A randomized controlled trial comparing a multimodal intervention and standard obstetrics care for low back and pelvic pain in pregnancy

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• 作者：James W. George ; DC^a ; ^{james.george@logan.edu} ; Clayton D. Skaggs ; DC^b ; Paul A. Thompson ; PhD^f ; D. Michael Nelson ; MD ; PhD^c ; Jeffrey A. Gavard ; PhD^d ; Gilad A. Gross ; MD^e
• 关键词：back pain ; exercise ; manipulation ; pregnancy
• 刊名：American Journal of Obstetrics and Gynecology
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：208
• 期：4
• 页码：295.e1-295.e7
• 全文大小：314 K

文摘

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Objective

Women commonly experience low back pain during pregnancy. We examined whether a multimodal approach of musculoskeletal and obstetric management (MOM) was superior to standard obstetric care to reduce pain, impairment, and disability in the antepartum period.

Study Design

A prospective, randomized trial of 169 women was conducted. Baseline evaluation occurred at 24-28 weeks' gestation, with follow-up at 33 weeks' gestation. Primary outcomes were the Numerical Rating Scale (NRS) for pain and the Quebec Disability Questionnaire (QDQ). Both groups received routine obstetric care. Chiropractic specialists provided manual therapy, stabilization exercises, and patient education to MOM participants.

Results

The MOM group demonstrated significant mean reductions in Numerical Rating Scale scores (5.8 ¡À 2.2 vs 2.9 ¡À 2.5; P < .001) and Quebec Disability Questionnaire scores (4.9 ¡À 2.2 vs 3.9 ¡À 2.4; P < .001) from baseline to follow-up evaluation. The group that received standard obstetric care demonstrated no significant improvements.

Conclusion

A multimodal approach to low back and pelvic pain in mid pregnancy benefits patients more than standard obstetric care.