How do women’s health physiotherapists manage pelvic girdle pain in pregnancy? A UK-wide survey
Pelvic girdle pain (PGP) affects approximately 20% of pregnant women, and can have major physical and psychological effects. However, there is a lack of good-quality evidence to support and direct physiotherapy intervention. At present, there is little information regarding the details of current physiotherapy management in the UK. The aims of this study were to identify current practice with regard to PGP in terms of preventative measures, management, and especially, the most commonly used treatment modalities. These were compared with previous practice with a view to directing future research, and service development and redesign. The usage of groups and the wider context, including triage and referral, were also examined. In April 2012, an invitation to complete an electronic questionnaire was posted in the Pelvic, Obstetric and Gynaecological Physiotherapy professional network (PN) area of the interactive section of the Chartered Society of Physiotherapy (CSP) website (iCSP), and this drew 102 responses. A literature search and critique of the evidence was conducted in order to inform the questionnaire and the study. The results of the survey showed that education was “always” given by just over 95% of respondents, while more than 70% “never” used acupuncture, hydrotherapy or manipulations. Only 17% reported having a service for preventing PGP, and just under 40% used groups. Only 14.6% of respondents reported any form of patient self-referral. The use of mobilizations “often” appears to have risen, while the use of belts “often” has decreased, although the reasons for this are unknown. The use of groups was found to be statistically associated with triage and the National Health Service. The study generated a large quantity of data and raised many questions. Because of low respondent numbers and the sampling method employed, the results cannot be generalized. Suggestions for future research are made, and it is recommended that priority is given to those interventions that are most frequently used in clinical practice, i.e. advice, maternity belts, mobilizations and stability exercises.
Keywords: pelvic girdle pain, physiotherapy, pregnancy, prevention, survey.