Effects of Core Stabilization Exercises and High-Velocity Thrust Manipulation on Pelvic-Girdle Pain: A Randomized Controlled Trial
Exercises and HVT in Pelvic-Girdle Pain
DOI:
https://doi.org/10.54393/pbmj.v6i09.939Keywords:
Pelvic Girdle Pain, Thrust Manipulation, Core Stabilization Exercises, Low Back Pain, Oswestry Disability IndexAbstract
Pelvic-girdle pain is a mechanical disorder is very prevalent that leads the individual to suffer with disability and functional limitations. Objective: To determine the effectiveness of core stabilization exercises with thrust manipulation (HVT) on pelvic girdle pain in postpartum women. Methods: This randomized, placebo treatment-controlled trial was conducted in Physiotherapy OPD clinic in Jinnah Memorial Trust Hospital Gujranwala, Pakistan. We included 40 post-partum females consecutively aged 18 to 45 years presenting with pelvic girdle pain for over the past 6 to 16 months of the delivery meeting were isolated in two groups using convenient sampling. The control group received stabilization exercises with routine physical therapy treatment and the treatment group received a high velocity thrust manipulations technique (HVTT). The study instruments included Oswestry Disability Index Questionnaire and numeric pain rating scale. Data were analysed using SPSS 21.0. Results: The findings indicated demographics age with a mean and S.D score of 31.08 ± 6.36. In participants pain numeric pain and ODI scores in the post-treatment group were significant with a p <0.01 and general exercise with a p<0.02. The pre and post ODI scores in both groups had a p-value <0.05 except the within-group score of p >0.068. Conclusions: The application of high velocity thrust manipulation is effective approach in reducing pelvic girdle pain and discomfort in postpartum women. The HVTT treatment therapy can be deemed superior to core stabilization exercises.
References
REFERENCES
Bastiaanssen JM, de Bie RA, Bastiaenen CH, Essed GG, Van den Brandt PA. A historical perspective on pregnancy-related low back and/or pelvic girdle pain. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2005 May; 120(1): 3-14. doi: 10.1016/j.ejogrb.2004.11.021. DOI: https://doi.org/10.1016/j.ejogrb.2004.11.021
Robinson HS, Eskild A, Heiberg E, Eberhard-Gran M. Pelvic girdle pain in pregnancy: the impact on function. Acta Obstetricia et Gynecologica Scandinavica. 2006 Jan; 85(2): 160-4. doi: 10.1080/00016340500410024. DOI: https://doi.org/10.1080/00016340500410024
Bergström C, Persson M, Mogren I. Sick leave and healthcare utilisation in women reporting pregnancy related low back pain and/or pelvic girdle pain at 14 months postpartum. Chiropractic & Manual Therapies. 2016 Dec; 24(1): 1-10. doi: 10.1186/s12998-016-0088-9. DOI: https://doi.org/10.1186/s12998-016-0088-9
Vermani E, Mittal R, Weeks A. Pelvic girdle pain and low back pain in pregnancy: a review. Pain Practice. 2010 Jan; 10(1): 60-71. doi: 10.1111/j.1533-2500.2009.00327.x. DOI: https://doi.org/10.1111/j.1533-2500.2009.00327.x
Bergström C, Persson M, Nergård KA, Mogren I. Prevalence and predictors of persistent pelvic girdle pain 12 years postpartum. BMC Musculoskeletal Disorders. 2017 Dec; 18(1): 1-3. doi: 10.1186/s12891-017-1760-5. DOI: https://doi.org/10.1186/s12891-017-1760-5
Eggen MH, Stuge B, Mowinckel P, Jensen KS, Hagen KB. Can supervised group exercises including ergonomic advice reduce the prevalence and severity of low back pain and pelvic girdle pain in pregnancy? A randomized controlled trial. Physical Therapy. 2012 Jun; 92(6): 781-90. doi: 10.2522/ptj.20110119. DOI: https://doi.org/10.2522/ptj.20110119
Vleeming A, Albert HB, Östgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. European Spine Journal. 2008 Jun; 17: 794-819. doi: 10.1007/s00586-008-0602-4. DOI: https://doi.org/10.1007/s00586-008-0602-4
Elden H, Ostgaard HC, Fagevik-Olsen M, Ladfors L, Hagberg H. Treatments of pelvic girdle pain in pregnant women: adverse effects of standard treatment, acupuncture and stabilising exercises on the pregnancy, mother, delivery and the fetus/neonate. BMC Complementary and Alternative Medicine. 2008 Dec; 8(1): 1-3. doi: 10.1186/1472-6882-8-34. DOI: https://doi.org/10.1186/1472-6882-8-34
Crockett KL, Bowen A, Madill SJ, Kumaran M, Epp C, Graham AM. A review of the effects of physical therapy on self-esteem in postpartum women with lumbopelvic dysfunction. Journal of Obstetrics and Gynaecology Canada. 2019 Oct; 41(10): 1485-96. doi: 10.1016/j.jogc.2018.07.015. DOI: https://doi.org/10.1016/j.jogc.2018.07.015
Davenport MH, Marchand AA, Mottola MF, Poitras VJ, Gray CE, Garcia AJ, et al. Exercise for the prevention and treatment of low back, pelvic girdle and lumbopelvic pain during pregnancy: a systematic review and meta-analysis. British Journal of Sports Medicine. 2019 Jan; 53(2): 90-8. doi: 10.1136/bjsports-2018-099400. DOI: https://doi.org/10.1136/bjsports-2018-099400
Stuge B, Lærum E, Kirkesola G, Vøllestad N. The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: a randomized controlled trial. 2004 Feb; 29(4): 351-9. doi: 10.1097/01.brs.0000090827.16926.1d. DOI: https://doi.org/10.1097/01.BRS.0000090827.16926.1D
Al-Sayegh NA, George SE, Boninger ML, Rogers JC, Whitney SL, Delitto A. Spinal mobilization of postpartum low back and pelvic girdle pain: an evidence-based clinical rule for predicting responders and nonresponders. PM&R. 2010 Nov; 2(11): 995-1005. doi: 10.1016/j.pmrj.2010.07.481. DOI: https://doi.org/10.1016/j.pmrj.2010.07.481
Afzal K, Sajjad AG, Memon SI, Tariq R, Sulaiman M. Effects of Maitland s segmental mobilization and general spine mobilization in patients with cervical spondylosis. Rawal Medical Journal. 2022 Dec; 47(4): 940.
Khalil M, Memon SI, Saleem R, Ali SZ. Prevalence of Low Back Pain among Overweight Persons. (cross sectional study). Indo American Journal of Pharmaceutical Sciences. 2019; 6(09): 15635-15641. doi: 10.5281/zenodo.3384189.
Memon SI, Rasheed S, Sindhu S, Payal, Qureshi F, Smith CMG, et al., Prevalence & Risk Factors Of Low Back Pain Among Teaching Staff At Ksu Riyadh, Cross Sectional Study. Indo American Journal of Pharmaceutical Sciences. 2019; 6(11): 15079-15086. doi: 10.5281/zenodo.3554958.
Mapinduzi J, Ndacayisaba G, Mahaudens P, Hidalgo B. Effectiveness of motor control exercises versus other musculoskeletal therapies in patients with pelvic girdle pain of sacroiliac joint origin: A systematic review with meta-analysis of randomized controlled trials. Journal of Back and Musculoskeletal Rehabilitation. 2022 Jan; 35(4): 713-28. doi: 10.3233/BMR-210108. DOI: https://doi.org/10.3233/BMR-210108
Gutke A, Sjödahl J, Öberg B. Specific muscle stabilizing as home exercises for persistent pelvic girdle pain after pregnancy: a randomized, controlled clinical trial. Journal of Rehabilitation Medicine. 2010 Oct; 42(10): 929-35. doi: 10.2340/16501977-0615. DOI: https://doi.org/10.2340/16501977-0615
Yu CY, Yu TY, Chen YW, Lin LF, Peng CW, Chen HC. Core stabilization exercise in prenatal and postnatal women with urinary incontinence: A systematic review and meta-analysis of randomized controlled trials. American Journal of Physical Medicine & Rehabilitation. 2023 Apr: 10-97. doi: 10.1097/PHM.0000000000002260. DOI: https://doi.org/10.1097/PHM.0000000000002260
Haavik H, Murphy BA, Kruger J. Effect of spinal manipulation on pelvic floor functional changes in pregnant and nonpregnant women: a preliminary study. Journal of Manipulative and Physiological Therapeutics. 2016 Jun; 39(5): 339-47. doi: 10.1016/j.jmpt.2016.04.004. DOI: https://doi.org/10.1016/j.jmpt.2016.04.004
Fatima I, Goyal M, Singh G. Comparing the effect of thrust manipulation and muscle energy technique on pain and disability in patients with sacroiliac joint dysfunction. Physiotherapy Quarterly. 2021 Jul; 29(3): 49-55. doi: 10.5114/pq.2020.100294. DOI: https://doi.org/10.5114/pq.2020.100294
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