A randomized controlled trial comparing a multimodal intervention and standard obstetrics care for low back and pelvic pain in pregnancy

Objective Women commonly experience low back pain during pregnancy. We examined whether a multimodal approach of musculoskeletal and obstetric management (MOM) was superior to standard obstetric care to reduce pain, impairment, and disability in the antepartum period. Study Design A prospective, ran...

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Veröffentlicht in:American journal of obstetrics and gynecology 2013-04, Vol.208 (4), p.295.e1-295.e7
Hauptverfasser: George, James W., DC, Skaggs, Clayton D., DC, Thompson, Paul A., PhD, Nelson, D. Michael, MD, PhD, Gavard, Jeffrey A., PhD, Gross, Gilad A., MD
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container_end_page 295.e7
container_issue 4
container_start_page 295.e1
container_title American journal of obstetrics and gynecology
container_volume 208
creator George, James W., DC
Skaggs, Clayton D., DC
Thompson, Paul A., PhD
Nelson, D. Michael, MD, PhD
Gavard, Jeffrey A., PhD
Gross, Gilad A., MD
description Objective Women commonly experience low back pain during pregnancy. We examined whether a multimodal approach of musculoskeletal and obstetric management (MOM) was superior to standard obstetric care to reduce pain, impairment, and disability in the antepartum period. Study Design A prospective, randomized trial of 169 women was conducted. Baseline evaluation occurred at 24-28 weeks' gestation, with follow-up at 33 weeks' gestation. Primary outcomes were the Numerical Rating Scale (NRS) for pain and the Quebec Disability Questionnaire (QDQ). Both groups received routine obstetric care. Chiropractic specialists provided manual therapy, stabilization exercises, and patient education to MOM participants. Results The MOM group demonstrated significant mean reductions in Numerical Rating Scale scores (5.8 ± 2.2 vs 2.9 ± 2.5; P < .001) and Quebec Disability Questionnaire scores (4.9 ± 2.2 vs 3.9 ± 2.4; P < .001) from baseline to follow-up evaluation. The group that received standard obstetric care demonstrated no significant improvements. Conclusion A multimodal approach to low back and pelvic pain in mid pregnancy benefits patients more than standard obstetric care.
doi_str_mv 10.1016/j.ajog.2012.10.869
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Michael, MD, PhD ; Gavard, Jeffrey A., PhD ; Gross, Gilad A., MD</creator><creatorcontrib>George, James W., DC ; Skaggs, Clayton D., DC ; Thompson, Paul A., PhD ; Nelson, D. Michael, MD, PhD ; Gavard, Jeffrey A., PhD ; Gross, Gilad A., MD</creatorcontrib><description>Objective Women commonly experience low back pain during pregnancy. We examined whether a multimodal approach of musculoskeletal and obstetric management (MOM) was superior to standard obstetric care to reduce pain, impairment, and disability in the antepartum period. Study Design A prospective, randomized trial of 169 women was conducted. Baseline evaluation occurred at 24-28 weeks' gestation, with follow-up at 33 weeks' gestation. Primary outcomes were the Numerical Rating Scale (NRS) for pain and the Quebec Disability Questionnaire (QDQ). Both groups received routine obstetric care. Chiropractic specialists provided manual therapy, stabilization exercises, and patient education to MOM participants. Results The MOM group demonstrated significant mean reductions in Numerical Rating Scale scores (5.8 ± 2.2 vs 2.9 ± 2.5; P &lt; .001) and Quebec Disability Questionnaire scores (4.9 ± 2.2 vs 3.9 ± 2.4; P &lt; .001) from baseline to follow-up evaluation. The group that received standard obstetric care demonstrated no significant improvements. Conclusion A multimodal approach to low back and pelvic pain in mid pregnancy benefits patients more than standard obstetric care.</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1016/j.ajog.2012.10.869</identifier><identifier>PMID: 23123166</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>Adult ; back pain ; exercise ; Female ; Humans ; Low Back Pain - therapy ; manipulation ; Obstetrics and Gynecology ; Pelvic Pain - therapy ; Pregnancy ; Pregnancy Complications - therapy ; Young Adult</subject><ispartof>American journal of obstetrics and gynecology, 2013-04, Vol.208 (4), p.295.e1-295.e7</ispartof><rights>Mosby, Inc.</rights><rights>2013 Mosby, Inc.</rights><rights>Copyright © 2013 Mosby, Inc. 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Michael, MD, PhD</creatorcontrib><creatorcontrib>Gavard, Jeffrey A., PhD</creatorcontrib><creatorcontrib>Gross, Gilad A., MD</creatorcontrib><title>A randomized controlled trial comparing a multimodal intervention and standard obstetrics care for low back and pelvic pain in pregnancy</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>Objective Women commonly experience low back pain during pregnancy. We examined whether a multimodal approach of musculoskeletal and obstetric management (MOM) was superior to standard obstetric care to reduce pain, impairment, and disability in the antepartum period. Study Design A prospective, randomized trial of 169 women was conducted. Baseline evaluation occurred at 24-28 weeks' gestation, with follow-up at 33 weeks' gestation. Primary outcomes were the Numerical Rating Scale (NRS) for pain and the Quebec Disability Questionnaire (QDQ). Both groups received routine obstetric care. Chiropractic specialists provided manual therapy, stabilization exercises, and patient education to MOM participants. Results The MOM group demonstrated significant mean reductions in Numerical Rating Scale scores (5.8 ± 2.2 vs 2.9 ± 2.5; P &lt; .001) and Quebec Disability Questionnaire scores (4.9 ± 2.2 vs 3.9 ± 2.4; P &lt; .001) from baseline to follow-up evaluation. The group that received standard obstetric care demonstrated no significant improvements. Conclusion A multimodal approach to low back and pelvic pain in mid pregnancy benefits patients more than standard obstetric care.</description><subject>Adult</subject><subject>back pain</subject><subject>exercise</subject><subject>Female</subject><subject>Humans</subject><subject>Low Back Pain - therapy</subject><subject>manipulation</subject><subject>Obstetrics and Gynecology</subject><subject>Pelvic Pain - therapy</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - therapy</subject><subject>Young Adult</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kstq3DAYhUVpaSZpX6CLomU3nugyI9sQAiG0SSDQRdu1kKXfgxxZciR5yvQJ-tiVO2kWWRSELofvHJCOEPpAyZoSKs6HtRrCbs0IZUVYN6J9hVaUtHUlGtG8RitCCKtaXjcn6DSlYTmylr1FJ4zTMoRYod9XOCpvwmh_gcE6-ByDc2Wbo1WuCOOkovU7rPA4u2zHYIpsfYa4B59t8LjYccplVtHg0KUMxasT1ioC7kPELvzEndIPf8kJ3N5qPCnrSwyeIuy88vrwDr3plUvw_mk9Qz--fP5-fVvdf725u766r_SG0lxxUtOupj1v-JZzAUoxLQzvW1H3WjTQAWMbuqmFEQUpdLfVXduA6rt60yvDz9CnY-4Uw-MMKcvRJg3OKQ9hTpJyRjnfbkldUHZEdQwpRejlFO2o4kFSIpcG5CCXBuTSwKKVBorp41P-3I1gni3_nrwAF0cAyi33FqJM2oLXYGwEnaUJ9v_5ly_s2llvtXIPcIA0hDn68n6SysQkkd-W0pcvQEtIK1rG_wBvHq6s</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>George, James W., DC</creator><creator>Skaggs, Clayton D., DC</creator><creator>Thompson, Paul A., PhD</creator><creator>Nelson, D. Michael, MD, PhD</creator><creator>Gavard, Jeffrey A., PhD</creator><creator>Gross, Gilad A., MD</creator><general>Mosby, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130401</creationdate><title>A randomized controlled trial comparing a multimodal intervention and standard obstetrics care for low back and pelvic pain in pregnancy</title><author>George, James W., DC ; Skaggs, Clayton D., DC ; Thompson, Paul A., PhD ; Nelson, D. Michael, MD, PhD ; Gavard, Jeffrey A., PhD ; Gross, Gilad A., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-3071b71f3835336eaa2c6d3f967fc68ebe2241476d6383307b5cb98eafb74fad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>back pain</topic><topic>exercise</topic><topic>Female</topic><topic>Humans</topic><topic>Low Back Pain - therapy</topic><topic>manipulation</topic><topic>Obstetrics and Gynecology</topic><topic>Pelvic Pain - therapy</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - therapy</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>George, James W., DC</creatorcontrib><creatorcontrib>Skaggs, Clayton D., DC</creatorcontrib><creatorcontrib>Thompson, Paul A., PhD</creatorcontrib><creatorcontrib>Nelson, D. Michael, MD, PhD</creatorcontrib><creatorcontrib>Gavard, Jeffrey A., PhD</creatorcontrib><creatorcontrib>Gross, Gilad A., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>George, James W., DC</au><au>Skaggs, Clayton D., DC</au><au>Thompson, Paul A., PhD</au><au>Nelson, D. Michael, MD, PhD</au><au>Gavard, Jeffrey A., PhD</au><au>Gross, Gilad A., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A randomized controlled trial comparing a multimodal intervention and standard obstetrics care for low back and pelvic pain in pregnancy</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>208</volume><issue>4</issue><spage>295.e1</spage><epage>295.e7</epage><pages>295.e1-295.e7</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><abstract>Objective Women commonly experience low back pain during pregnancy. We examined whether a multimodal approach of musculoskeletal and obstetric management (MOM) was superior to standard obstetric care to reduce pain, impairment, and disability in the antepartum period. Study Design A prospective, randomized trial of 169 women was conducted. Baseline evaluation occurred at 24-28 weeks' gestation, with follow-up at 33 weeks' gestation. Primary outcomes were the Numerical Rating Scale (NRS) for pain and the Quebec Disability Questionnaire (QDQ). Both groups received routine obstetric care. Chiropractic specialists provided manual therapy, stabilization exercises, and patient education to MOM participants. Results The MOM group demonstrated significant mean reductions in Numerical Rating Scale scores (5.8 ± 2.2 vs 2.9 ± 2.5; P &lt; .001) and Quebec Disability Questionnaire scores (4.9 ± 2.2 vs 3.9 ± 2.4; P &lt; .001) from baseline to follow-up evaluation. The group that received standard obstetric care demonstrated no significant improvements. Conclusion A multimodal approach to low back and pelvic pain in mid pregnancy benefits patients more than standard obstetric care.</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>23123166</pmid><doi>10.1016/j.ajog.2012.10.869</doi></addata></record>
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ispartof American journal of obstetrics and gynecology, 2013-04, Vol.208 (4), p.295.e1-295.e7
issn 0002-9378
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source MEDLINE; Access via ScienceDirect (Elsevier)
subjects Adult
back pain
exercise
Female
Humans
Low Back Pain - therapy
manipulation
Obstetrics and Gynecology
Pelvic Pain - therapy
Pregnancy
Pregnancy Complications - therapy
Young Adult
title A randomized controlled trial comparing a multimodal intervention and standard obstetrics care for low back and pelvic pain in pregnancy
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