Department of Health and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, S-405 30, Gothenburg, Sweden.
Department of Physical Therapy, Sahlgrenska University Hospital, S-413 45, Gothenburg, Sweden.
BMC Musculoskelet Disord. 2021 Mar 1;22(1):237. doi: 10.1186/s12891-021-04103-0.
Many women develop pelvic girdle pain (PGP) during pregnancy and about 10% have chronic pain several years after delivery. Self-administered pain provocation tests are one way to diagnose and evaluate this pain. Their validity in post-partum women is not yet studied. The purpose of this study was to evaluate the validity of self-administered test for assessment of chronic pregnancy-related PGP several years after delivery.
Women who previously have had PGP during pregnancy and who participated in one of three RCT studies were invited to a postal follow up of symptoms including performance of self-administered tests after two, 6 or 11 years later, respectively. In total, 289 women returned the questionnaire and the test-results. Of these, a sub-group of 44 women with current PGP underwent an in-person clinical examination. Comparisons were made between test results in women with versus without PGP but also, in the sub-group, between the self-administered tests and those performed during the clinical examination.
Fifty-one women reported PGP affecting daily life during the last 4 weeks, and 181 reported pain when performing at least one of the tests at home. Those with chronic PGP reported more positive tests (p < 0.001). There was no significant difference between diagnosis from the self-administered tests compared to tests performed during the in-person clinical examination (p = 0.305), either for anterior or posterior PGP. There were no significant differences of the results between the tests performed self-administered vs. during the clinical examination.
A battery of self-administered tests combined with for example additional specific questions or a pain-drawing can be used as a screening tool to diagnose chronic PGP years after delivery. However, the modified SLR test has limitations which makes its use questionable.
许多女性在怀孕期间会出现骨盆带疼痛（PGP），约有 10%的女性在分娩后数年仍持续慢性疼痛。自我管理的疼痛诱发测试是诊断和评估这种疼痛的一种方法。但它们在产后女性中的有效性尚未得到研究。本研究的目的是评估自我管理的测试在产后数年评估慢性妊娠相关性 PGP 的有效性。
先前曾在怀孕期间出现 PGP 并参加过三项随机对照试验之一的女性被邀请参加邮寄随访，分别在两年、六年或十一年后报告症状，包括自我管理测试的结果。共有 289 名女性返回了问卷和测试结果。其中，44 名当前患有 PGP 的女性参加了面对面的临床检查。比较了有和没有 PGP 的女性的测试结果，也比较了亚组中自我管理测试和临床检查中的测试结果。
51 名女性报告在过去 4 周内日常生活受到 PGP 影响，181 名女性在进行至少一项家庭测试时报告疼痛。患有慢性 PGP 的女性报告更多阳性测试（p<0.001）。自我管理测试的诊断与面对面临床检查的测试相比（p=0.305），无论是对前 PGP 还是后 PGP，均无显著差异。自我管理测试和临床检查中进行的测试之间的结果没有显著差异。
一套自我管理的测试结合例如其他特定问题或疼痛图可以作为一种筛查工具，用于诊断分娩后数年的慢性 PGP。但是，改良的 SLR 测试存在局限性，使其使用值得怀疑。
