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Pregnancy-Related Pelvic Girdle Pain and Diastasis Rectus Abdominis

Chiarello, Cynthia M. PT, PhD

Journal of Women’s Health Physical Therapy: January/April 2017 - Volume 41 - Issue 1 - p 3–9
doi: 10.1097/JWH.0000000000000068
Research Report

Objective: To compare inter rectus distance (IRD) of pregnant women with pelvic girdle pain (PGP) with those with other types of pregnancy-related back pain (BP).

Study Design: Cross-sectional case-control design.

Background: Abdominal and pelvic muscular stability is reduced in PGP. Compromise to these muscles occurs in diastasis rectus abdominis (DRA), resulting in a larger IRD. There is minimal conflicting research relating to DRA and PGP.

Methods and Measures: The IRD of 66 pregnant women with self-reports of BP was first measured using nylon digital calipers with the abdominal muscles at rest and during a curl-up. All participants were evaluated using a pain location drawing, the numerical rating scale, the posterior pelvic pain provocation test, active straight leg raise, and the sacral compression test. Post hoc, a blinded research assistant classified subjects either into a PGP group if 3 of these tests were positive or into a nonspecific BP group.

Results: In both groups, the IRD was widest at the umbilicus, narrowest below the umbilicus, and decreased with a curl-up. Odds ratios (ORs) were adjusted for factors when a relationship with PGP was suggested as follows: pregnancies 2 or more (OR = 1.07; 95% confidence interval [CI] = 0.40-2.87), weeks of gestation more than 25 (OR = 1.28; 95% CI = 0.49-3.35), and abdominal circumference more than 103 cm (OR = 1.75; 95% CI = 0.65-4.72). The adjusted ORs were very close to 1 with CIs that contain 1, indicating that PGP does not seem to be related to the IRD.

Conclusions: There was no significant difference in the IRD of pregnant women with PGP compared with BP at any location or contraction condition.

Program in Physical Therapy, Columbia University Medical Center, New York.

This article was reviewed and accepted by the previous editors.

The author declares no other potential conflicts of interest.

This original study was funded by the Section on Women's Health Research Grant Awards Program.

Copyright © 2017 by the Section on Women's Health, American Physical Therapy Association.
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