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Abstract:
Objective:
The main objective of this study was to assess the effectiveness weather osteopathic treatment influences the pain-symptomatology of women with pregnancy related pain in the pelvic and/or lumbar area.
Design:
Randomized controlled trial based on the classical “waiting list design”.
Setting:
The study was accomplished by two osteopaths, qualified at the “Still Academy”, in their practice in Überlingen and Mülheim.
Patients:
In the trial participated sixty pregnant women with a pain-symptomatology in the pelvic and/or lumbar area (on average 30 years old, on average in the 25th week of pregnancy).
The pain symptomatology had to occur in the time of pregnancy and had to be present for at least one week (VAS>3).
30 women were allocated to an intervention group and 30 to a control group by randomization. During the trial three patients of the control group dropped out.
Intervention:
The intervention group received four osteopathic treatments in weekly intervals. The patients of the control group did not receive any treatment during that time. They received osteopathic treatment after 5 weeks, which was not relevant for the trial. The osteopathic dysfunctions in the cranial, visceral and parietal system, found on the day of treatment, were diagnosed and treated individually.
Main outcome parameters:
The primary parameter was the greatest pain intensity within the last 3 days, measured with a visual analogue scale (VAS). The secondary parameter was the interference of every day activities through back pain, measured by the Quebec Back Pain Disability Scale.
Results:
In the intervention group the pain intensity, measured by VAS, was on the average reduced from with pain in the pelvic and/or lumbar area 6,5 to 2,1, which corresponds to an improvement of 68% (p<0.0005, 95% CI=3.5 to 5.2). In the control group no improvement occurred during that time (p=0.404, 95% CI=-1.0 to 0.4). From this a statistic significance is calculated (p<0.0005). The Quebec Back Pain Disability Scale was improved by 11 points in the intervention group and thus by 28% (p=0.001, 95% CI=4.9 to 17.3), whereas the control group worsened here by 20% (p<0.0005, 95% CI=-12.9 to -4.6).
Conclusion:
Four osteopathic treatments, over a period of five weeks, could cause a clinically relevant influence on the pain-symptomatology and on the interference of daily life of pregnant women with pain in the pelvic and/or lumbar area. This result encourages implementing further studies on this problem. For further studies it seems to be useful to document the sustainability of the effect about the remaining process of the pregnancy.
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