Pregnancy-Related Pelvic Girdle Pain

Background

I have long been fascinated with the pelvic girdle pain and the sacroiliac joint. I became interested, specifically, in pelvic girdle pain during pregnancy when I experienced the phenomenon for myself during all three of my pregnancies. In my own personal experience with pelvic girdle pain, I was advised by well-meaning physicians that this pain was just a part of pregnancy and something I had to deal with. I was never offered physical therapy treatment. For this capstone project, I wanted to learn more about evidence-based physical therapy interventions for pregnancy-related pelvic girdle pain. I hope this knowledge will help me to serve my pregnant and post-partum patients with the best possible care.

 

Project Overview and Purpose:

Pregnancy-related pelvic girdle pain is a very common condition, impacting 48-56% of pregnant women. Symptoms of pelvic girdle pain can be severe and debilitating for the women who experience them.^1-3 The goal for this project was two-fold; first I wanted to conduct a literature review to determine which physical therapy interventions are best supported in research for the treatment of pregnancy related pelvic girdle pain and associated symptoms. Second, I wanted to create a pamphlet aimed at providing education to patients who may be experiencing pelvic girdle pain.

 

Statement of Need:

Pelvic girdle pain has an audience of obstetricians, primary care physicians, physical therapists, nurses, and other health care clinicians who are providing care for pregnant or postpartum women. In addition to health care professionals, pregnant women and their loved ones can significantly benefit from understanding pregnancy-related pelvic girdle pain. This literature review and patient education pamphlet can provide information relevant to both patients and providers.

 

Product:

I have created a literature review for pregnancy-related pelvic girdle pain and a patient education handout.

Capstone Brocure Final Draft

NiemanR_Literature Review_Final Draft

 

Health Literacy Evaluation:

With regards to the health literacy component of this capstone project, my main focus was on creating a patient education pamphlet that is useful, relevant, and clear for a broad audience of patients. In order to achieve this goal, I reviewed the health literacy information provided in the capstone course and sought out additional sources of information related to health literacy.^4-6 I attempted to provide information that was concise and free of medical jargon, utilized bullet points, and provided the most important information at the top of each section. I attempted to communicate information in small “tidbits” and avoid the utilization of words beyond a middle school reading level.

Evaluation:

This scope of this project did not necessitate a formal evaluation process beyond the feedback of my committee members and my own self reflection/assessment of my work on the capstone project.

 

Self Reflection/Assessment:

I am really pleased with my final products. When I began this DPT program, one of my goals was to become a better writer. I have never felt confident in my writing skills, and although I would never consider writing to be one of my strong points, I definitely feel that I have improved significantly over the past 2 years. Analyzing research is area where I lacked confidence and hoped to improve during this DPT program. I am happy to say that my skills in this area have improved significantly and I feel much more capable of research review and I think this is reflected in this capstone project. The literature review was a major undertaking for me, in particular, because analyzing research and writing are two areas where I have lacked confidence in the past.  The feedback that I received from Dr. Prue Plummer was very valuable allowed me to fine tune my academic writing.  During her review, she pointed out areas where I lacked support for my analysis and conclusions of the data obtained during the literature review.  This feedback allowed me to create a more thorough assessment of the data and create a more solid conclusion.

 

My strengths in this process were attention to detail, organization, a strong interest in the topic at hand, and a strong desire to do my best work. Throughout this capstone project (and entire transitional DPT program) I have worked full-time as a physical therapist, in addition to being a wife and mother of 3 boys. Balancing work, family, and school would not have been possible without organization, attention to detail, and a strong desire to succeed. I believe I carried these strengths with me throughout the program and into my work on this capstone project. Another strength that helped me with this project is my commitment to my patients and providing the best possible care. I really wanted to educate myself and be better able to educate my patients in order to provide the best possible care. This was a driving factor that kept my focus on the quality of my work.

 

As mentioned previously, my weaknesses include a lack of confidence in my ability to write and analyze research. In addition to this, one of my biggest constraints during this project was a lack of time. As mentioned above, I have numerous responsibilities and my days are very busy. It was difficult for me to set aside enough distraction-free time to complete this capstone project. This was evident in some of the feedback that I received from my committee members who noted some minor typos and grammatical edits.  I would like to have been able to strike a better balance between my family, professional, and school responsibilities.

 

As a whole, I am happy with my final products. I think that I achieved my goal and created materials that are useful to both patients and professionals. The work I did on this project also allowed me to overcome some of my own perceived limitations.

 

Acknowledgements:

This project would not have been possible without the support of my husband Erik Nieman who spent many weeknight and weekend hours “solo parenting” our 3 energetic boys so that I could complete schoolwork. I would also like to acknowledge the support of my parents who have provided unlimited support to me throughout my entire life, and my children who did their best to provide me with peace and quiet when I was working on “homework”.

 

Sincere gratitude to Dr. Prue Plummer PhD, PT, BPhysio(Hons) who provided me with significant guidance as I attempted to write my first literature review. Her insight and revisions were an essential component of the final project. I would also like to thank Jennifer Harrington PT, DPT, WCS, CLT and Laura Suter MPT, CLT, CMP for taking time away from their busy lives to provide valuable capstone project feedback.

 

 

References

1. Rost CC, Jacqueline J, Kaiser A, et al. Pelvic pain during pregnancy: a descriptive study of signs and symptoms of 870 patients in primary care. 2004;29(22):2567-72. doi: 10.1097/01.brs.0000145416.22782.9f.
2. Mens JM, Vleeming A, Stoeckart R, et al. Understanding peripartum pelvic pain. Implications of a patient survey. Spine. 1996;21(11):1363-1369. https://oce-ovid-com.libproxy.lib.unc.edu/article/00007632-199606010-00017/HTML.
3. Filipec M, Jadanec M, Kostovic-Srzentic M, et al. Incidence, pain, and mobility assessment of pregnant women with sacroiliac dysfunction. Int J Gynaecol Obstet. 2018;142(3):283-287. doi: 10.1002/ijgo.12560
4. Quick guide to health literacy. Health.gov website. Accessed at https://health.gov/communication/literacy/quickguide/factsbasic.htm
5. Health literacy. National network of libraries of medicine website. Accessed at https://nnlm.gov/initiatives/topics/health-literacy
6. Health literacy. Centers for disease control and prevention website. Accessed at https://www.cdc.gov/healthliteracy/learn/index.html