Evaluation of self-administered tests for pelvic girdle pain in pregnancy

BMC Musculoskeletal Disorders

Annelie Gutke¹  Helen Elden²  Monika Fagevik Olsén¹ 

[1] Department of Physical Therapy and Occupational Therapy, Institute of Neuroscience and Physiology Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

关键词: Tests;    Pregnancy;    Pelvic girdle pain;    Agreement;   

Others  :  1127697
DOI  :  10.1186/1471-2474-15-138

 received in 2014-01-29, accepted in 2014-04-23,  发布年份 2014

【 摘 要 】

Background

Different tests are used in order to classify women with pelvic girdle pain (PGP). One limitation of the tests is that they need to be performed by an examiner. Self-administered tests have previously been described and evaluated by women who performed the tests directly before the examiner performed the original tests. Thus, an evaluation of the self-administered tests performed in a more natural setting, such as the women’s home is needed.

The purpose of this study was to investigate the agreement between self-administered tests performed at home and tests performed by an examiner on women with suspected PGP. Additionally to compare the classification made by an examiner and classification based on results of the self-administered tests and questionnaire.

Methods

One hundred and twenty three pregnant women with suspected PGP participated. Before the appointment at the clinic the women performed the self-administered tests and filled in a questionnaire. During the appointment one specialized physiotherapist performed the tests. Result of the two different sets of tests and the classifications made by the examiner and the self-administered tests including questionnaires were compared concerning percentage of agreement (POA), sensitivity and positive predicted value (PPV).

Results

The P4 and the bridging test had the highest POA (≥74.8%), sensitivity (≥75.5%) and PPV (≥91.2%) for posterior PGP. For anterior PGP the MAT test had highest POA (76.4%), and PPV (69.5%), and the modified Trendelenburg test the highest sensitivity (93.0%). Agreement between the two classifications was 87%.

A significantly higher number of positive P4 and bridging tests (p < 0.01) and a significantly lower number of positive Trendelenburg tests, Active Straight Leg raise and Straight Leg Raise (p < 0.05) were recorded by the examiner compared to the self-administered ones.

Conclusions

Our results indicate that self-administered test and questionnaires are possible to use for testing and classification of women with suspected PGP.

【 授权许可】

   
2014 Fagevik Olsén et al.; licensee BioMed Central Ltd.

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【 参考文献 】

• [1]Sydsjo A, Sydsjo G, Kjessler B: Sick leave and social benefits during pregnancy–a Swedish-Norwegian comparison. Acta Obstet Gynecol Scand 1997, 76:748-754.
• [2]Gutke A, Ostgaard HC, Oberg B: Pelvic girdle pain and lumbar pain in pregnancy: a cohort study of the consequences in terms of health and functioning. Spine 2006, 31:E149-E155.
• [3]Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B: European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J 2008, 17:794-819.
• [4]Kristiansson P, Svardsudd K, Von Schoultz B: Back pain during pregnancy: a prospective study. Spine 1996, 21:702-709.
• [5]Rost CC, Jacqueline J, Kaiser A, Verhagen AP, Koes BW: Pelvic pain during pregnancy: a descriptive study of signs and symptoms of 870 patients in primary care. Spine 2004, 29:2567-2572.
• [6]Olsson C, Nilsson-Wikmar L: Health-related quality of life and physical ability among pregnant women with and without back pain in late pregnancy. Acta Obstet Gynecol Scand 2004, 83:351-357.
• [7]Gutke A, Josefsson A, Oberg B, Gutke A, Josefsson A, Oberg B: Pelvic girdle pain and lumbar pain in relation to postpartum depressive symptoms. Spine 2007, 32:1430-1436.
• [8]Stuge B, Laerum E, Kirkesola G, Vollestad N: The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: a randomized controlled trial. Spine 2004, 29:351-359.
• [9]Elden H, Ladfors L, Olsen MF, Ostgaard HC, Hagberg H: Effects of acupuncture and stabilising exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised single blind controlled trial. BMJ 2005, 330:761-764.
• [10]Robinson HS, Veierod MB, Mengshoel AM, Vollestad NK: Pelvic girdle pain–associations between risk factors in early pregnancy and disability or pain intensity in late pregnancy: a prospective cohort study. BMC Musculoskelet Disord 2010, 11:91. BioMed Central Full Text
• [11]Robinson HS, Mengshoel AM, Veierod MB, Vollestad N: Pelvic girdle pain: potential risk factors in pregnancy in relation to disability and pain intensity three months postpartum. Man Ther 2010, 5:522-528.
• [12]Albert H, Godskesen M, Westergaard J: Evaluation of clinical tests used in classification procedures in pregnancy-related pelvic joint pain. Eur Spine J 2000, 9:161-166.
• [13]Albert H, Godskesen M, Westergaard J: Prognosis in four syndromes of pregnancy-related pelvic pain. Acta Obstet Gynecol Scand 2001, 80:505-510.
• [14]Fagevik Olsen M, Gutke A, Elden H, Nordenman C, Fabricius L, Gravesen M, Lind A, Kjellby-Wendt G: Self-administered tests as a screening procedure for pregnancy-related pelvic girdle pain. Eur Spine J 2009, 18:1121-1129.
• [15]Laslett M, Aprill CN, McDonald B, Young SB: Diagnosis of sacroiliac joint pain: validity of individual provocation tests and composites of tests. Man Ther 2005, 10:207-218.
• [16]Mens JM, Vleeming A, Snijders CJ, Koes BW, Stam HJ: Reliability and validity of the active straight leg raise test in posterior pelvic pain since pregnancy. Spine 2001, 26:1167-1171.
• [17]Ostgaard HC, Zetherstrom G, Roos-Hansson E: The posterior pelvic pain provocation test in pregnant women. Eur Spine J 1994, 3:258-260.
• [18]Deville WL, van der Windt DA, Dzaferagic A, Bezemer PD, Bouter LM: The test of Lasegue: systematic review of the accuracy in diagnosing herniated discs. Spine 2000, 25:1140-1147.
• [19]Mogren I, Winkvist A, Dahlgren L: Trust and ambivalence in midwives’ views towards women developing pelvic pain during pregnancy; a qualitative study. BMC Public Health 2010, 10:600.
• [20]Gutke A, Hansson ER, Zetherstrom G, Ostgaard HC: Posterior pelvic pain provocation test is negative in patients with lumbar herniated discs. Eur Spine 2009, 18:1008-1012.
• [21]Laslett M, Young SB, Aprill CN, McDonald B: Diagnosing painful sacroiliac joints: a validity study of a McKenzie evaluation and sacroiliac provocation tests. Aust J Physiother 2003, 49:89-97.
• [22]Elden H, Fagevik-Olsen M, Ostgaard HC, Stener-Victorin E, Hagberg H: Acupuncture as an adjunct to standard treatment for pelvic girdle pain in pregnant women: randomised double-blinded controlled trial comparing acupuncture with non-penetrating sham acupuncture. BJOG 2008, 115:1655-1668.
• [23]Gutke A, Ostgaard HC, Oberg B: Predicting persistent pregnancy-related low back pain. Spine 2008, 33:E386-E393.
• [24]Rost CC, Jacqueline J, Kaiser A, Verhagen AP, Koes BW: Prognosis of women with pelvic pain during pregnancy: a long-term follow-up study. Acta Obstet Gynecol Scand 2006, 85:771-777.
• [25]Gutke A, Lundberg M, Ostgaard HC, Oberg B: Impact of postpartum lumbopelvic pain on disability, pain intensity, health-related quality of life, activity level, kinesiophobia, and depressive symptoms. Eur Spine J 2011, 20:440-448.
• [26]Ostgaard HC, Zetherstrom G, Roos-Hansson E: Back pain in relation to pregnancy: a 6-year follow-up. Spine 1997, 22:2945-2950.