Abstract
Objective
The purpose of this study was to describe the clinical outcomes of patients with pregnancy-related
lumbopelvic pain (PRLP) treated according to a diagnosis-based clinical decision rule.
Methods
This was a prospective observational cohort of consecutive patients with PRLP. Data
on 115 patients were collected at baseline and on 78 patients at the end of the active
treatment. Disability was measured using the Bournemouth Disability Questionnaire
(BDQ). Pain intensity was measured using the Numerical Rating Scale for pain (NRS).
Patients were also asked to self-rate their improvement. Care was provided by a chiropractic
physician/physical therapist team.
Results
Fifty-seven patients (73%) reported their improvement as either “excellent” or “good.”
The mean patient-rated improvement was 61.5%. The mean improvement in BDQ was 17.8
points. The mean percentage of improvement in BDQ was 39% and the median was 48%.
Mean improvement in pain was 2.9 points. Fifty-one percent of the patients had experienced
clinically significant improvement in disability and 67% patients had experienced
clinically significant improvement in pain. Patients were seen an average 6.8 visits.
Follow-up data for an average of 11 months after the end of treatment were collected
on 61 patients. Upon follow-up, 85.5% of patients rated their improvement as either
“excellent” or “good.” The mean patient-rated improvement was 83.2%. The mean improvement
in BDQ was 28.1 points. The mean percentage of improvement in BDQ was 68% and the
median was 87.5%. Mean improvement in pain was 3.5 points. Seventy-three percent of
the patients had experienced clinically significant improvement in disability and
82% patients had experienced clinically significant improvement in pain.
Conclusions
The management strategy used in this study appeared to yield favorable outcomes in
this patient population and appears to be a safe option for patients with PRLP, although
because of this study's sample size, rare complications are not likely to be detected.
In addition, the absence of randomization and a control group limits interpretation
with regard to clinical effectiveness. Randomized, controlled trials are necessary
to distinguish treatment effects from the natural history of PRLP.
Key Indexing Terms
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Article info
Publication history
Accepted:
April 6,
2009
Received in revised form:
February 20,
2009
Received:
March 28,
2008
Footnotes
Second prize at the 2008 ACC.
Identification
Copyright
© 2009 Published by Elsevier Inc.
