Gausel Anne M, Dalen Ingvild, Kjærmann Inger, Malmqvist Stefan, Andersen Knut, Larsen Jan Petter, Økland Inger
Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway.
Department of Research, Section of Biostatistics, Stavanger University Hospital, Stavanger, Norway.
J Manipulative Physiol Ther. 2019 Oct;42(8):601-607. doi: 10.1016/j.jmpt.2018.12.006.
The purpose of this study was to investigate the feasibility of conducting a study examining the influence of individualized rehabilitation and chiropractic treatment, compared with individualized rehabilitation alone, in women with persistent dominating 1-sided pelvic girdle pain (PGP) 3 to 6 months after delivery.
Women were recruited from an outpatient clinic at Stavanger University Hospital, Norway and in a private chiropractic clinic in Stavanger. Those with persistent, dominating 1-sided PGP were included in this pilot study. Those who met inclusion criteria were randomized into 2 groups, one group received individualized rehabilitation and chiropractic treatment and the other group women received individualized rehabilitation alone. Treatment was measured for 20 weeks.
Of 330 consenting women who were recruited who reported pelvic pain during pregnancy, 68 reported PGP or low back pain, and 63 consented to fill in a questionnaire. Forty-seven women underwent a clinical examination 3 to 6 months after delivery. During the examination, the women were diagnosed into subgroups for PGP. After exclusion of the women with low back pain only, a total of 13 women were diagnosed with dominating 1-sided PGP and thus included in this study. Six were randomized to the individualized rehabilitation and chiropractic treatment group and 5 to the individualized rehabilitation alone group. After 20 weeks of intervention, both groups reported improvement in disability and pain, but not in general health status. No serious or long-lasting adverse events were registered after treatment or training.
We found that a study of this nature is feasible. However, the conditions of patient recruitment need to be considered carefully. We learned that a trial to investigate the effect of chiropractic treatment for PGP pain should include all subgroups of PGP to reach an acceptable sample size.
本研究旨在探讨一项研究的可行性,该研究将比较个体化康复与整脊治疗联合应用与单独进行个体化康复,对产后3至6个月持续存在单侧骨盆带疼痛(PGP)且疼痛占主导的女性的影响。
从挪威斯塔万格大学医院的门诊诊所和斯塔万格的一家私人整脊诊所招募女性。纳入本试点研究的是那些持续存在单侧PGP且疼痛占主导的女性。符合纳入标准的女性被随机分为两组,一组接受个体化康复与整脊治疗,另一组女性仅接受个体化康复。治疗时间为20周。
在招募的330名在孕期报告有骨盆疼痛的同意参与研究的女性中,68名报告有PGP或腰痛,63名同意填写问卷。47名女性在产后3至6个月接受了临床检查。在检查过程中,这些女性被诊断为PGP亚组。在排除仅患有腰痛的女性后,共有13名女性被诊断为单侧PGP且疼痛占主导,因此纳入本研究。6名被随机分配到个体化康复与整脊治疗组,5名被分配到仅接受个体化康复组。经过20周的干预,两组均报告残疾和疼痛有所改善,但总体健康状况未改善。治疗或训练后未记录到严重或长期的不良事件。
我们发现这类性质的研究是可行的。然而,患者招募条件需要仔细考虑。我们了解到,一项研究整脊治疗对PGP疼痛效果的试验应包括PGP的所有亚组,以达到可接受的样本量。