Aldabe Daniela, Lawrenson Peter, Sullivan John, Hyland Gail, Bussey Melanie D, Hammer Niels, Bryant Katrina, Woodley Stephanie J
Department of Anatomy, School of Biomedical Sciences, University of Otago, PO Box 56, Dunedin, New Zealand; Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, PO Box 56, Dunedin, New Zealand.
Department of Anatomy, School of Biomedical Sciences, University of Otago, PO Box 56, Dunedin, New Zealand; School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.
Physiotherapy. 2022 Jun;115:66-84. doi: 10.1016/j.physio.2021.09.002. Epub 2021 Sep 22.
Pregnancy-related pelvic girdle pain (PPGP) contributes to significant prenatal and postpartum impairments; however, various clinical practices exist around the conservative treatment of this condition. This study sought to reach a consensus on the essential components of PPGP management through an international Delphi survey of experts in women's health.
Eighty-seven international experts in the field of PPGP were invited to participate and surveyed over three rounds. Round 1 of the survey utilised open-ended questions to gain feedback on 16 components of PPGP management previously identified by a focus group. Feedback from panel members guided modification and refinement of questions for Rounds 2 and 3. A 5-point Likert scale was used to rate level of agreement, with a minimum threshold for consensus of ≥75% agreement set across all survey rounds.
Forty-four of the 87 (50%) invited professionals agreed to participate in the panel, with 77% (34/44) of panellists contributing to all three rounds. Of the 16 initial components, 15 were included in Round 2. The final consensus was reached on 10 important components of assessment and management after Round 3: pain education, postural and ergonomic advice, social and lifestyle factors, psychological factors, cultural considerations, strengthening exercise, other exercise, exercise precautions, manual therapy and the use of crutches.
This study identified 10 key components that should be considered in the management of PPGP. In addition, these components provide a potential framework for future research around the conservative management of PPGP.
妊娠相关骨盆带疼痛（PPGP）会导致严重的产前和产后功能障碍；然而，针对这种疾病的保守治疗存在多种临床实践。本研究旨在通过对女性健康领域专家进行国际德尔菲调查，就PPGP管理的基本要素达成共识。
邀请了87位PPGP领域的国际专家参与，并进行三轮调查。第一轮调查使用开放式问题，以获取对先前由一个焦点小组确定的PPGP管理16个要素的反馈。专家小组成员的反馈指导了第二轮和第三轮问题的修改和完善。使用5点李克特量表对同意程度进行评分，所有调查轮次的最低共识阈值设定为≥75%的同意率。
87位受邀专业人员中有44位（50%）同意参加专家小组，77%（34/44）的小组成员参与了所有三轮调查。在最初的16个要素中，15个被纳入第二轮。第三轮后就评估和管理的10个重要要素达成了最终共识：疼痛教育、姿势和人体工程学建议、社会和生活方式因素、心理因素、文化考量、强化锻炼、其他锻炼、锻炼注意事项、手法治疗和使用拐杖。
本研究确定了PPGP管理中应考虑的10个关键要素。此外，这些要素为未来围绕PPGP保守管理的研究提供了一个潜在框架。
