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Low-back Pain During Pregnancy and Its Psycho-social Implications

Not Applicable
Conditions
Pregnancy Related
Low Back Pain
Pelvic Girdle Pain
Interventions
Other: Usual care
Other: Osteopathic manipulative treatment
Other: Mindfulness
Other: Yoga
Other: Clinical nutrition
Other: Coaching
Registration Number
NCT04682002
Lead Sponsor
Come Collaboration
Brief Summary

Pregnancy-related pelvic girdle pain (PPP) and pregnancy-related lumbar pain (PLBP) are two distinct symptoms, which can occur together as lumbar-pelvic pain.The primary objective is to measure the impact of osteopathic manipulative treatment on pregnancy-related lumbar and pelvic pain. The secondary objective is to study the interaction between pain and psycho-social factors during the gestational period.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
Female
Target Recruitment
75
Inclusion Criteria
  • Women aged 18-44
  • Primiparae
  • Single pregnancy
  • Spontaneous pregnancy - fisiological pregnancy
  • pregnancy >= 12 weeks
  • low-back pain (between the 12th rib and the lumbo-pelvic region) and/or pelvic (in the pubic region and/or in one or both of the sacro-iliac joint and/or of the gluteal region) non specific
  • consent to treatment
  • absence of linguistic barriers
Exclusion Criteria
  • Women aged <18 o >44
  • Pathological pregnancy, twins
  • Metabolic pathologies
  • Obstetrician's emergencies
  • Pre-term birth
  • Specific lumbar and/or pelvic pain - Genetics disorders
  • Major congenital anomalies
  • Absence of consent to treatment
  • Presence of linguistic barriers

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
OMT + multidisciplinary pathCoachingPatients in the experimental group will follow the obstetrician's and multidisciplinary path which provides osteopathic treatments, mindfulness, yoga, clinical nutrition, coaching and usual obstetric care.
Usual careUsual carePatients in control group will continue the routine obstetrical care as established by international guidelines
OMT + multidisciplinary pathMindfulnessPatients in the experimental group will follow the obstetrician's and multidisciplinary path which provides osteopathic treatments, mindfulness, yoga, clinical nutrition, coaching and usual obstetric care.
OMT + multidisciplinary pathClinical nutritionPatients in the experimental group will follow the obstetrician's and multidisciplinary path which provides osteopathic treatments, mindfulness, yoga, clinical nutrition, coaching and usual obstetric care.
OMT + multidisciplinary pathOsteopathic manipulative treatmentPatients in the experimental group will follow the obstetrician's and multidisciplinary path which provides osteopathic treatments, mindfulness, yoga, clinical nutrition, coaching and usual obstetric care.
OMT + multidisciplinary pathYogaPatients in the experimental group will follow the obstetrician's and multidisciplinary path which provides osteopathic treatments, mindfulness, yoga, clinical nutrition, coaching and usual obstetric care.
Primary Outcome Measures
NameTimeMethod
Change in PGQ at 6 months6 months

Change from Pelvic-girdle pain questionnaire (PGQ) of the score at 6 months. The PGQ is a condition-specific, patient-reported outcome measure designed to measure pregnancy-related back pain and pelvic girdle pain for use both during pregnancy and postpartum in research and clinical practice. The questionnaire includes items relating to 2 scales (activity/ participation and body functions \[symptoms\]). Self-report questionnaire of 20 activity items and 5 symptom items scored on a 4-point response scale. Each question is scored from 'Not at all' (0) to 'To a large extent' (3). Questions on the activity sub-scale range from difficulty with dressing, climbing stairs, doing housework, rolling in bed to pushing a shopping cart. Item scores are summed and transformed to yield a score of 0 to 100, where 100 is the worst possible score.

Change in VAS at 6 months6 months

Change from Visual Analogue Scale (VAS) of pain at 6 months. VAS values range from 0-10, where 10 means highest pain and 0 no pain

Change in ODI at 6 months6 months

Change from Oswestry disability index 2.1° - Italian version (ODI) of the score at 6 months. The ODI represents a ten 6-point questionnaire. The first section rates the intensity of pain and the remaining ones cover the disabling effect of pain on typical daily activities: personal care, lifting, walking, sitting, standing, sleeping, sex life, social life, and travelling. Each item ranges from 0 to 5 and the sum of the 10 scores is expressed as a percentage of the maximum scores, varying from 0 (no disability) to 100 (maximum disability)

Change in PMI at 6 months6 months

Change from Pregnancy mobility index (PMI) of the score at 6 months. PMI is a self-report questionnaire to assess mobility in relation to back and pelvic girdle pain. The PMI consists of three scales: daily mobility in the house, household activities and mobility outdoors. Every item has a score option from 0-3 (respectively 'no problems performing this task', 'some effort performing this task', 'much effort performing this task', 'performing this task is impossible or only possible with the aid of others'), which was transformed to a 0-100 scale. Each domain score is the mean of all included items.

Secondary Outcome Measures
NameTimeMethod
Change in PWB at 6 months6 months

Change from Ryff's Psychological Well-Being Scales (PWB) of the score at 6 months. Ryff, the 42-item Psychological Wellbeing (PWB) Scale measures six aspects of wellbeing and happiness: autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Respondents rate how strongly they agree or disagree with 42 statements using a 7-point scale (1 = strongly agree; 7 = strongly disagree).

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