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

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6. Discussion 6.1 Topic discussion The choice of this theme is based on the authors personal interest in pelvic instability. On regular basis it is experienced in the practice of osteopathy that still little is known about the causes of pelvic instability. To support the clarification of the cause of pelvic instability it is first very important fo find the right diagnosis test battery . A proper diagnosis can then be the right basis to search for the cause(s) and a possible cure. The ASLR test to determine pelvic instability seems to be questionable According to the test results many women suffering from pelvic instability would not be diagnosed if only the ASLR-test would be differentiating factor for pelvic instability or not..This is from the perspective of the individual client unacceptable. This study wants to contribute to the formation of a good test battery for diagnosing clients with pelvic instability. There is also the suspicion that, if the diagnosis improves, less severe instability problems are found as well. This less pronounced forms of pelvic instability are at the moment classified as non-specific low back pain. If also these clients can be diagnosed right, appropriate therapy can be developed whereby these people would not need to experience many years of discomfort. Hopefully this research will contribute that more and more people will live without lower back and pelvic complaints after all. 6.2 Discussion on methods In the the authors bachelor thesis the prevalence was compared between the various studies on different themes. These themes were: population, description of complaints, the diagnostic methods, the period of measurement and the time of measurement. The methodology of this study is assessed in the same way to get a clear picture on the research results. Including also statements are made in the area of validity, sensitivity, specificity and reliability. Osteopathie Schule Deutschland Dresden International University Page 73
6.2.1 Population The recruitment of the population has gone through different paths like via midwivery practices, different forms of pregnancy gym and yoga groups. Within this various maternity support groups women with and without symptoms could be found. The population consists of 40 women who participated in the study. This is a relatively small population mostly due to the limited period in which the study took place and the limited area in which women could be appointed. For a better comparison, representation and significance of the population group the author believes that this population ideally needs to be larger. Although this study is done with a relative small population, it did bring more or less significant and discussable results leading to a good picture on the prevalence of pelvic instability and the relevance of testing with the ASLR and other pelvic instability tests. The results seem to be striking enough to start focussing on follow-up studies. 6.2.2 Description of pain complaints There is no real clear definition for pelvic instability. In the European guidelines for the diagnosis and treatment of pelvic girdle pain there is a definition for joint stability. However this definition (see below) is very general and vague. "The effective accommodation of the joints to each specific load demand through an adequately tailored joint compression, as a function of gravity, coordinated muscle and ligament forces, to produce effective joint reaction forces under changing condition“. In this study the DPQ is used to determine whether there are low back or pelvis complaints. Physical examination is chosen to be the decisive factor to differentiate whether there is pelvic pain or pelvic instability. Although there is no clear definition for pelvic instability there is a validated test, the ASLR test. In this physical examination several tests are used, including the ASLR test. All tests are carried out with and without compression. This study may contribute to the definition of the conditions indicating that there is pelvic instability. Belonging to the to be created definition should be: To diagnose pelvic instability, a physical examination will always be needed. Osteopathie Schule Deutschland Dresden International University Page 74
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Conformity declaration Author: Joha
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Pelvic girdle pain and relevance of ASLR testing: A ... - Cindy Verheul

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