Other Specified Pregnancy-Related Conditions Clinical Trial
Official title:
Mulligan Concept Intervention for Pregnancy Related Lumbo Pelvic Pain
Women in rural communities receive less access to prenatal care, and experience slightly higher rates of complications during pregnancy. A very prevalent pregnancy related complication is Pregnancy Related Pelvic Girdle Pain (PPGP), effecting up to 76% of all pregnant women. Historically, PPGP has been thought to originate from hormonal changes associated with pregnancy, but its cause is more likely due to loss of motor control and/or malpositioning of the pelvic bones. Despite growing interest and clinical awareness of the condition, treatment outcomes of PPGP are inconsistent and intervention studies are lacking. The goal of this proposal is to investigate a treatment modality with minimal risks and potential to be self-administered. The Mulligan Concept manual therapy technique aims to restore mechanical function of the lumbopelvic region and has yet to be measured in women with PPGP.
The long-term goal of this project is to develop an effective conservative treatment protocol
that is easily accessible. The objective of this application is to determine if patients who
are treated with Mulligan Concept manual therapy experience immediate and significant changes
in pain and function. Our specific aims are: In women with PPGP, 1.) Determine if Mulligan
Concept treatment produces immediate changes in pain and function, 2.) Determine whether the
Mulligan Concept immediately restores or alters dysfunctional gait characteristics and pelvic
girdle motor control, and 3.) Identify factors that mathematically predict treatment outcome.
Our central hypothesis is that restoration of lumbopelvic positioning will result in
immediate decrease in pain, increase in function, and improved gait mechanics.
Volunteers in the 20th-34th week of pregnancy, ages 20-45 years, who are experiencing PPGP
will be screened and randomly assigned into treatment or placebo group based on age, weight,
height, gestational week and number of pregnancies. All participants will undergo a
standardized examination, complete patient reported outcome measures, and perform a walking
gait, sit to stand, and active straight leg raise tasks. Kinematic, kinetic, and EMG
recordings will be taken during performance of the tasks. The participants of the treatment
group will receive a Mulligan Concept evaluation and treatment. Participants in the placebo
group will receive only the Mulligan Concept evaluation. Participants will then repeat the
same tasks and measures. The study will be conducted under a randomized triple blinded
placebo trial design; the patients, researchers, and treating clinician will be blinded to
group assignment. Independent sample t-tests will be conducted to determine if significant
differences exist between the intervention and placebo group across several dependent
variables. Regression analysis will be conducted in order to determine if intake factors
mathematically predict treatment outcome.
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