SIJ dysfunction and SIJ arthrosis. The model is based on the results of our own research. It was proved, that patients with SIJ osteoarthritis have an asymmetry of the width of the joint slits, the inclination of the sacrum and pelvis, sacral rotation, hyperlordosis in the LV–SI segment. These factors lead to a shift of the horizontal axis of sacral rotational mobility relative to the pelvic bones. This horizontal axis shift leads to the instabili­ty of the SIJ on one side of the joint, and to the functional block on another side. The results of these functional changes were damage of the SIJ ligaments-stabilizers, dysfunction of the SIJ muscles-stabilizers, degenerative changes of SIJ elements and pain. The deve­loped model allows to explain the distortion of muscular response pattern in patients with improper SIJ biomechanics in conditions of SIJ osteoarthritis. The increase of the SIJ biomechanics changes enlarges the the muscle response pattern distortion. Conclusions. The developed conceptual model explains many clinical manifestations of the SIJ osteoarthritis and will help to understand better the mechanics of the pelvic girdle pain in such conditions, will improve the results of diagnosis and treatment.

Sacroiliac Joint and Pelvic Dysfunction Due to Symphysiolysis in Postpartum Women.

Pregnancy-related pain in the sacroiliac joint (SIJ), lumbosacral region, pubic symphysis, or in any combination of these joints has been coined as pelvic girdle pain (PGP) and has been estimated to affect almost half of all pregnant women. SIJ dysfunction in pregnancy is due to multiple biomechanical mechanisms, such as increased weight, change in posture, increased abdominal and intrauterine pressure, and laxity of the spine and pelvic structures. Moreover, when compared to men, women have increased SIJ mobility due to increased pubic angle and decreased SIJ curvature. These differences may assist in parturition where hormones, such as relaxin and estrogen, cause symphysiolysis. A retrospective review of the literature was conducted in the PubMed database using the search term “pregnancy-related sacroiliac joint pain.” All peer-reviewed studies were included. Around 8%-10% of women with PGP continue to have pain for one to two years postpartum. Patients that were treated with SIJ fusion show statistically significant improvement in pain scores when compared to patients that had non-operative treatment. Although we have a number of studies following patients after sacroiliac (SI) joint fusion for pelvic pain with SI joint dysfunction, further research is needed to study sacroiliac fusion for SI joint dysfunction in postpartum women to better tailor and optimize surgical outcomes for this patient population.

Maintenance of physical activity level, functioning and health after non-pharmacological treatment of pelvic girdle pain with either transcutaneous electrical nerve stimulation or acupuncture: a randomised controlled trial

ObjectiveTo investigate if there are differences between acupuncture and transcutaneous electrical nerve stimulation (TENS) as treatment for pelvic girdle pain (PGP) in pregnancy in order to manage pain and thus...

Management of women with pregnancy-related pelvic girdle pain: an international Delphi study

ObjectivesPregnancy-related pelvic girdle pain (PPGP) contributes to significant prenatal and postpartum impairments; however, various clinical practices exist around the conservative treatment of this condition. This study sought to reach a consensus on the essential components of PPGP management through an international Delphi survey of experts in women's health. Design and participantsEighty-seven international experts in the field of PPGP were invited to participate and surveyed over three rounds. Round 1 of the survey utilised open-ended questions to gain feedback on 16 components of PPGP management previously identified by a focus group. Feedback from panel members guided modification and refinement of questions for Rounds 2 and 3. A 5-point Likert scale was used to rate level of agreement, with a minimum threshold for consensus of ≥75% agreement set across all survey rounds. ResultsForty-four of the 87 (50%) invited professionals agreed to participate in the panel, with 77% (34/44) of panellists contributing to all three rounds. Of the 16 initial components, 15 were included in Round 2. The final consensus was reached on 10 important components of assessment and management after Round 3: pain education, postural and ergonomic advice, social and lifestyle factors, psychological factors, cultural considerations, strengthening exercise, other exercise, exercise precautions, manual therapy and the use of crutches. ConclusionThis study identified 10 key components that should be considered in the management of PPGP. In addition, these components provide a potential framework for future research around the conservative management of PPGP.

Perinatal Sacroiliitis Diagnostic Challenges: A Case Report

Background: Lumbo-pelvic (LPP) pain is common and non specific problem during pregnancy and post partum. Despite the fact that perinatal pyogenic sacroiliitis (PSI) during this period is rare, it should be considered as a vital differential diagnosis in women who have debilitating lower back and pelvic girdle pain. Case: A 34 years old primigravida presented to the emergency department with extreme right sided lower back pain radiating to the right gluteal region and down to the back of the right thigh. This pain began twelve days prior to her presentation and eventually worsened to the point that she couldn't stand or walk. Her vital signs were within normal limits, and she was febrile. Apart from a slight widening of the symphysis pubis, her pelvic and lumbo-sacral plain x-rays revealed no important findings. With the clinical impression of right LPP, the patient was admitted for pain management and further inquiries. Conclusion: Despite the fact that lower back and pelvic girdle pain are normal throughout pregnancy and the postpartum period, perinatal PSI is uncommon. It's a tough diagnosis to make because the symptoms and signs aren't clear, and the tests aren't definitive. When pathognomonic clinical and radiologic signs indicate an infectious process and isolation of pathogenic bacteria is not possible, medical management with empirical antibiotics should not be delayed.

Clinical Tests and Patient-Reported and Performance-Based Outcome Measures in Pelvic Girdle Pain

Pelvik kuşak ağrısı (PKA) yaygın olarak görülen bir kas-iskelet sistemi hastalığıdır. Gebelik, travma, artrit ve osteoartrit ile ilişkili olarak artan PKA, hormonal, biyomekanik, travmatik, metabolik, genetik, psikolojik, nörofizyolojik ve dejeneratif faktörlere bağlı olarak ortaya çıkmaktadır. PKA ağrı ve aktivite limitasyonu gibi durumlara yol açarak yaşam kalitesinde azalmaya yol açmaktadır. PKA’lı bireylerde açığa çıkan bu durumların hasta bildirimli ve performansa yönelik sonuç ölçümleriyle değerlendirilmesi, tedavi programının planlaması ve etkinliğinin gösterilmesi açısından önemli rol oynamaktadır. Bu çalışmanın amacı PKA’lı bireylerin tanı ve değerlendirilmesinde kullanılan klinik testleri ile hasta bildirimli ve performansa dayalı sonuç ölçümlerini derlemektir. Bu amaçla PubMed, Google Scholar ve ScienceDirect veri tabanlarında ilgili anahtar sözcükler kullanılarak 1 Aralık 2020 tarihine kadar yayımlanmış olan çalışmalarda tarama yapılmıştır. PKA’lı bireylerin tanısında kullanılan klinik testler ve değerlendirilmesinde kullanılan hasta bildirimli ve performansa dayalı sonuç ölçümleri psikometrik analizlerle sunulmuş, gerek performansa dayalı sonuç ölçümleri ve gerekse bunların karşılaştırıldığı çalışmaların oldukça az sayıda olduğu görülmüştür. Bu derlemenin bulgularının PKA’lı bireylerle çalışan tüm sağlık profesyonelleri ve araştırmacılar için yol gösterici olacağı düşünülmektedir.

Clinical assessment of pelvic floor and abdominal muscles 3 months post partum: an inter-rater reliability study

ObjectivesEvaluation of the inter-rater reliability of clinical assessment methods for pelvic floor muscles and diastasis recti abdominis post partum.DesignA multicentre inter-rater reliability study.SettingThree primary care rehabilitation centres in Sweden.ParticipantsA total...

Effect of pregnancy exercises and education on pregnancy related musculoskeletal discomforts

Aim. Women experience significant physiological and anatomical adaptations during pregnancy to meet the maternal and foetal demands. Biomechanical and hormonal factors, ligament laxity, posture and weight gain may put lot of stress on musculoskeletal system which may in turn induce various musculoskeletal symptoms in pregnancy. Most of the women believe that physical activity during pregnancy is harmful to maternal and foetal health, which results reduction in their routine physical activity. Physical inactivity during gestational period leads to various maternal discomforts and complications. The purpose of this study is to evaluate the effect of structured antenatal exercise programme and education on pregnancy related musculoskeletal discomforts. Material and Methods. Total of 186 mothers were recruited for the study. 94 Participants were selected as the study group samples and 92 were chosen as the control group .The study group received structured antenatal classes and education in addition to routine antenatal care whereas the control group received routine antenatal care and exercises. Antenatal classes were conducted as individualised therapy for the interventional group along with routine antenatal care from 20th week of gestation. The primary outcome measure was pregnancy induced musculoskeletal dysfunction scale (PMDS scale). PMDS scale was assessed at 20, 24 and 32 weeks. Results and Discussion. There was a significant difference in the values of low back pain, symphysis pubic pain, knee pain, pelvic girdle pain and edema at 32 weeks (p value p&lt; 0.05). Exercise during pregnancy increased the β endorphin levels and decrease the perception of pain and pregnancy induced musculoskeletal symptoms. Conclusion. The antenatal exercise programme and education were found to be effective in reducing pregnancy induced musculoskeletal dysfunction. Hence we suggest the pregnancy exercise and education programme in routine antenatal care to improve maternal quality of life.

Women's and men's health physiotherapy, the content covered and it's perceived importance within entry-level physiotherapy programs in Australia – an observational study

Purpose Women’s and men’s health physiotherapy are expanding areas of clinical practice. The aims of this study were to examine the course content and its perceived importance of specific content on women’s and men’s health within physiotherapy programs and identify any barriers to delivering the content. Methods An online survey, with open and closed questions was distributed to universities in Australia with an entry-level physiotherapy program, in 2019. The ‘Likert’ scale responses were then analysed by assigning a scale from 1–5. The open responses were descriptively analysed for themes. Results There were 15 responses from the 22 university programs in Australia. Content that should be covered ‘well’ to ‘very well’ include pelvic floor first exercise; pelvic floor anatomy; incontinence urinary and bowel; exercise – during pregnancy and post-natal; pelvic girdle pain; pelvic organ prolapse; rectus diastasis; osteoporosis; the role of physiotherapist in maternity ward; and pelvic floor muscle assessment-external with real time ultrasound; and in men’s health: male culture and pelvic health; and prostate cancer pre and post-surgical rehabilitation. A barrier to teach content for some courses included space within the curriculum. Clinical placements and research projects were not available in all programs. Conclusion Women’s and men’s health content is perceived to be important to be taught in entry level physiotherapy programs. Identifying what is perceived important content to cover may assist future curriculum design.

Empathy During Patient-Provider Interactions for Women With Chronic Pelvic Pain: A Qualitative Study

Log in or Register Subscribe to journalSubscribe Get new issue alertsGet alerts Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Subscribe to eTOC Secondary Logo Journal Logo All Articles Images Videos Podcasts Blogs Advanced Search Toggle navigation Subscribe Register Login Articles & Issues Current IssuePrevious IssuesPublished Online First VideosFor Authors Information for AuthorsLanguage Editing ServicesCall for Manuscript (PDF)Submit a Manuscript Author Permissions Reviewers Guidelines for ReviewersReviewer Application Form Reviewer Job DescriptionSpecific Reviewer TemplateLWW Reviewer Guide Peer Reviewer Training Course CollectionsJournal Info About the JournalEditorial BoardAffiliated SocietyAdvertisingOpen AccessSubscription ServicesReprintsRights and Permissions News Guideline on Pelvic Girdle Pain During Pregnancy All Articles Images Videos Podcasts Blogs Advanced Search

Association of Pelvic Alignment and Posture in Pregnancy with Lower Back or Pelvic Girdle Pain During Postpartum Recovery: Myth or Reality? A Systematic Review

Association of Pelvic Alignment and Posture in Pregnancy with Lower Back or Pelvic Girdle Pain During Postpartum Recovery: Myth or Reality? A Systematic Review

Cross-cultural adaptation, reliability, and validity of a Chinese version of the pelvic girdle questionnaire

BackgroundThe Pelvic Girdle Questionnaire (PGQ) is the only specific instrument designed to evaluate pain and activity limitations in pregnant or postpartum women with pelvic girdle pain (PGP). This study aimed to translate and culturally adapt the PGQ for Chinese patients and to verify the validation of the psychometric items of the PGQ in the Chinese population.MethodsFirst, the translation and cultural adaptation process of the PGQ was conducted on the basis of international guidelines. Eighteen women suffering from PGP (11 pregnant women and 7 postpartum women) were enrolled in the pilot tests. Second, a total of 130 pregnant and postpartum women with PGP were enrolled to evaluate the validation of the psychometric items of the Chinese version.ResultsThe calculated Cronbach’s alphas demonstrated a high level of internal consistency for the Chinese version of the PGQ, ranging from 0.77 to 0.93. The convergent validity showed a high positive correlation between the PGQ total score and the Oswestry Disability Index (0.84) and Numeric Rating Scale (0.73) for pain intensity. Furthermore, a good discriminatory ability was found for the Chinese version of the PGQ for distinguishing women who needed treatment from those not (area under the curve [AUC] = 0.843, p < 0.001), but not for discriminating the pregnant and postpartum states (AUC = 0.488, p = 0.824). The results of test–retest showed good reproducibility for the total PGQ (ICC = 0.93), the PGQ activity subscale (ICC = 0.92), and the PGQ symptom subscale (ICC = 0.77).ConclusionOur study presents the translation, validation and psychometric features of the Chinese version of the PGQ, showing good construct validity and discriminative power for assessing the consequences of PGP among pregnant or postpartum Chinese women.

Effect of Muscle Energy Technique in Patients with Non-traumatic Lumbo-pelvic Pain in the Age Group of 30-40 Years

Purpose: Pelvic girdle and low back pain have fallen under the diagnostic umbrella of non-specific low back pain (NSLBP). It is true that low back pain can have it’s etiology in pelvic girdle mal-alignment, and similarly low back pain with neural irritation can lead to in co-ordination of muscles causing pelvic malalignment, it is important to understand that motor in co-ordination in the pelvic girdle can be the result of peripheral and/or central mechanisms. Peripheral mechanisms include reflexogenic muscle spasms whilst central mechanisms include cortical inhibition of muscles and/or delayed central transmission due to noxious input affecting intra-cortical synergistic control between various regions of the central nervous system (CNS). Muscle energy technique (MET) is a common conservative treatment for pathology around the spine, particularly lumbopelvic pain (LPP). MET is a gentle manual therapy for restricted motion of the spine and extremities and is an active technique where the patient, not the clinician, controls the corrective force. MET of the low back has decreased pain, increased range of motion, decreased muscle tension and spasm, and increased strength when used with supervised neuromuscular re-education and resistance exercise training. At present, the treatment effect and the outcome of one or two MET session is undefined. This study is designed to determine the effectiveness of brief MET sessions on posterior innominate/ Pelvic pain when used on subjects with non-traumatic pelvic pain. Materials and method: 20 male patients of convenient random sampling based on the inclusion criteria were included in the study and were given muscle energy technique- anterior rotation of Innominate bone for single session once a day for two days and the pre and post treatment outcome were recorded using VAS score and Pelvic inclinometer (PALM) measure. Results: The pre and post treatment effects using paired t-test and the correlation on VAS, shows a decrease of mean and SD from baseline (4.7 ± 1.03) to (1.95 ± 1.14) with (t=14.457, p =.001) indicating a very high level of significance. The pre and post treatment effects using paired t-test and the correlation on PALM, shows a decrease of mean and SD from baseline (10.5 ± 1.50) to (7.1 ± 1.07) with (t=12.803, p =.004) indicating a high level of significance. Conclusion: The results showed that Muscle Energy Technique is as effective as any other manual therapy techniques in the treatment of lumbo-pelvic pain or posterior innominate considered in this study, suggests that MET was highly effective in managing pain and neutralising the pelvic rotation angles with LPP. The treatment is evidenced, and provided as much benefit as any other manual therapy techniques for LPP. Some objective outcomes showed a trend which suggested that there might have been a great interaction if the sample size was larger. Thus the conclusion from this research is that there was a high statistical significance between the pre and post treatment with brief MET sessions in acute LPP.

SPECTRUM OF MUSCULOSKELETAL DISCOMFORTSIN PREGNANT WOMEN AND IMPACT OF ANTENATALEXERCISES OR POSTURAL CARE ON STATUS OF RELIEF: A SYSTEMATIC REVIEW STUDY

Pregnancy is a normal physical state of womens life when they carried a 9 month developmental stages of the foetus. On these durations some pregnancy induced changes leads normal signs naturally but there is an increased risk of musculoskeletal pain or discomforts associated with increase of uterine size and mental stress of pregnant women, needed non-medicines approached like antenatal physiotherapy care. These possible pain or discomforts can make difficult to carry the pregnancy may leadsome complications. Various research studies are point out these problems of pregnant women and find out the triggers. Some studies show the spectrums of these musculoskeletal problems during pregnancy period. Various case studies are assuredtheparticular physiotherapy techniques as antenatal exercises have good impact on relief of respective musculoskeletal pain.Various researches are also covered some another aspects of musculoskeletal problems during pregnancies. In thepresent study an attempt has been made to comprehensive analysis of these review studies to identify the most common musculoskeletal problems in different stages of pregnancy and efficacy of physiotherapy techniques and antenatal exercises to overcome the problem. It was found in the spectrum analysis that most of the women (68.33 %) faced this problem during their pregnancy. On the analysis of most commonmusculoskeletal problem, the mean percent of reviews reveals showed that the most of the women found to be in muscle cramps and pain in neck and shoulder during I trimester whereas maximum women had low back pain (42.87 %) and pelvic girdle pain (11.65 %) on II and III trimester respectively. The satisfactory impacts of antenatal exercises were observed in different musculoskeletal pain by different techniques of Physiotherapy.These results can utilize to make suggestions and recommendations foradoption of suitable physiotherapy techniques in pregnancy to avoid the problem.

SPECTRUM OF MUSCULOSKELETAL DISCOMFORTS IN PREGNANT WOMEN AND IMPACT OF ANTENATALEXERCISES OR POSTURAL CARE ON THE STATUS OF RELIEF: A SYSTEMATIC REVIEW STUDY

Pregnancy is a normal physical state of womens life when they carried a 9 month developmental stages of the foetus. On these durations some pregnancy induced changes leads normal signs naturally but there is an increased risk of musculoskeletal pain or discomforts associated with increase of uterine size and mental stress of pregnant women, needed non-medicines approached like antenatal physiotherapy care. These possible pain or discomforts can make difficult to carry the pregnancy may leadsome complications. Various research studies have been pointed out these problems of pregnant women and found out the triggers. Some studies show the spectrums of these musculoskeletal problems during pregnancy period. Various case studies are assured to theparticular physiotherapy techniques as antenatal exercises have good impact on relief of respective Musculo-skeletalpain. Various researches have also covered some other aspects of Musculo-skeletal problems during pregnancies. In thepresent study an attempt has been made to comprehensive analysis of these review studies to identify the most common musculoskeletal problems in different stages of pregnancy and efficacy of physiotherapy techniques and antenatal exercises to overcome the problem.It was found in the spectrum analysis that most of the women (68.33 %) faced this problem during their pregnancy. On the analysis of most commonmusculoskeletal problem, the mean percent of reviews reveals showed that the most of the women found to be in muscle cramps and pain in neck and shoulder during I trimester whereas maximum women had low back pain (42.87 %) and pelvic girdle pain (11.65 %) on II and IIItrimesters respectively. The satisfactory impacts of antenatal exercises were observed in different musculoskeletal pain by different techniques of Physiotherapy.These results can utilize to make suggestions and recommendations foradoption of suitable physiotherapy techniques in pregnancy to avoid the problem.

The impact of a sacroiliac joint belt on function and pain using the active straight leg raise in pregnancy-related pelvic girdle pain.

Pelvic girdle pain (PGP) is the most common musculoskeletal concern in pregnancy. The Active Straight Leg Raise (ASLR) test is diagnostic. Sacroiliac joint (SIJ) belts are included in multimodal therapy, but there is no established predictive measure to determine which pregnant women will benefit. To determine if the ASLR score is immediately reduced by SIJ belt application and whether PGP pain and function improves after 4 weeks of belt use. Prospective observational cohort study. Academic medical center. Pregnant women at least 18 years of age in the second or third trimester of pregnancy with posterior PGP and ASLR score of 2 to 10. Four-week SIJ belt use. ASLR, Numerical Rating Scale (NRS), Pelvic Girdle Questionnaire (PGQ), Perceived Global Impression of Improvement (PGII). Sixty-three women enrolled. On multivariable analysis, immediate belted ASLR score was -2.70 points lower than the non-belted ASLR score (P < .001). Four weeks later there was significant improvement in the ASLR score with a belt (Mdiff = -0.99; P = .001) and without a belt (Mdiff = -1.94; P < .001); the decline was more precipitous for the non-belted response (Mdiff = -0.96; P = .02). Current NRS pain scores declined from baseline by approximately -0.94 points (P < .001). This decline did not depend on ASLR scores (interaction P = .43) or wearing a belt at the time of testing (interaction P = .51). Similar conclusions held for participants' usual NRS score and average PGQ score. After 4 weeks, 82% reported improvement based on the PGII. SIJ belts are a safe, well-tolerated, and effective therapeutic option for pregnancy-related PGP. The ASLR score is immediately reduced following SIJ belt application but does not predict pain score 4 weeks later. SIJ belt leads to significant improvements in pain and function over time.