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Jan Mens - One of the best experts on this subject based on the ideXlab platform.
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the transverse abdominal muscle is excessively active during active straight leg raising in pregnancy related posterior Pelvic girdle pain an observational study
BMC Musculoskeletal Disorders, 2017Co-Authors: Jan Mens, Annelies PoolgoudzwaardAbstract:Many studies suggest that impairment of motor control is the mechanical component of the pathogenesis of painful disorders in the lumbo-sacral region; however, this theory is still unproven and the results and recommendations for intervention remain questionable. The need for a force to compress both innominate bones against the sacrum is the basis for treatment of pregnancy-related Pelvic girdle pain (PGP). Therefore, it is advised to use a Pelvic Belt and do exercises to enhance contraction of the muscles which provide this compression. However, our clinical experience is that contraction of those muscles appears to be excessive in PGP. Therefore, in patients with long-lasting pregnancy-related posterior PGP, there is a need to investigate the contraction pattern of an important muscle that provides a compressive force, i.e. the transverse abdominal muscle (TrA), during a load transfer test, such as active straight leg raising (ASLR). TrA thickness was measured by means of ultrasound imaging at rest and during ASLR in 43 non-pregnant women with ongoing posterior PGP that started during a pregnancy or delivery, and in 39 women of the same age group who had delivered at least once and had no current PGP (healthy controls). In participants with PGP, the median TrA thickness increase with respect to rest during ipsilateral and contralateral ASLR was 31% (SD 46%) and 31% (SD 57%), respectively. In healthy controls, these values were 11% (SD 25%) and 13% (SD 22%), respectively. Significant excessive contraction of the TrA is present during ASLR in patients with long-lasting pregnancy-related posterior PGP. The present findings do not support the idea that contraction of the TrA is decreased in long-lasting pregnancy-related PGP. This implies that there is no rationale for the prescription of exercises to enhance contraction of TrA in patients with long-lasting pregnancy-related PGP.
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does a Pelvic Belt reduce hip adduction weakness in pregnancy related posterior Pelvic girdle pain a case control study
European Journal of Physical and Rehabilitation Medicine, 2017Co-Authors: Jan MensAbstract:Background: The cause of non-specific lumboPelvic pain is unknown. Pregnancy-related Pelvic girdle pain seems to be a subgroup that deserves a specific treatment. One of the options is the use of a Pelvic Belt. Aim: To objectify the influence of a Pelvic Belt in patients with Pelvic girdle pain. Design. Case-control study. Setting: Outpatient clinic. Population: A total of 49 women with long-lasting posterior Pelvic girdle pain and 37 parous women of the same age group without Pelvic girdle pain. Methods: Hip adduction force was measured by asking the participant to squeeze a hand-held dynamometer between the knees. This was firstly performed without a Pelvic Belt and then with a Pelvic Belt. The increase of hip adduction force after applying the Pelvic Belt was expressed in percentages. Results: After tightening a Pelvic Belt hip adduction force increased 25.9±33.9% in patients with Pelvic girdle pain (P<0.0001) and 1.0±8.6% in participants without (P=0.67). The difference between groups was significant (P<0.00001). ConclusionS: A Pelvic Belt has a positive influence on hip adduction force in pregnancy-related posterior Pelvic girdle pain. Clinical Rehabilitation Impact: The results show an objective positive effect of the Pelvic Belt in women with long-lasting pregnancy-related posterior Pelvic girdle pain in a test-situation. The results support the idea that the use of a Belt could be part of a multidisciplinary rehabilitation of those patients.
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relation between subjective and objective scores on the active straight leg raising test
Spine, 2010Co-Authors: Jan Mens, Annelies Poolgoudzwaard, Rikie E P M Beekmans, Marijke T F TijhuisAbstract:DESIGN: Cross sectional. OBJECTIVE: To fill a gap in the validation of the active straight leg raising (ASLR) test concerning the relation between a patient's subjective score on the ASLR test and the objective measured force. SUMMARY OF BACKGROUND DATA: The ASLR test is used to classify patients presenting with pain in the low back and/or Pelvic girdle. Although its reliability and validity have been demonstrated, some details are still lacking. METHODS: The ASLR test was performed by 21 parous women with various ASLR scores. Subjective weakness was scored by the patient both with and without a Pelvic Belt; moreover the isometric forces of leg raising were measured. RESULTS: The correlation coefficients between the subjective ASLR score and objective measured force at 0 and 20 cm elevation were -0.58 (P < 0.01) and -0.52 (P < 0.05), respectively, at the left side; and -0.45 (P < 0.05) and -0.63 (P < 0.01), respectively, at the right side. When measured with a Pelvic Belt the correlations were, respectively, -0.51 and -0.48 at the left side, and -0.47 and -0.50 at the right side (all P < 0.05). After applying a Pelvic Belt the mean subjective ASLR score decreased with 0.38 point at the left side and 0.48 point at the right side (both P < 0.05). With the Belt, the measured force at 0 cm elevation increased by 11.6% (P < 0.001) at the left side and by 8.6% (P < 0.05) at the right side; at 20 cm elevation the changes in measured force were negligible. No significant correlation was found between the subjective and the objective changes elicited by the Pelvic Belt. CONCLUSION: The subjective scores on the ASLR test correlate well with the objective measured forces; this supports the reliability of the ASLR test. The subjective influence of a Pelvic Belt on the ASLR score could not be objectified.
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possible harmful effects of high intra abdominal pressure on the Pelvic girdle
Journal of Biomechanics, 2006Co-Authors: Jan Mens, Annelies Poolgoudzwaard, Gilbert Hoek Van Dijke, Victor Van Der Hulst, Henk J StamAbstract:The present study explores the hypothesis that a high intra-abdominal pressure (IAP) loads the ligaments of the Pelvic girdle to such an extent that frequent periods of high IAP might cause pain and/or interfere with recovery of patients with Pelvic girdle pain (PGP). In a theoretical model the size of the load of IAP on the Pelvic girdle was computed. The diameters of abdomen and pelvis needed for the calculations were measured on MRI scans; the IAP values during activities were gained from literature. In slim, healthy subjects the calculated load on the Pelvic ring during activities of daily living was 26.0-52.0 N with peaks to 135 N. During straining, vigorous work or heavy exercises the load could increase to values ranging from 104 to 520 N. The load is higher in subjects with pain or fatigue, or in case of a distended abdomen. When the load on the Pelvic ring induced by IAP is larger than 100 N, the force exceeds the force at which a Pelvic Belt relieves complaints in PGP; at 90 N, the force is larger than the force at which isometric hip adduction provokes pain in PGP. We conclude that the size of the load induced by IAP on the Pelvic girdle seems to be sufficient to cause pain in patients with PGP and might interfere with recovery. It seems worthwhile to give patients with PGP instructions to reduce IAP as much as possible during activities.
Meyer Valentine - One of the best experts on this subject based on the ideXlab platform.
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Contribution of the virtual reconstruction of the pelvis Regourdou 1 (Dordogne, France) in the knowledge of the Neandertal obstetrical mechanics.
2020Co-Authors: Meyer ValentineAbstract:La découverte d’un nouveau bassin, Regourdou 1, offre l’occasion de discuter de l’implication fonctionnelle de la morphologie pelvienne néandertalienne. Dans un premier temps, ce spécimen est décrit, ce qui permet de vérifier son appartenance aux Néandertaliens et mettre en évidence certains traits spécifiques à cette population. Bien qu’aucun ne soit autapomorphique, la combinaison de ces caractères caractérise la ceinture pelvienne néandertalienne. Le bassin Regourdou 1 est ensuite reconstruit à l’aide d’une estimation desdonnées manquantes, par thin-plate spline à partir de Kebara 2. Les dimensions du canal pelvien de Regourdou 1sont comparées à celles de deux autres spécimens néandertaliens (Tabun C1 et Kebara 2) et d’une populationmoderne (n=151). L’analyse de la morphologie des détroits obstétricaux néandertaliens (par morphométrie géométrique), et de la relation céphalo-pelvienne, met en évidence la présence de caractéristiques associées chez l’Homme anatomiquement moderne à la naissance rotationnelle. Notre travail confirme l’existence de mécaniques obstétricales néandertaliennes de type moderne. Cette interprétation permet d’enrichir notre connaissance biologique et culturelle de cette population.The discovery of a new Neandertal pelvis, Regourdou 1, allows discussing the functional implications of Neandertal Pelvic morphology. First, the specimen is described, which offers to proveits affiliation to the Neandertal population and to highlight specific Neandertal features. Even if none of these are autapomorphic, the combinaison of these traits characterize the Neandertal Pelvic Belt. The pelvis Regourdou 1 is reconstructed, by an estimation of missing-data, thanks to the thin-plate splines method, applied on Kebara 2. The dimensions of Regourdou 1 birth canal are compared with those of two others Neandertal individuals (Tabun C1 and Kebara 2) as well as a modern population (n=151).The analysis of the obstetrical planes morphology (by geometric morphometrics) and the cephalo-Pelvic relation highlights the presence of traits associated with rotational birth in modern Human. Our work attests the existence of modern type obstetrical mechanics, in Neandertal. This interpretation allows enriching our biological and cultural knowledge of this population
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Apport de la reconstruction virtuelle du bassin Regourdou 1 (Dordogne, France) à la connaissance des mécaniques obstétricales néandertaliennes.
HAL CCSD, 2013Co-Authors: Meyer ValentineAbstract:The discovery of a new Neandertal pelvis, Regourdou 1, allows discussing the functional implications of Neandertal Pelvic morphology. First, the specimen is described, which offers to proveits affiliation to the Neandertal population and to highlight specific Neandertal features. Even if none of these are autapomorphic, the combinaison of these traits characterize the Neandertal Pelvic Belt. The pelvis Regourdou 1 is reconstructed, by an estimation of missing-data, thanks to the thin-plate splines method, applied on Kebara 2. The dimensions of Regourdou 1 birth canal are compared with those of two others Neandertal individuals (Tabun C1 and Kebara 2) as well as a modern population (n=151).The analysis of the obstetrical planes morphology (by geometric morphometrics) and the cephalo-Pelvic relation highlights the presence of traits associated with rotational birth in modern Human. Our work attests the existence of modern type obstetrical mechanics, in Neandertal. This interpretation allows enriching our biological and cultural knowledge of this population.La découverte d’un nouveau bassin, Regourdou 1, offre l’occasion de discuter de l’implication fonctionnelle de la morphologie pelvienne néandertalienne. Dans un premier temps, ce spécimen est décrit, ce qui permet de vérifier son appartenance aux Néandertaliens et mettre en évidence certains traits spécifiques à cette population. Bien qu’aucun ne soit autapomorphique, la combinaison de ces caractères caractérise la ceinture pelvienne néandertalienne. Le bassin Regourdou 1 est ensuite reconstruit à l’aide d’une estimation desdonnées manquantes, par thin-plate spline à partir de Kebara 2. Les dimensions du canal pelvien de Regourdou 1sont comparées à celles de deux autres spécimens néandertaliens (Tabun C1 et Kebara 2) et d’une populationmoderne (n=151). L’analyse de la morphologie des détroits obstétricaux néandertaliens (par morphométrie géométrique), et de la relation céphalo-pelvienne, met en évidence la présence de caractéristiques associées chez l’Homme anatomiquement moderne à la naissance rotationnelle. Notre travail confirme l’existence de mécaniques obstétricales néandertaliennes de type moderne. Cette interprétation permet d’enrichir notre connaissance biologique et culturelle de cette population
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Apport de la reconstruction virtuelle du bassin Regourdou 1 (Dordogne, France) à la connaissance des mécaniques obstétricales néandertaliennes.
2013Co-Authors: Meyer Valentine, Bruzek Jaroslav, Couture ChristineAbstract:La découverte d un nouveau bassin, Regourdou 1, offre l occasion de discuter de l implication fonctionnelle de la morphologie pelvienne néandertalienne. Dans un premier temps, ce spécimen est décrit, ce qui permet de vérifier son appartenance aux Néandertaliens et mettre en évidence certains traits spécifiques à cette population. Bien qu aucun ne soit autapomorphique, la combinaison de ces caractères caractérise la ceinture pelvienne néandertalienne. Le bassin Regourdou 1 est ensuite reconstruit à l aide d une estimation desdonnées manquantes, par thin-plate spline à partir de Kebara 2. Les dimensions du canal pelvien de Regourdou 1sont comparées à celles de deux autres spécimens néandertaliens (Tabun C1 et Kebara 2) et d une populationmoderne (n=151). L analyse de la morphologie des détroits obstétricaux néandertaliens (par morphométrie géométrique), et de la relation céphalo-pelvienne, met en évidence la présence de caractéristiques associées chez l Homme anatomiquement moderne à la naissance rotationnelle. Notre travail confirme l existence de mécaniques obstétricales néandertaliennes de type moderne. Cette interprétation permet d enrichir notre connaissance biologique et culturelle de cette population.The discovery of a new Neandertal pelvis, Regourdou 1, allows discussing the functional implications of Neandertal Pelvic morphology. First, the specimen is described, which offers to proveits affiliation to the Neandertal population and to highlight specific Neandertal features. Even if none of these are autapomorphic, the combinaison of these traits characterize the Neandertal Pelvic Belt. The pelvis Regourdou 1 is reconstructed, by an estimation of missing-data, thanks to the thin-plate splines method, applied on Kebara 2. The dimensions of Regourdou 1 birth canal are compared with those of two others Neandertal individuals (Tabun C1 and Kebara 2) as well as a modern population (n=151).The analysis of the obstetrical planes morphology (by geometric morphometrics) and the cephalo-Pelvic relation highlights the presence of traits associated with rotational birth in modern Human. Our work attests the existence of modern type obstetrical mechanics, in Neandertal. This interpretation allows enriching our biological and cultural knowledge of this population.BORDEAUX1-Bib.electronique (335229901) / SudocSudocFranceF
Thomas L. Milani - One of the best experts on this subject based on the ideXlab platform.
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Pelvic Belt effects on health outcomes and functional parameters of patients with sacroiliac joint pain
PLOS ONE, 2015Co-Authors: Niels Hammer, Robert Möbius, Stefan Schleifenbaum, Karl-heinz Hammer, Stefan Klima, Odette Soisson, Dirk Winkler, Justin Lange, Thomas L. MilaniAbstract:Introduction The sacroiliac joint (SIJ) is a common source of low back pain. However, clinical and functional signs and symptoms correlating with SIJ pain are widely unknown. Pelvic Belts are routinely applied to treat SIJ pain but without sound evidence of their pain-relieving effects. This case-control study compares clinical and functional data of SIJ patients and healthy control subjects and evaluates Belt effects on SIJ pain. Methods 17 SIJ patients and 17 healthy controls were included in this prospective study. The short-form 36 survey and the numerical rating scale were used to characterize health-related quality of life in patients in a six-week follow-up and the pain-reducing effects of Pelvic Belts. Electromyography data were obtained from the gluteus maximus, biceps femoris, rectus femoris and medial vastus. Alterations of muscle activity, variability and gait patterns were compared in patients and controls along with the Belts’ effects in a dynamic setting when walking. Results Significant improvements were observed in the short-form 36 survey of the SIJ patients, especially in the physical health subscores. Minor declines were also observed in the numerical rating scale on pain. Belt-related changes of muscle activity and variability were similar in patients and controls with one exception: the rectus femoris activity decreased significantly in patients with Belt application when walking. Further Belt effects include improved cadence and gait velocity in patients and controls. Conclusions Pelvic Belts improve health-related quality of life and are potentially attributed to decreased SIJ-related pain. Belt effects include decreased rectus femoris activity in patients and improved postural steadiness during locomotion. Pelvic Belts may therefore be considered as a cost-effective and low-risk treatment of SIJ pain. Trial Registration ClinicalTrials.gov NCT02027038
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Gait analyses of patients with sacroiliac joint pain and healthy controls without and with Pelvic Belt application: Cadence: ○ = no Pelvic Belt; Δ = Pelvic Belt application with moderate tension; □ = Pelvic Belt application with maximum tension.
2015Co-Authors: Niels Hammer, Robert Möbius, Stefan Schleifenbaum, Karl-heinz Hammer, Stefan Klima, Justin S. Lange, Odette Soisson, Dirk Winkler, Thomas L. MilaniAbstract:Gait analyses of patients with sacroiliac joint pain and healthy controls without and with Pelvic Belt application: Cadence: ○ = no Pelvic Belt; Δ = Pelvic Belt application with moderate tension; □ = Pelvic Belt application with maximum tension.
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Gait analyses of patients with sacroiliac joint pain and healthy controls without and with Pelvic Belt application: Gait velocity; ○ = no Pelvic Belt; Δ = Pelvic Belt application with moderate tension; □ = Pelvic Belt application with maximum tension.
2015Co-Authors: Niels Hammer, Robert Möbius, Stefan Schleifenbaum, Karl-heinz Hammer, Stefan Klima, Justin S. Lange, Odette Soisson, Dirk Winkler, Thomas L. MilaniAbstract:Gait analyses of patients with sacroiliac joint pain and healthy controls without and with Pelvic Belt application: Gait velocity; ○ = no Pelvic Belt; Δ = Pelvic Belt application with moderate tension; □ = Pelvic Belt application with maximum tension.
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A: Application of a Pelvic Belt (SacroLoc, Bauerfeind AG, Zeulenroda-Triebes, Germany) to a 26 year-old female control. B: Recording of gait pattern data on force plates in all participants without Pelvic Belt, under moderate and maximum tolerable compression.
2015Co-Authors: Niels Hammer, Robert Möbius, Stefan Schleifenbaum, Karl-heinz Hammer, Stefan Klima, Justin S. Lange, Odette Soisson, Dirk Winkler, Thomas L. MilaniAbstract:A: Application of a Pelvic Belt (SacroLoc, Bauerfeind AG, Zeulenroda-Triebes, Germany) to a 26 year-old female control. B: Recording of gait pattern data on force plates in all participants without Pelvic Belt, under moderate and maximum tolerable compression.
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Comparison of gait pattern data of SIJ patients and controls without Pelvic Belt application, under moderate and maximum Belt tension.
2015Co-Authors: Niels Hammer, Robert Möbius, Stefan Schleifenbaum, Karl-heinz Hammer, Stefan Klima, Justin S. Lange, Odette Soisson, Dirk Winkler, Thomas L. MilaniAbstract:Comparison of gait pattern data of SIJ patients and controls without Pelvic Belt application, under moderate and maximum Belt tension.
Feipel Véronique - One of the best experts on this subject based on the ideXlab platform.
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Pelvic Belts and pregnancy-related Pelvic girdle pain ::influence on temporal and spatial gait parameters
'Informa UK Limited', 2019Co-Authors: Bertuit Jeanne, Leyh Clara, Feipel VéroniqueAbstract:The aims of this study were to analyze temporal and spatial parameters of gait during pregnancy in women with and without PGP, to evaluate the effect of Pelvic Belts on temporal and spatial gait parameters, and to compare two types of Belts. A total of 46 pregnant women with PGP, 58 healthy pregnant women and 23 non-pregnant women were recruited. Temporal and spatial parameters were analysed by an walkway. Two Pelvic Belts for pregnant women were used. An analysis of variance for repeated measures were used. In pregnant women with PGP, compared to healthy pregnant women, gait cycle and stance phase times were lower and single support time was higher. Compared to the non-pregnant women, gait velocity and step length were lower. Stance phase and double support times were higher. During pregnancy, wearing a Pelvic Belt modified gait velocity, single support phase, step length, step width, stance phase and toe in/out in pregnant women with PGP. Gait adaptations in pregnant women with PGP showed nearly the same changes found in women without PGP. The Belts had an effect on gait in pregnant women with PGP, probably through a biomechanical and proprioceptive mechanism
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Analysis of the influence of various types and positions of Pelvic Belts on gait parameters in pregnant women with Pelvic pain
'IOS Press', 2019Co-Authors: Bertuit Jeanne, Feipel VéroniqueAbstract:BACKGROUND:Many pregnant women develop Pelvic pain during their pregnancy. Pregnancy can modify Pelvic geometry while causing micro-mobility, leading to some instability, which will manifest itself through pain and an increase of tiredness when walking. Pelvic Belts could restore stability and help reduce pain, thus facilitating motor activities such as walking. However, there are no guidelines on the use of Pelvic Belts. PURPOSE:The objective of this study was to compare the effects of two types of Belts and several Belt positions on gait parameters in pregnant women. METHODS:Forty-six pregnant women with Pelvic girdle pain and 23 non-pregnant women were recruited. The motor task consisted in several gait trials at three different speeds, with and without Pelvic Belt. Temporal and spatial parameters were analysed. Two Pelvic Belts (narrow and flexible or broad and rigid) and several positions (high or low) were used. An analysis of variance for repeated measures (ANOVA) assessed the effects of group (pregnant/not pregnant), gait speed and Belt. RESULTS:Gait parameters did not show any significant difference according to Belt type or position. For pregnant women, gait velocity was reduced. Gait cycle phases were modified by an increase of stance phase and double support. Gait pattern displayed alterations during pregnancy. These changes favour a more stable and safe gait. Conclusion:There was no difference between Belt positions (high and low) or between Belt types (narrow and flexible or broad and rigid) on gait parameters. This suggests that all Belt types and positions could be advised to pregnant women
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Analysis of the influence of various types and positions of Pelvic Belts on gait parameters in pregnant women with Pelvic pain
'IOS Press', 2019Co-Authors: Bertuit Jeanne, Feipel VéroniqueAbstract:BACKGROUND: Many pregnant women develop Pelvic pain during their pregnancy. Pregnancy can modify Pelvic geometry while causing micro-mobility, leading to some instability, which will manifest itself through pain and an increase of tiredness when walking. Pelvic Belts could restore stability and help reduce pain, thus facilitating motor activities such as walking. However, there are no guidelines on the use of Pelvic Belts. PURPOSE: The objective of this study was to compare the effects of two types of Belts and several Belt positions on gait parameters in pregnant women. METHODS: Forty-six pregnant women with Pelvic girdle pain and 23 non-pregnant women were recruited. The motor task consisted in several gait trials at three different speeds, with and without Pelvic Belt. Temporal and spatial parameters were analysed. Two Pelvic Belts (narrow and flexible or broad and rigid) and several positions (high or low) were used. An analysis of variance for repeated measures (ANOVA) assessed the effects of group (pregnant/not pregnant), gait speed and Belt. RESULTS: Gait parameters did not show any significant difference according to Belt type or position. For pregnant women, gait velocity was reduced. Gait cycle phases were modified by an increase of stance phase and double support. Gait pattern displayed alterations during pregnancy. These changes favour a more stable and safe gait. Conclusion: There was no difference between Belt positions (high and low) or between Belt types (narrow and flexible or broad and rigid) on gait parameters. This suggests that all Belt types and positions could be advised to pregnant women.SCOPUS: ar.jinfo:eu-repo/semantics/publishe
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Pregnancy and Pelvic girdle pain: Analysis of Pelvic Belts on pain
'Wiley', 2018Co-Authors: Bertuit Jeanne, Rooze Marcel, Feipel VéroniqueAbstract:AIMS AND OBJECTIVES:To analyse pain and functional capacity in women with Pelvic girdle pain and to evaluate the effect of Pelvic Belt on these parameters. Two types of Belts were to compare.BACKGROUND:Pelvic girdle pain is very common during pregnancy. To prevent and relieve Pelvic pain, women can use a set of techniques and tools such as a Pelvic Belt. While scientific evidence is lacking, commercial industries suggest the effectiveness of Pelvic Belts.DESIGN:Randomised control trial.METHODS:Forty-six pregnant women with Pelvic girdle pain were evaluated. Pain analysis included a quantitative and a qualitative assessment. A daily activities questionnaire was used for functional capacity evaluation. Women were tested at two times during the pregnancy for a longitudinal evaluation, and they used one of the two Belt models during their pregnancy.RESULTS:Pelvic pain started between the 14th-21st week of pregnancy. Pain intensity was 60 ± 20 mm. Daily activities could increase pain. The use of Belts reduced pain. The intensity of pain decreased by 20 mm on a visual analogue scale. The daily activities were also easier. However, all these conclusions are valid only if pregnant women used Belts regularly on short periods.CONCLUSIONS:The Belts appear to be interesting tools to reduce Pelvic pain and improve comfort of pregnant women. This effect might be explained by an analgesic effect with proprioceptive and biomechanical effect. The different types of Belts could have differential effects on global, sacroiliac joint and back pain during pregnancy, but this hypothesis requires confirmation.RELEVANCE TO CLINICAL PRACTICE:Relevant for patient: to use an easy and validated tool. Relevant for clinical practice: to suggest a tool scientifically validated for patient. Relevant to economic issues: Belts decrease Pelvic pain and increase comfort of pregnant women. Sick leave could decrease.info:eu-repo/semantics/publishe
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Pelvic Belts and pregnancy-related Pelvic girdle pain: influence on temporal and spatial gait parameters
'Informa UK Limited', 2018Co-Authors: Bertuit Jeanne, Leyh Clara, Feipel VéroniqueAbstract:The aims of this study were to analyze temporal and spatial parameters of gait during pregnancy in women with and without PGP, to evaluate the effect of Pelvic Belts on temporal and spatial gait parameters, and to compare two types of Belts. A total of 46 pregnant women with PGP, 58 healthy pregnant women and 23 non-pregnant women were recruited. Temporal and spatial parameters were analysed by an walkway. Two Pelvic Belts for pregnant women were used. An analysis of variance for repeated measures were used. In pregnant women with PGP, compared to healthy pregnant women, gait cycle and stance phase times were lower and single support time was higher. Compared to the non-pregnant women, gait velocity and step length were lower. Stance phase and double support times were higher. During pregnancy, wearing a Pelvic Belt modified gait velocity, single support phase, step length, step width, stance phase and toe in/out in pregnant women with PGP. Gait adaptations in pregnant women with PGP showed nearly the same changes found in women without PGP. The Belts had an effect on gait in pregnant women with PGP, probably through a biomechanical and proprioceptive mechanism.SCOPUS: ar.jinfo:eu-repo/semantics/publishe
Annelies Poolgoudzwaard - One of the best experts on this subject based on the ideXlab platform.
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the transverse abdominal muscle is excessively active during active straight leg raising in pregnancy related posterior Pelvic girdle pain an observational study
BMC Musculoskeletal Disorders, 2017Co-Authors: Jan Mens, Annelies PoolgoudzwaardAbstract:Many studies suggest that impairment of motor control is the mechanical component of the pathogenesis of painful disorders in the lumbo-sacral region; however, this theory is still unproven and the results and recommendations for intervention remain questionable. The need for a force to compress both innominate bones against the sacrum is the basis for treatment of pregnancy-related Pelvic girdle pain (PGP). Therefore, it is advised to use a Pelvic Belt and do exercises to enhance contraction of the muscles which provide this compression. However, our clinical experience is that contraction of those muscles appears to be excessive in PGP. Therefore, in patients with long-lasting pregnancy-related posterior PGP, there is a need to investigate the contraction pattern of an important muscle that provides a compressive force, i.e. the transverse abdominal muscle (TrA), during a load transfer test, such as active straight leg raising (ASLR). TrA thickness was measured by means of ultrasound imaging at rest and during ASLR in 43 non-pregnant women with ongoing posterior PGP that started during a pregnancy or delivery, and in 39 women of the same age group who had delivered at least once and had no current PGP (healthy controls). In participants with PGP, the median TrA thickness increase with respect to rest during ipsilateral and contralateral ASLR was 31% (SD 46%) and 31% (SD 57%), respectively. In healthy controls, these values were 11% (SD 25%) and 13% (SD 22%), respectively. Significant excessive contraction of the TrA is present during ASLR in patients with long-lasting pregnancy-related posterior PGP. The present findings do not support the idea that contraction of the TrA is decreased in long-lasting pregnancy-related PGP. This implies that there is no rationale for the prescription of exercises to enhance contraction of TrA in patients with long-lasting pregnancy-related PGP.
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relation between subjective and objective scores on the active straight leg raising test
Spine, 2010Co-Authors: Jan Mens, Annelies Poolgoudzwaard, Rikie E P M Beekmans, Marijke T F TijhuisAbstract:DESIGN: Cross sectional. OBJECTIVE: To fill a gap in the validation of the active straight leg raising (ASLR) test concerning the relation between a patient's subjective score on the ASLR test and the objective measured force. SUMMARY OF BACKGROUND DATA: The ASLR test is used to classify patients presenting with pain in the low back and/or Pelvic girdle. Although its reliability and validity have been demonstrated, some details are still lacking. METHODS: The ASLR test was performed by 21 parous women with various ASLR scores. Subjective weakness was scored by the patient both with and without a Pelvic Belt; moreover the isometric forces of leg raising were measured. RESULTS: The correlation coefficients between the subjective ASLR score and objective measured force at 0 and 20 cm elevation were -0.58 (P < 0.01) and -0.52 (P < 0.05), respectively, at the left side; and -0.45 (P < 0.05) and -0.63 (P < 0.01), respectively, at the right side. When measured with a Pelvic Belt the correlations were, respectively, -0.51 and -0.48 at the left side, and -0.47 and -0.50 at the right side (all P < 0.05). After applying a Pelvic Belt the mean subjective ASLR score decreased with 0.38 point at the left side and 0.48 point at the right side (both P < 0.05). With the Belt, the measured force at 0 cm elevation increased by 11.6% (P < 0.001) at the left side and by 8.6% (P < 0.05) at the right side; at 20 cm elevation the changes in measured force were negligible. No significant correlation was found between the subjective and the objective changes elicited by the Pelvic Belt. CONCLUSION: The subjective scores on the ASLR test correlate well with the objective measured forces; this supports the reliability of the ASLR test. The subjective influence of a Pelvic Belt on the ASLR score could not be objectified.
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possible harmful effects of high intra abdominal pressure on the Pelvic girdle
Journal of Biomechanics, 2006Co-Authors: Jan Mens, Annelies Poolgoudzwaard, Gilbert Hoek Van Dijke, Victor Van Der Hulst, Henk J StamAbstract:The present study explores the hypothesis that a high intra-abdominal pressure (IAP) loads the ligaments of the Pelvic girdle to such an extent that frequent periods of high IAP might cause pain and/or interfere with recovery of patients with Pelvic girdle pain (PGP). In a theoretical model the size of the load of IAP on the Pelvic girdle was computed. The diameters of abdomen and pelvis needed for the calculations were measured on MRI scans; the IAP values during activities were gained from literature. In slim, healthy subjects the calculated load on the Pelvic ring during activities of daily living was 26.0-52.0 N with peaks to 135 N. During straining, vigorous work or heavy exercises the load could increase to values ranging from 104 to 520 N. The load is higher in subjects with pain or fatigue, or in case of a distended abdomen. When the load on the Pelvic ring induced by IAP is larger than 100 N, the force exceeds the force at which a Pelvic Belt relieves complaints in PGP; at 90 N, the force is larger than the force at which isometric hip adduction provokes pain in PGP. We conclude that the size of the load induced by IAP on the Pelvic girdle seems to be sufficient to cause pain in patients with PGP and might interfere with recovery. It seems worthwhile to give patients with PGP instructions to reduce IAP as much as possible during activities.