Pelvic girdle pain (PGP) has a high incidence during pregnancy and in some women pain will persist for years. Most studies have used pain as the outcome measure, and little attention is given to functioning or disability. A better understanding of prognostic factors for recovery seems important for clinical care and treatment. The aim of the present paper was to identify prognostic factors for recovery from postpartum PGP and disability, and to determine the impacts of prognostic factors when pain intensity and disability are used as outcome measures. Seventy-eight women with diagnosed PGP were included 6–16 weeks postpartum. Possible prognostic factors were obtained through clinical tests and questionnaires at baseline. The clinical tests were posterior pelvic pain provocation (P4) test, active straight leg raise (ASLR) test and pain provocation of long dorsal sacroiliac ligament (LDL). One year postpartum outcome measures were obtained by Oswestry disability index (ODI ver 2.0) and worst evening pain (VAS 0–100). Multiple linear regression and logistic regression analyses were used to identify significant prognostic factors. At baseline 60% believed they would recover and 40% were uncertain or believed they would not recover. Fifty per cent had a history of low back pain (LBP), and 20% had high emotional distress (HSCL25-item ≥1.75). About 75% had positive LDL and P4 at both sides and 24% had pain located to all three pelvic joints. Forty per cent had ASLR scores of at least 4 (sum score range 0–10). Multivariate analyses showed consistently that ASLR and belief in improvement were statistical significant predictors for both disability and pain as outcome measures. ASLR score <4 predicted 10 points lower ODI and 19 points lower evening pain compared with having ASLR score of at least 4. Pain location was a statistical significant predictor in only one analysis. History of LBP or high psychological distress was not prognostic for recovery. ASLR test and belief in improvement are predictors of clinical significance in women having PGP postpartum.
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机译：骨盆带痛（PGP）在怀孕期间发生率很高，并且在某些女性中，疼痛会持续多年。大多数研究都使用疼痛作为结果指标，而很少关注功能或残疾。更好地了解恢复的预后因素对于临床护理和治疗似乎很重要。本文的目的是确定从产后PGP和残疾中恢复的预后因素，并确定将疼痛强度和残疾用作预后指标时预后因素的影响。产后6–16周纳入了诊断为PGP的78名妇女。可能的预后因素是通过临床试验和基线调查表获得的。临床测试包括后路骨盆疼痛刺激（P4）测试，主动直腿抬高（ASLR）测试和长背sa韧带（LDL）疼痛刺激。通过Oswestry残疾指数（ODI ver 2.0）和最严重的夜间疼痛（VAS 0-100）获得了一年的产后结局指标。多元线性回归和逻辑回归分析用于确定重要的预后因素。在基线时，有60％的人认为他们会恢复，而40％的人不确定或认为他们不会恢复。 50％的人有下腰痛（LBP）的病史，而20％的人有极高的情绪困扰（HSCL25项目≥1.75）。大约75％的两侧LDL和P4阳性，而24％的三个骨盆关节疼痛。 40％的ASLR分数至少为4（总分数范围为0-10）。多变量分析一致地表明，ASLR和对改善的信念是残疾和疼痛作为结果衡量指标的统计学显着预测指标。与ASLR得分至少为4相比，ASLR得分<4预测ODI降低10点，夜间疼痛降低19点。仅在一项分析中，疼痛部位是统计学上显着的预测因子。 LBP病史或高度心理困扰不能预示恢复。 ASLR测试和对改善的信念是产后PGP妇女临床意义的预测指标。
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