Mens Jan M A, Huis in 't Veld Yvonne H, Pool-Goudzwaard Annelies
Department of Rehabilitation Medicine, Erasmus MC, University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
Man Ther. 2012 Apr;17(2):175-9. doi: 10.1016/j.math.2011.12.012. Epub 2012 Jan 16.
Data on the severity of signs and symptoms of lumbopelvic pain (LPP) during pregnancy are scarce. Therefore, this cross-sectional study examines the severity of LPP and pain-related signs and symptoms. Women with an uncomplicated pregnancy of 20-30 weeks were invited to participate. They rated their pain and fatigue on a numerical rating scale, and pain location was indicated on a drawing. Disability was scored on the Quebec Back Pain Disability Scale (QBPDS) and urine incontinence on a Likert scale. Physical examination consisted of the Active Straight Leg Raise (ASLR) test, the Posterior Pelvic Pain Provocation (PPPP) test and pain score, and force during isometric bilateral hip adduction. Of all 182 participants, 60.4% reported LPP. Mean pain level was 3.6 (SD 2.2); in 20.0% of the women the score was >5. The mean score on the QBPDS was 27 (SD 16); in 20.9% the score was >40. Compared to women without LPP, women with LPP more frequently suffered back pain in the past (p<0.001), had a higher body mass index (p<0.01), more often had urinary incontinence (p<0.05), had less isometric hip adduction force (p<0.001), had more pain on isometric hip adduction (p<0.01), had a higher ASLR score (p<0.001) and more had often a positive PPPP test (p<0.001). Fatigue was not related to LPP during pregnancy. The main conclusion is that pain and disability of LPP during pregnancy can be interpreted as mild to moderate in most cases, and as severe in about 20%.
关于孕期腰骶部疼痛（LPP）体征和症状严重程度的数据很少。因此，这项横断面研究调查了LPP的严重程度以及与疼痛相关的体征和症状。邀请妊娠20 - 30周且无并发症的女性参与。她们通过数字评分量表对疼痛和疲劳进行评分，并在图上标明疼痛位置。采用魁北克腰痛残疾量表（QBPDS）对残疾情况进行评分，采用李克特量表对尿失禁情况进行评分。体格检查包括主动直腿抬高（ASLR）试验、骨盆后疼痛激发（PPPP）试验及疼痛评分，以及双侧等长髋关节内收时的力量测试。在所有182名参与者中，60.4%报告有LPP。平均疼痛水平为3.6（标准差2.2）；20.0%的女性评分>5。QBPDS的平均评分为27（标准差16）；20.9%的评分>40。与无LPP的女性相比，有LPP的女性过去更频繁出现背痛（p<0.001），体重指数更高（p<0.01），更常出现尿失禁（p<0.05），等长髋关节内收力量更小（p<0.001），等长髋关节内收时疼痛更明显（p<0.01），ASLR评分更高（p<0.001），PPPP试验阳性的情况更常见（p<0.001）。疲劳与孕期LPP无关。主要结论是，孕期LPP的疼痛和残疾在大多数情况下可解释为轻度至中度，约20%为重度。
