Chiropractic Science Division, College of Chiropractic, Logan University, Chesterfield, MO, USA.
Am J Obstet Gynecol. 2013 Apr;208(4):295.e1-7. doi: 10.1016/j.ajog.2012.10.869. Epub 2012 Oct 23.
Women commonly experience low back pain during pregnancy. We examined whether a multimodal approach of musculoskeletal and obstetric management (MOM) was superior to standard obstetric care to reduce pain, impairment, and disability in the antepartum period.
A prospective, randomized trial of 169 women was conducted. Baseline evaluation occurred at 24-28 weeks' gestation, with follow-up at 33 weeks' gestation. Primary outcomes were the Numerical Rating Scale (NRS) for pain and the Quebec Disability Questionnaire (QDQ). Both groups received routine obstetric care. Chiropractic specialists provided manual therapy, stabilization exercises, and patient education to MOM participants.
The MOM group demonstrated significant mean reductions in Numerical Rating Scale scores (5.8 ± 2.2 vs 2.9 ± 2.5; P < .001) and Quebec Disability Questionnaire scores (4.9 ± 2.2 vs 3.9 ± 2.4; P < .001) from baseline to follow-up evaluation. The group that received standard obstetric care demonstrated no significant improvements.
A multimodal approach to low back and pelvic pain in mid pregnancy benefits patients more than standard obstetric care.
女性在怀孕期间通常会经历下腰痛。我们研究了多模式的肌肉骨骼和产科管理(MOM)方法是否优于标准产科护理,以减少产前的疼痛、损伤和残疾。
对 169 名女性进行了前瞻性、随机试验。基线评估在 24-28 周妊娠时进行,随访在 33 周妊娠时进行。主要结局是数字评定量表(NRS)的疼痛评分和魁北克残疾问卷(QDQ)。两组均接受常规产科护理。脊骨神经医学专家为 MOM 组参与者提供手法治疗、稳定练习和患者教育。
MOM 组的数字评定量表评分(5.8 ± 2.2 与 2.9 ± 2.5;P <.001)和魁北克残疾问卷评分(4.9 ± 2.2 与 3.9 ± 2.4;P <.001)从基线到随访评估均有显著的平均降低。接受标准产科护理的组没有显著的改善。
在妊娠中期对下腰痛和骨盆痛采用多模式方法比标准产科护理更有益于患者。