Group care exercise class vs individual physiotherapy care for the treatment of pelvic and back pain in pregnancy

Completed

• Conditions: Pelvic girdle pain in pregnancy; Pregnancy and Childbirth; Abdominal and pelvic pain

• Registration Number: ISRCTN26238431
• Lead Sponsor: Cork University Maternity Hospital (Ireland)

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2009-03-24
• Last Update Posted: 13 January 2015

Recruitment & Eligibility

• Status: Completed
• Sex: Female
• Target Recruitment: 226

Inclusion Criteria

Pregnant women (primigravida and multigravida; no age limits) from 20-35 weeks of gestation attending Cork University Maternity Hospital (CUMH) low risk antenatal clinics who are referred to the physiotherapy department by their health care provider or following self referral with back pain or pelvic pain will be assessed for inclusion in the trial. Women referred to the physiotherapy department with symptoms of pelvic girdle pain (PGP) will be assessed on presentation by a one of six departmental physiotherapists specializing in women's health.

To make the diagnosis of PGP the following tests will be performed as per the European Guidelines on the diagnosis and treatment of Pelvic Girdle Pain and a pain history taken as detailed.

Sacroiliac joint assessment:
1. Posterior pelvic pain provocation test (P4)
2. Gaenslen's test
3. Compression of anterior superior iliac spines (ASIS)
4. Distraction Sacro-Iliac Joint (SIJ) pain provocation test
5. Assessment of Sulci depth in lumbar spine in neutral and extension

Functional pelvic test:
6. Active straight leg raise test (ASLR)

Pain history (according to the criteria of Ostgaard):
7. It is recommended that a pain history be taken with specific attention paid to pain patterns and irritability of PGP
8. There must be no nerve root syndrome
9. The severity of pain must be related to motion

The diagnosis of PGP will be made if the patient has two or more of criteria 1-4 (Laslett's criteria) in combination with a negative McKenzie and negative neurological examination. Criteria 5-9 will be performed and assessed to try and improve diagnostic sensitivity and specificity as well as help exclude other pathologies that may cause pelvic and back pain.

Exclusion Criteria

1. Women with other pain conditions, history of orthopaedic disease or surgery in the spine or pelvic girdle systemic disorders or if attending the high risk antenatal clinic in CUMH
2. Women who volunteered a history of sexual abuse at any point of the study
3. Women who do not speak English fluently
4. Women with non viable pregnancies
5. Women who have already received treatment for PGP outside of this trial
6. Pregnant women who present who will not be booking at CUMH for their pregnancy or are not resident in the South West of Ireland
7. Women with a history of severe PGP in previous pregnancies. Severe PGP will be defined as occurring less than 20 weeks gestation in a previous pregnancy or requiring crutches in a previous pregnancy or women with a history of PGP in two or more previous pregnancies.

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
A reduction in the current intensity of PGP related to motion on a 100-point visual analogue scale (VAS) in the morning and in the evening recorded in the patient's diaries (0 represented no pain and 100 represented worst conceivable pain).