Aspects of generalised joint hypermobility on pelvic girdle pain and physical disability during and after pregnancy

Pelvic girdle pain is common during pregnancy, but its multifactorial mechanisms are not completely understood. Generalised joint hypermobility is associated with musculoskeletal pain due to fragile connective tissue. The increased laxity of ligaments during pregnancy may be related to pelvic girdle pain. Women with fragile connective tissue may be more prone to developing pain during pregnancy. The overall aim was to examine whether generalised joint hypermobility increases the likelihood of experiencing pelvic girdle pain and physical disability during and after pregnancy. In Study I, the inter- and intra-rater reliability of joint mobility measurements in 49 adults were investigated, evaluating 12 joints. Study II explored the association between self-reported generalised joint hypermobility and pelvic girdle pain during pregnancy involving 2,217 women. In study III, the association between clinically assessed generalised joint hypermobility and pelvic girdle pain during and after pregnancy were examined, involving 356 women. Study IV focused on the development of physical disability from early pregnancy to nine months postpartum considering pelvic girdle pain, generalised joint hypermobility and overweight, and wheather the onset of pelvic girdle pain and the level of physical disability during pregnancy was associated with physical disability nine months postpartum. The findings in this thesis indicated good-to-excellent inter- and intra-rater reliability in most mobility measurements. Women who self-reported generalised joint hypermobility exhibited higher odds of experiencing pelvic-girdle pain, particularly in early pregnancy. Clinically assessed generalised joint hypermobility was associated with increased pain intensity in early pregnancy and, when combined with overweight, an increased risk of pelvic girdle pain. Physical disability increased during pregnancy irrespective of pelvic girdle pain status, but the overall prognosis was positive. Pelvic girdle pain had the strongest influence on disability, in contrast to generalized joint hypermobility and overweight. Early-onset pelvic girdle pain during pregnancy and a higher disability index during pregnancy were associated with physical disability nine months postpartum. Women experiencing pelvic girdle pain early in pregnancy may benefit from evaluation for generalised joint hypermobility, as they may experience more intense pain. It is crucial to develop methods for preventing and managing pelv