Beales Darren, Lutz Alison, Thompson Judith, Wand Benedict Martin, O'Sullivan Peter
School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
The School of Physiotherapy, The University of Notre Dame Australia, PO Box 1225, Fremantle, Western Australia, 6959, Australia.
Man Ther. 2016 Feb;21:69-75. doi: 10.1016/j.math.2015.04.016. Epub 2015 May 1.
For a small but significant group, pregnancy-related lumbopelvic pain may become persistent. While multiple factors may contribute to disability in this group, previous studies have not investigated sleep impairments, body perception or mindfulness as potential factors associated with disability post-partum.
To compare women experiencing no pain post-pregnancy with those experiencing pregnancy-related persistent lumbopelvic pain (either low- or high-level disability) across multiple biopsychosocial domains.
Cross-sectional.
Participants completed questionnaires for thorough profiling of factors thought to be important in pregnancy-related lumbopelvic pain. Specific measures were the Urinary Distress Inventory, Medical Outcomes Study Sleep Scale, Back Beliefs Questionnaire, Tampa Scale for Kinesiophobia, Depression Anxiety Stress Scale, Coping Strategies Questionnaire, Pain Catastrophising Scale, The Fremantle Back Awareness Questionnaire and the Mindful Attention Awareness Scale. Women where categorised into three groups; pain free (n = 26), mild disability (n = 12) and moderate disability (n = 12) (based on Oswestry Disability Index scores). Non-parametric group comparisons were used to compare groups across the profiling variables.
Differences were identified for kinesiophobia (p = 0.03), body perception (p = 0.02), sleep quantity (p < 0.01) and sleep adequacy (p = 0.02). Generally subjects in the moderate disability group had more negative findings for these variables.
Disturbances in body-perception, sleep and elevated kinesiophobia were found in pregnancy-related lumbopelvic pain subjects with moderate disability, factors previously linked to persistent low back pain. The cross-sectional nature of this study does not allow for identification of directional pathways between factors. The results support the consideration of these factors in the assessment and management of pregnancy-related lumbopelvic pain.
对于一小部分但数量可观的人群而言，与妊娠相关的腰骨盆疼痛可能会持续存在。尽管多种因素可能导致该群体出现功能障碍，但既往研究尚未将睡眠障碍、身体感知或正念作为产后功能障碍的潜在相关因素进行调查。
在多个生物心理社会领域，比较产后无疼痛的女性与患有与妊娠相关的持续性腰骨盆疼痛（轻度或重度功能障碍）的女性。
横断面研究。
参与者完成问卷，以全面了解被认为在与妊娠相关的腰骨盆疼痛中重要的因素。具体测量指标包括泌尿困扰量表、医学结局研究睡眠量表、背部信念问卷、坦帕运动恐惧量表、抑郁焦虑压力量表、应对策略问卷、疼痛灾难化量表、弗里曼特尔背部觉知问卷和正念注意觉知量表。女性被分为三组：无痛组（n = 26）、轻度功能障碍组（n = 12）和中度功能障碍组（n = 12）（基于奥斯威斯功能障碍指数评分）。采用非参数组间比较来比较各变量在不同组间的差异。
在运动恐惧（p = 0.03）、身体感知（p = 0.02）、睡眠质量（p < 0.01）和睡眠充足度（p = 0.02）方面发现了差异。一般来说，中度功能障碍组的受试者在这些变量上有更多负面结果。
在患有中度功能障碍的与妊娠相关的腰骨盆疼痛受试者中，发现了身体感知、睡眠方面的紊乱以及运动恐惧增加，这些因素先前与持续性腰痛有关。本研究的横断面性质不允许确定各因素之间的方向性路径。研究结果支持在评估和管理与妊娠相关的腰骨盆疼痛时考虑这些因素。
