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

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In the study of Stuge et al by means of ultrasound research it has shown that women with a narrower PGP there is a thinner levator hiatus at rest. This indicates the tendency towards a higher vaginal tension at rest. (Stuge et al. 2012) This again indicates that as described, there is an increased activity of the PFM. Meaning the results O'Sullivan study seems to be confirmed. (P. O’Sullivan et al. 2002) A distinction between the superficial and deeper layer of the pelvic floor is made in the study of Fitzgerald et al. Here it is shown that the tension in the deeper layer of the PFM, the m. levator ani and m. obturatorius internus, with almost all women with pelvic pain is positive. This in contrast with the women without pelvic pain, here there is no higher tension in this layer of the PFM. For both groups, however, the involuntary contraction of the PFM is weak in 50% of the cases. (Fitzgerald & Mallinson 2012) Summarizing these studies, we could conclude that the described tension of the PFM has an impact on the stability of the pelvis. Women with pelvic pain show a changed muscle tension pattern, where mostly an increased tension has been observed. This increased tension is located particular in the deeper layer of the PFM. 2.1.6 Symptomatology Women with pelvic girdle pain have complaints due to the reduced stability of the pelvis which affects their quality of life very seriously. (Jan Mens 2009; Röst 2011) The pain, for these women, is always around the symphysis pubis or the left or right SI joint. Of course these women can also have pain around more then one pelvic joint. The pain of the SI joint is normally present in the lower back lateral of the median / centerline at the level of the sacrum. Are both SI joints painful, then the client will experience this as a large area around the center line. (Jan Mens 2009) Radiation of the pain often occurs toward the side of the pelvis, sitz bone, the side of the coccyx, groin and into the back of the leg. It is rare that the client also experience pain in the lower abdomen. (Jan Mens 2009) When the pubic symphysis is painful, this pain is mostly experienced exactly in the middle front of the pelvis, however sometimes right next to the center of the pubis. This pain is usually symmetrical. The adductor canal, pelvic and lower abdomen and groin, are the areas where the pain can radiate to.(Jan Mens 2009) Osteopathie Schule Deutschland Dresden International University Page 17
This description of the symptoms corresponds to the definition as it is described in the European Guidelines for the diagnosis and treatment of pelvic girdle pain. This description is: ”Pelvic girdle pain (PGP) generally arise in relation to pregnancy, trauma, arthritis and osteoarthritis. Pain is experienced between the posterior iliac crest and the gluteal fold, particularly in the vicinity to the SI joint. The pain may radiate in the posterior thigh and can also occur in conjunction with or separately in the symphysis. The endurance capacity for standing, walking, and sitting is diminished. The diagnosis of PGP can be reached after exclusion of lumbar causes. The pain or functional disturbances in relation to PGP must be reproducible bij specific clinical tests.” (Andry Vleeming et al. 2008) Other symptoms of pelvic instability are: feelings of not being able to control the movement in the legs (catching leg), waddle, tingling or numbness and also the limitations in daily life.(Jan Mens 2009) In particular, prolonged standing, walking and / or sitting provokes pelvic pain. The other daily activities that are limited by the instability are (Jan Mens 2009; Röst 2011): Turning in bed Bending or moving forward from the shoulders Getting up from a couch or chair (especially if it is low). Stair Climbing In a similar attitude to lie Sneezing / coughing Love making Child caring Housekeeping activities as vacuuming, ironing, washing, cooking Getting in and out of bed or the car Bicycling Driving Swimming Carying bags Etc. Osteopathie Schule Deutschland Dresden International University Page 18
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 and 14: 2. Basics This study aims to assess
Page 15 and 16: As third reasons there are the ridg
Page 17: The anterior oblique sling: The ant
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
Page 65 and 66: Figure 11: Hypothesis 4: Score on t
Page 67 and 68: 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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Pelvic girdle pain and relevance of ASLR testing: A ... - Cindy Verheul

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