Stuge Britt, Laerum Even, Kirkesola Gitle, Vøllestad Nina
Section for Health Science, University of Oslo, Oslo, Norway.
Spine (Phila Pa 1976). 2004 Feb 15;29(4):351-9. doi: 10.1097/01.brs.0000090827.16926.1d.
A randomized controlled trial with stratified block design.
To evaluate a treatment program focusing on whether specific stabilizing exercises for patients with pelvic girdle pain after pregnancy reduce pain, improve functional status, and improve quality of life. SUMMARY OF BACKGROUND DATA. : The evidence of effectiveness of treatment for pelvic girdle pain is weak. Recent research has focused on the importance of activation of muscles for motor control and stability of the lumbopelvic region. To the authors' knowledge, the efficacy of applying these principles for pelvic girdle pain has not previously been evaluated in a randomized controlled trial.
Eighty-one women with pelvic girdle pain were assigned randomly to two treatment groups for 20 weeks. One group received physical therapy with a focus on specific stabilizing exercises. The other group received individualized physical therapy without specific stabilizing exercises. Assessments were administered by a blinded assessor, at baseline, after intervention and 1 year post partum. Main outcome measures were pain, functional status and quality of life.
There were no dropouts. After intervention and at 1 year post partum, the specific stabilizing exercise group showed statistically and clinically significant lower pain intensity, lower disability, and higher quality of life compared with the control group. Group difference in median values for evening pain after treatment was 30 mm on the Visual Analog Scale. Disability was reduced by more than 50% for the exercise group; changes were negligible in the control group. Significant differences were also observed for physical tests, in favor of the specific exercise group.
An individualized treatment approach with specific stabilizing exercises appears to be more effective than physical therapy without specific stabilizing exercises for women with pelvic girdle pain after pregnancy.
采用分层区组设计的随机对照试验。
评估一项针对产后骨盆带疼痛患者的治疗方案，该方案着重于特定的稳定练习是否能减轻疼痛、改善功能状态并提高生活质量。背景数据总结：骨盆带疼痛治疗有效性的证据不足。近期研究聚焦于激活肌肉对腰骨盆区域运动控制和稳定性的重要性。据作者所知，此前尚未在随机对照试验中评估将这些原则应用于骨盆带疼痛的疗效。
81名骨盆带疼痛的女性被随机分配到两个治疗组，为期20周。一组接受以特定稳定练习为重点的物理治疗。另一组接受无特定稳定练习的个体化物理治疗。评估由一名盲法评估者在基线、干预后和产后1年进行。主要结局指标为疼痛、功能状态和生活质量。
无脱落病例。干预后及产后1年，与对照组相比，特定稳定练习组在统计学和临床上均显示出疼痛强度更低、残疾程度更低且生活质量更高。治疗后夜间疼痛视觉模拟量表中位数的组间差异为30毫米。运动组残疾程度降低超过50%；对照组变化可忽略不计。在体格检查方面也观察到显著差异，支持特定运动组。
对于产后骨盆带疼痛的女性，采用特定稳定练习的个体化治疗方法似乎比无特定稳定练习的物理治疗更有效。
