The starting point of this thesis was based on the histories of many women who suffered from low back pain (LBP) in relation to their pregnancy. The prevalence of low back pain (LBP) is higher in pregnant women compared to women of the same age in a general population. Pregnancy-related LBP persists 6 years after pregnancy in 16% of women. Consequently, pregnancy represents a specific risk for LBP and persistent LBP. Pregnancy-related LBP is usually studied as a single entity, however, only one subgroup of LBP, i.e. pelvic girdle pain (PGP), seems to be associated with pregnancy. Accordingly, possible differences in subgroups of patients with LBP are unknown. The aims of this thesis were the following: 1) to describe the prevalence of clinically classified subgroups of women with LBP in a cohort (no LBP, lumbar pain, PGP, and combined pain (PGP and lumbar pain)) during pregnancy and postpartum, and 2) to determine if there was a disparity in the course, health-related quality of life (HRQL), pain intensity, disability, depressive symptoms, or muscle function in subgroups of the cohort, and 3) to identify predictors for having persistent pregnancy-related PGP postpartum. Consecutively-enrolled pregnant women were classified into LBP subgroups by mechanical assessment of the lumbar spine, pelvic pain provocation tests, standard history, and pain drawings. All women answered questionnaires (background data, EQ-5D)…
Contents
INTRODUCTION
BACKGROUND
TERMINOLOGY
EPIDEMIOLOGY
Prevalence of low back pain in women
Course and predictors of low back pain
PREGNANCY RELATED PELVIC GIRDLE PAIN AND LUMBAR PAIN
Classification of low back pain
CAUSES OF PREGNANCY RELATED PELVIC GIRDLEȱPAIN
Muscle function in relation to lumbopelvic stability
Gait
CONSEQUENCES OF PREGNANCY RELATED LOW BACK PAIN
Health related quality of life
Pain
Disability
DEPRESSION
Postpartum depression
AIMS OF THE THESIS
MATERIALS AND METHODS
DESIGN
STUDY POPULATION
MEASUREMENTS AND PROCEDURES
Self reported questionnaires
Health related quality of life
Pain
Disability
Postpartum depression
Classification of the cohort
Criteria for the cohort classification
Reliability of the classification procedure
Physical functioning
Back flexor muscles endurance
Back extensor muscles endurance
Maximal voluntary isometric hip extension
Gait speed
STATISTICAL ANALYSES
ETHICAL CONSIDERATIONS
RESULTS
PREVALENCE OF LOW BACK PAIN IN PREGNANCY AND
POSTPARTUM
Drop out analysis
THE COURSE OF LOW BACK PAIN
PREDICTORS FOR PELVIC GIRDLE PAIN OR COMBINED PAIN
HEALTH RELATED QUALITY OF LIFE IN EARLY PREGNANCY
PAIN AND DISABILITY IN EARLY PREGNANCY
POSTPARTUM DEPRESSIVE SYMPTOMS
PHYSICAL MEASURES IN PREGNANCY AND POSTPARTUM
Back flexor muscles endurance
Back extensor muscles endurance
Maximal voluntary isometric hip extension
Gait speed
Pain intensity in relation to physical measures
DISCUSSION
PREVALENCE OF LOW BACK PAIN IN PREGNANCY AND
POSTPARTUM
Power
Classification of low back pain
COURSE AND PREDICTORS
HEALTH RELATED QUALITY OF LIFE,PAIN AND DISABILITY
Measures of health related quality of life and disability
POSTPARTUM DEPRESSION
MUSCLE FUNCTION
INTERNATIONAL CLASSIFICATION OF FUNCTIONING,DISABILITY
AND HEALTH
CLINICAL IMPLICATIONS
FUTURE RESEARCH
CONCLUSIONS
SUMMARY IN SWEDISH
ACKNOWLEDGEMENTS
REFERENCES
Author: Gutke, Annelie
Source: Linköping University
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