Highlights
- •Sacroiliac dysfunction during pregnancy is a primary cause of pain and disability.
- •There is wide heterogeneity in approaches to sacroiliac dysfunction in pregnancy.
- •Expert advice is effective for the reduction of symptoms of sacroiliac dysfunction.
Abstract
Objective
To assess primiparous and multiparous women, and singleton and multiple pregnancies
in a recently published randomized trial.
Study design
Secondary analysis of a randomized clinical trial was performed. In total, 500 women
with sacroiliac dysfunction diagnosed in pregnancy were randomized into a study group
(who received expert advice about therapeutic exercise) and a control group (who continued
with their normal lifestyle habits). The outcome measures assessed were: pain intensity
[visual analogue scale (VAS)] and degree of functional disability (Quebec scale) at
enrolment and after 3 and 6 weeks. Primiparous and multiparous women, and singleton
and multiple pregnancies in the study and control groups were analysed separately.
Results
Sacroiliac dysfunction was more common in primiparous women compared with multiparous
women (84.70% vs 77.16%), and in multiple pregnancies compared with singleton pregnancies
(86.53% vs 80.07%). For all four subgroups analysed in this secondary analysis, the
reduction in pain intensity (p = 0.001) and the degree of functional disability (p = 0.001) were better in the study group compared with the control group. Better results
for the two outcome measures were found when comparing primiparous and multiparous
women in the study group at follow-up, but the difference in functional disability
disappeared 6 weeks after enrolment (p = 0.383). There was no difference in the two outcome measures between singleton and
multiple pregnancies 3 and 6 weeks after enrolment (p = 0.061, p = 0.489 and p = 0.741, p = 0.353, respectively).
Conclusion
Expert advice about therapeutic exercise is effective for the reduction of symptoms
of sacroiliac dysfunction in all four subgroups (primiparous and multiparous women,
singleton and multiple pregnancies). Earlier reduction of pain intensity and degree
of functional disability were obtained in primiparous women compared with multiparous
women in the study group.
Keywords
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References
- Psychological determinants of pregnancy related lumbopelvic pain: a prospective cohort study.Acta Obstet Gynecol Scand. 2013; 92: 797-803
- Pelvic girdle pain and lumbar pain in pregnancy: a cohort study of the consequences in terms of health and functioning.Spine. 2006; 31: E149-E155
- Pelvic girdle pain in pregnancy: the impact on function.Acta Obstet Gynaecol Scand. 2006; 85: 160-164
- Predictors and consequences of long-term pregnancy-related pelvic girdle pain: a longitudinal follow-up study.BMC Musculoskel Disord. 2016; 17: 276-289
Hilde G, Gutke A, Slade SC, Stuge B. Physical therapy interventions for pelvic girdle pain (PGP) after pregnancy. Cochrane Database System Rev 2016;11:CD012441.
- Can supervised group exercises including ergonomic advice reduce the prevalence and severity of low back pain and pelvic girdle pain in pregnancy? A randomized controlled trial.Phys Ther. 2012; 92: 781-790
- Diagnosis and classification of pelvic girdle pain disorders —Part 1: a mechanism based approach within a biopsychosocial framework.Man Ther. 2007; 12: 86-97
- Pregnancy-related lumbopelvic pain: listening to Australian women.Nurs Res. 2012; 2012: 1-10
- Pelvic girdle pain during or after pregnancy: a review of recent evidence and a clinical care path proposal.Facts Views Vis Obgyn. 2013; 5: 33-43
Clinical practice guideline management of pelvic girdle pain in pregnancy and post-partum. Dublin: Royal College of Physicians of Ireland; 2014.
- Pelvic girdle pain in the antepartum population.J Wom Health Phys Ther. 2017; 5: 3-39
- Persistence of back pain symptoms after pregnancy and bone mineral density changes as measured by quantitative ultrasound – a two year longitudinal follow up study.BMC Musculoskel Disord. 2011; 12: 1-7
Filipec M, Matijević M. Expert advice about therapeutic exercise during pregnancy reduces the symptoms of sacroiliac dysfunction. J Perinatal Med 2020;48:565–71.
- Evidence-based diagnosis and treatment of the painful sacroiliac joint.J Man Manip. 2008; 16: 142-152
- Interpretation of visual analogue scale ratings and change scores: a reanalysis of two clinical trials of postoperative surgery pain.J Pain. 2003; 4: 407-414
- A comparison of five low back pain disability questionnaires: realiability and responsiveness.Phys Ther. 2012; 82: 8-24
- The Quebec back pain disability scale.Spine. 1995; 20: 341-352
- The influence of gestational trimester, physical activity practice and weight gain on the low back and pelvic pain intensity in low risk pregnant women.J Back Musculoskelet Rehabil. 2019; 32: 671-676
- Strengthening transversus abdominis in pregnancy related pelvic pain: the pressure biofeedback stabilization training.Glob J Health Sci. 2012; 4: 55-61
- Clinical practice guidelines: pregnancy care.Australian Government Department of Health, Canberra2018: 355-357
Walters C, West S. Nippita TA. Pelvic girdle pain in pregnancy. Melbourne: Royal Australian College of General Practitioners; 2018.
- Determining the prevalence of patterns of pregnancy-induced pelvic girdle pain and low back pain in urban and rural populations: a cross-sectional study.J Sci Soc. 2016; 43: 70-74
Bjelland EK, Eskild A, Johansen R, Eberhard-Gran M. Pelvic girdle pain in pregnancy: the impact of parity. Am J Obstet Gynecol 2010;203:141–6.
- Pregnancy-related pelvic girdle pain and its relationship with relaxin levels during pregnancy: a systematic review.Eur Spine J. 2012; 21: 1769-1776
- The effect of relaxin on the musculoskeletal system.Scand J Med Sci Sports. 2014; 24: e220-e229
- The biomechanics of pregnancy: a systematic review.J Funct Morphol Kinesiol. 2019; 4: 72-88
- Association between the serum levels of relaxin and responses to the active straight leg raise test in pregnancy.Man Ther. 2012; 17: 225-230
- Pregnancy and menstrual hormone levels in mothers of twins compared to mothers of singletons.Ann Hum Biol. 1998; 25: 69-75
- Mid-pregnancy, perinatal, and neonatal reproductive endocrinology: a prospective cohort study in twins and singleton control subjects.Fertil Steril. 2015; 104: 1527-1534.e9
- Association of pre-pregnancy body mass index, pregnancy-related weight changes, and parity with the risk of developing degenerative musculoskeletal conditions.Arthr Rheum. 2016; 68: 1156-1164
- Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up.Eur Spine J. 2002; 11: 267-271
- European guidelines for the diagnosis and treatment of pelvic girdle pain.Eur Spine J. 2008; 17: 794-819
Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database System Rev 2013;8:CD001139.
Article info
Publication history
Published online: August 09, 2021
Accepted:
August 6,
2021
Received in revised form:
July 13,
2021
Received:
April 29,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
