Pelvic girdle pain and relevance of ASLR testing: A ... - Cindy Verheul

10.2 Informed Consent
Permission-based information (informed consent)
The study: Prevalence of pelvic instability in a population with low back pain and pelvic girdle
pain after pregnancy: A clinical trial.
You can take part of this study, because there is a possibility after pregnancy, to have pelvic
girdle pain or instability.
This study examines the prevalence of pelvic instability in women with pain in the lower back
and pelvis, 6-8 weeks after childbirth. This study contributes to the prevention of pelvic
instability after childbirth.
The research, which takes place between March 2012 and May 2012, contains the following
components:
A group of women out of practices for obstetrics and physical therapy, is asked to
participate in the study (random). They fill in a form with their name, phone number
and date of expected delivery.
The women are approached by telephone for an appointment. The research will be
conducted in Heerlen.
The survey itself consists of two components:
1. The completion of the Dallas questionnaire in the presence of an independent
researcher.
2. Active movements of the hip in the supine position. These tests will be carried out
with or without manual compression of the pelvis.
The entire survey (questionnaire and tests) takes about 10 minutes.
There are no risks expected as a result of this research. It may be that the data are not used
when they are not useful for the study.
For participants in the research we will always retain the right to refuse participation or to
interrupt.
The data will be anonymous and treated confidentially. The privacy is guaranteed.
I have been reading this information carefully and agree that my data are being used for
research,
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Osteopathie Schule Deutschland
Dresden International University Page 104