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一项针对产后骨盆带疼痛的特定稳定练习治疗方案的疗效:一项随机临床试验的两年随访

The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: a two-year follow-up of a randomized clinical trial.

作者信息

Stuge Britt, Veierød Marit Bragelien, Laerum Even, Vøllestad Nina

机构信息

Section for Health Science, University of Oslo, Oslo, Norway.

出版信息

Spine (Phila Pa 1976). 2004 May 15;29(10):E197-203. doi: 10.1097/00007632-200405150-00021.

Abstract

STUDY DESIGN

A randomized clinical trial.

OBJECTIVES

To examine the effects of a treatment program focusing on specific stabilizing exercises after a 2-year follow-up period.

SUMMARY OF BACKGROUND DATA

An individualized treatment approach with specific stabilizing exercises is shown to be effective for women with pelvic girdle pain 1 year after delivery. No previous study has examined the long-term effects of treatment for women with postpartum pelvic girdle pain.

METHODS

Eighty-one women with pelvic girdle pain postpartum were assigned randomly to 2 treatment groups for 20 weeks. Patient self-reported questionnaires measuring pain, disability, and health-related quality of life were collected after 20 weeks of treatment and 1 and 2 years postpartum.

RESULTS

All 81 women returned the questionnaires for the 2-year follow-up. Sixteen were excluded from the analysis, mainly due to new pregnancies. The significant differences between the groups in functional status, pain, and physical health (SF-36) were maintained 2 years after delivery. Minimal disability was found in 85% of the specific stabilizing exercise group as compared to 47% in the control group. The control group showed significant improvement in functional status with median change score of 6.0 (Q1-Q3 of -12-0). Minimal evening pain was reported by 68% in the specific stabilizing exercise group versus 23% in the control group. However, the group differences disappeared for all measures when controlling for score level 1 year after delivery by regression analysis.

CONCLUSION

The significant differences between the groups persisted with continued low levels of pain and disability in the specific stabilizing exercise group 2 years after delivery. Significant reduction in disability was found within the control group. Those with the highest level of disability and greatest potential for improvements recovered most, regardless of intervention group.

摘要

研究设计

一项随机临床试验。

目的

在2年随访期后,研究一项专注于特定稳定练习的治疗方案的效果。

背景数据总结

对于产后骨盆带疼痛的女性,一种采用特定稳定练习的个体化治疗方法已被证明在产后1年是有效的。此前尚无研究探讨产后骨盆带疼痛女性治疗的长期效果。

方法

81名产后骨盆带疼痛的女性被随机分配到2个治疗组,为期20周。在治疗20周后以及产后1年和2年收集患者自我报告的测量疼痛、功能障碍和健康相关生活质量的问卷。

结果

所有81名女性都返回了2年随访的问卷。16名被排除在分析之外,主要原因是再次怀孕。产后2年,两组在功能状态、疼痛和身体健康(SF-36)方面的显著差异依然存在。特定稳定练习组85%的女性功能障碍最小,而对照组为47%。对照组功能状态有显著改善,中位变化评分为6.0(四分位间距为-12至0)。特定稳定练习组68%的女性报告夜间疼痛最小,而对照组为23%。然而,通过回归分析控制产后1年的评分水平后,所有测量指标的组间差异均消失。

结论

产后2年,特定稳定练习组两组之间的显著差异持续存在,疼痛和功能障碍水平持续较低。对照组功能障碍显著减轻。无论干预组如何,功能障碍水平最高且改善潜力最大的患者恢复得最多。

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