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

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The function of the pelvis is now to transfer the “load”. (DonTIGNY 1985; A Vleeming 2007; Jan Mens 2009) 2.1.3 Mobility of the pelvis Counternutation nutation are the movements which may occur in the SI joint. Nutation is a relative rotation of the anterior sacrum to the iliac bones. The mobility here is at the end of pregnancy at its maximum. At asymmetrical movement of the pelvis there is an opposite movement in both SI joints but also a movement in the pubic symphysis. In the pubic symphysis a so called “vertical shear” will take place. This mobility is normally within the limits of the joint. The stabilizing mechanisms of the pelvis There are three mechanisms to give the pelvis its stability: 1. The form closure by the shape of the articular surfaces of the joint. 2. The force closure 3. Self-locking mechanism. The form-closure is a passive mechanism the others are total or partial activation mechanisms. Below, these mechanisms are described and elucidated. (A. L. Pool- Goudzwaard et al. 1998; A Vleeming 2007) - Form closure: This is a term for the stable situation with closely fitting joint surfaces, where no extra forces are needed to maintain the state of the system, given the actual load situation. (A. L. Pool- Goudzwaard et al. 1998) There are three reasons why there is a stability in this form in the SI joints. (A. L. Pool- Goudzwaard et al. 1998; A Vleeming 2007) The first reasons is due to the wedge-shape from the sacrum. That is stabilized between the two iliac bones through this form. Secondary the roughened articular cartilage which is in contrast with a normal synovial joint. Osteopathie Schule Deutschland Dresden International University Page 13
As third reasons there are the ridges and grooves which are covered in cartilage in the joint. (A. L. Pool-Goudzwaard et al. 1998; A Vleeming 2007) - Force closure: This is a form of stability from the SI joints which is created by the compression on the joints. It is an active created stability force. For this mechanism the extra forces affecting the compression on the SI joint are created by different structures as muscles and ligaments. There are two ways to force the closure: o The first possibility is formed by the muscles which create a direct compression in the SI joints. Muscles like the m. piriformis and m. coccygeus increase the force closure. o However indirectly, the closure force is created by the muscles that change the position of the joint, which cause an increase in the tension of the ligamentous structures. (Annelies Pool-Goudzwaard et al. 2004) By a unilateral loading of the pelvis this mechanism is very important to keep an equilibrium. (A. L. Pool-Goudzwaard et al. 1998) - The self-locking mechanism: This ensures that the stability of the SI joint is ensured through the various mechanisms. It is clear that the contraction and relaxation of certain muscles have a clear effect on the stability of the SI joints. As described above, myofascial chains as the longitudinal sling, anterior oblique sling and the posterior oblique sling, determine the stability of the pelvis. Due to the tension of muscles, such as the m. gluteus maximus, m. latissimus dorsi, hamstings, mm. erector spinae, m. multifidus, m. splenius capitis, the oblique abdominis muscles and the m. transversus abdominis, the tension of the fascial structures such as the thoracolumbar fascia and the ligaments surrounding the SI joint and pelvis will be determined. So the force closure is influenced by the muscles and fascial and ligamentous structures. A change in tension of the ligaments, muscles or fascial structures, as well as poor coordination of the muscles have a negative effect on the force closure. If the force closure decreases the resistance against the shear force decreases as well and a lot more Osteopathie Schule Deutschland Dresden International University Page 14
Page 1 and 2: pelvic girdle pain and relevance of
Page 3 and 4: Conformity declaration Author: Joha
Page 5 and 6: 5.2.2 Hypothesis 2 ................
Page 7 and 8: Figure/Table # List of tables Descr
Page 9 and 10: Figure/Table # List of figures Desc
Page 11 and 12: 1. Introduction This Master researc
Page 13: 2. Basics This study aims to assess
Page 17 and 18: The anterior oblique sling: The ant
Page 19 and 20: This description of the symptoms co
Page 21 and 22: Table 2: Table by Bastiaanssen made
Page 23 and 24: which the period of measurement aft
Page 25 and 26: 2.3.2 Clinical tests These are divi
Page 27 and 28: For women with pregnancy-related po
Page 29 and 30: muscle strength. The highest score
Page 31 and 32: various aspects of the psychologica
Page 33 and 34: 3. Hypotheses Hypothesis 1 H0: The
Page 35 and 36: 4. Materials and Methods 4.1 Type o
Page 37 and 38: These physical tests were first per
Page 39 and 40: : With these data, I calculated how
Page 41 and 42: No further differentiation was made
Page 43 and 44: Initial posture therapist two: this
Page 45 and 46: The columns contain the following i
Page 47 and 48: 5. Results 5.1 Population character
Page 49 and 50: Figure 2: Characteristics of the gr
Page 51 and 52: Following test combinations are com
Page 53 and 54: Table 15: Hypothesis 1: Characteris
Page 55 and 56: There are no significant difference
Page 57 and 58: Figure 6: Hypothesis 2: Different s
Page 59 and 60: Figure 8: Hypothesis 3: Characteris
Page 61 and 62: Figure 9: Hypothesis 3: Score on th
Page 63 and 64: Table 28: Hypothesis 4: Differences
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Figure 11: Hypothesis 4: Score on t
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Table 33: Hypothesis 5: Total score
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Characteristics on negative physica
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Characteristics and differences: Th
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We have also seen that for 35% of t
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6.2.1 Population The recruitment of
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score of 2-3. From the perspective
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A reason that these women do not sc
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pain above the lumbar region. Howev
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tests exist out of the ASLR + the o
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As already mentioned, in the group
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6.3.6 Hypothesis 6 H0: There is no
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o Also significant differences were
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Gutke, A., Josefsson, A. & Oberg, B
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Vleeming, A, 2007. The role of the
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10 Appendix 10.1 Tables In this sec
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Prevalence of Pregnancy related LBP
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Prevalence of Pregnancy related LBP
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Table 12: Independent sample test f
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Table 25: Hypothesis 3: Independent
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10.2 Informed Consent Permission-ba
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Strookje (leaflet) Ik wil meewerken
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10.5 Dallas Pain Questionaire Naam_
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Niet veranderd Drastisch veranderd
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pelvic girdle pain and relevance of
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