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Pelvic Girdle PainMOPSNCT02648607

Management of Chronic Post-Partum Pelvic Girdle Pain Study

A study testing Customised Dynamic Elastomeric Fabric Orthosis (DEFO) in people with Pelvic Girdle Pain and Symphysis Pubis Dysfunction, run by University of Plymouth at 2 sites in United Kingdom.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Pelvic Girdle Pain (PGP) during pregnancy occurs in approximately 70% of females and 38% of women continue to suffer PGP symptoms beyond 12 weeks following delivery. PGP post- partum causes pain during everyday activities that impacts negatively on health related quality of life and is associated with significant… Read more about this study

Who is it for?
Ages 18 years and older, women onlyHealthy volunteers can take part
What is being tested?
Customised Dynamic Elastomeric Fabric Orthosis (DEFO)
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
8 participants
Where
2 sitesUnited Kingdom
Study dates
Jan 2016to Jul 2017
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

None listed.

Who cannot join

  • A recent history/signs or symptoms indicative of serious causes of pain that might be inflammatory infective, traumatic, neoplastic, degenerative or metabolic.
  • In particular exclusion will occur if following questioning or clinical examination there is evidence of:
  • trauma
  • Indicators of serious pathology
  • steroid use
  • drug abuse
Show all 15Show fewer
  • HIV infection
  • immunosuppressed state
  • neurological symptoms/signs (including cauda-equina)
  • fever
  • systemically unwell
  • obstetric complications
  • pain that does not improve with rest/severe disabling pain
  • history of chronic back or pelvic pain requiring surgery.
  • a known skin allergy to Lycra

Trial locations and contacts

2 sites in 1 country.

United Kingdom2 sites
  • Southmead Hospital

    Bristol, Avon, BS10 5NB

  • University of Plymouth

    Plymouth, Devon, PL6 8BH

Other trials in United Kingdom

About this study

Official title: Management of Chronic Post-Partum Pelvic Girdle Pain Study: Evaluating Effectiveness of Combined Physiotherapy and a Dynamic Elastomeric Fabric Orthosis

Pelvic Girdle Pain (PGP) during pregnancy occurs in approximately 70% of females and 38% of women continue to suffer PGP symptoms beyond 12 weeks following delivery. PGP post- partum causes pain during everyday activities that impacts negatively on health related quality of life and is associated with significant healthcare and societal costs. These women are often referred to physiotherapy, however management is difficult and there is a weak evidence base for its management.

Alongside the provision of advice and information, physiotherapists commonly prescribe orthoses such as a rigid belt with the aim of optimising pelvic stability and reducing pain. More recently a novel customised Dynamic Elastomeric Fabric Orthosis has been developed as an alternative to an 'off the shelf' pelvic belt. No studies have investigated their effectiveness in complementing standard physiotherapy advice and management.

The investigators will undertake a comprehensive systematic review of the literature to critically evaluate the evidence base for the conservative management of chronic post-partum PGP. This will inform a single case experimental design. Here eight AB single case studies will be performed with the point of intervention being randomised between subjects. The use of a randomisation test permits subsequent statistical analyses of group effects. Participants' pain, activity levels, and quality of life will be evaluated along with subjective changes in confidence and urinary incontinence. Adherence to orthosis use will be diarised. Exit interviews will assess aspects such as the appropriateness of the outcome measures and acceptability of the intervention that will help to inform future clinical trials.

Read the detailed description

Pelvic girdle pain (PGP) occurs in 70% of pregnant women; of whom 25% have severe pain and 8% severe disability requiring the use of crutches, wheelchair or confinement to bed (Wu et al, 2004). At a personal level, women with PGP find that everyday activities such as turning in bed, prolonged walking, or carrying items may cause pain; impacting negatively on quality of life (Wang et al, 2004). In economic terms societal costs are significant, mainly as a consequence of work absenteeism; with 20% of people requiring an average of 7 weeks sick leave (Noren et al, 1997). The impact of this problem is significant; with 812, 970 deliveries occurring throughout the UK in 2012/13 (http://www.statistics.gov.uk/hub/index.html). Pregnancy related PGP has also been documented to increase.

PGP during pregnancy is thought to occur due to increased pelvic joint motion as a consequence of hormonal and biomechanical factors. For many women PGP symptoms resolve within approximately 3 months of delivery, however, approximately 38% of females continue to experience pain beyond 3 months following delivery (Gutke et al 2010, Van de Pol et al 2006). It is unknown why chronic symptoms persist, but age, parity, pre- pregnancy body mass index (BMI), mode of delivery and previous PGP, along with emotional and psychosocial factors have been identified as risk factors associated with chronic PGP (Robinson et al, 2010)). Further, women having caesarean section are at increased risk of post-partum chronic PGP, which is noteworthy given the increasing percentage of women who are electing for caesarean section for early symptomatic relief of peri-partum PGP. Urinary incontinence is also documented to affect approximately 70% of females suffering with pregnancy related PGP. If PGP symptoms continue into the post-partum then urinary incontinence is reported to continue due to an association with PGP and pelvic floor muscle weakness (Fitzgerald et al, 2012).

PGP is difficult to manage with limited guidance from the literature on conservative management. European Guidelines recommend exercise prescription for PGP (Vleeming et al., 2008) leading to the development of a Specialist Women's Health group information booklet that will be used in the current study.

An integral part of physiotherapists' management approach for PGP is the provision of orthoses such as rigid pelvic belts, which aim to improve pelvic joint stability and thus reduce pain. Pelvic belts apply forces to the pelvis within the transverse plane. Recently dynamic elastomeric fabric orthoses (DEFO) have been developed. A DEFO is made of elastomeric panels (e.g. Lycra ®) that are pre-stretched and can provide forces in multiple directions to the pelvis. Thus they provide continued multi-axis support whilst being flexible enough to allow people to participate in everyday activities. Studies on sports people with pelvic girdle pain have shown that the application of forces in more than one plane decreases pain and improves function over and above that seen with the application of transverse forces associated with pelvic belts (Sawle et al, 2013). Therefore the DEFO may have advantages over current rigid pelvic belts in terms of mode of action, clinical effectiveness and user satisfaction. To date a comprehensive literature search has revealed there have been no trials of orthotic use in women with chronic PGP post-partum. This project will therefore follow the recommendations of the Medical Research Council in the development and evaluation of complex interventions to establish a clearer understanding of PGP and its management post-partum that can inform future clinical trials.

Being tested
Customised Dynamic Elastomeric Fabric Orthosis (DEFO)
Keywords
Pelvic Girdle Pain, Chronic Pelvic Girdle Pain, Symphysis Pubis Dysfunction, Sacroiliac Joint Dysfunction, Physiotherapy, Physical Therapy, Orthoses, Orthosis, Orthotic Devices
Medical subject headings
Pelvic Girdle Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Customised Dynamic Elastomeric Fabric Orthosis (DEFO)Device

    Also called Pelvic Support Garment, Customised Dynamic Elastomeric Fabric Orthosis

    Eligible participants will be measured and fitted with a customised Dynamic Elastomeric Fabric Orthosis (DEFO). Participants will also be issued with standardised advice on PGP management via an information leaflet from Association of Chartered Physiotherapists in Women's health website.

Study groups in NCT02648607
Study groupRoleWhat they receive
Customised OrthosisExperimentalCustomised Dynamic Elastomeric Fabric Orthosis (DEFO)
Receives: Device: Customised Dynamic Elastomeric Fabric Orthosis (DEFO)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pain Levels

    Change in pain levels at 1 weekly intervals will be measured by a self-report numerical pain rating scale

    Measured: Baseline (Pre intervention), 1 weekly intervals for 8, 9, 10 weeks (dependent on baseline randomisation), then a following 8,9,10 weeks Intervention (total 16 weeks)

Secondary outcomes (2)
  1. Activity Levels

    Change in activity levels at 1 weekly intervals will be measured by a self-report questionnaire

    Measured: Baseline (Pre intervention), 1 weekly intervals for 8, 9, 10 weeks (dependent on baseline randomisation), then a following 8,9,10 weeks Intervention (total 16 weeks)

  2. Quality if Life

    Change in quality of life levels at 1 weekly intervals will be measured by a self-report questionnaire

    Measured: Baseline (Pre intervention), 1 weekly intervals for 8, 9, 10 weeks (dependent on baseline randomisation), then a following 8,9,10 weeks Intervention (total 16 weeks)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Jan 2016 (estimated)
  2. Study startJan 2016
  3. Primary completionJul 2017
  4. Study completionJul 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
8 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02648607
Sponsor's protocol ID
PGP-LC15
Acronym
MOPS
Status last verified
Oct 2017
First submitted
6 Jan 2016
Last updated
1 Nov 2017
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Wu WH, Meijer OG, Uegaki K, Mens JM, van Dieen JH, Wuisman PI, Ostgaard HC. Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence. Eur Spine J. 2004 Nov;13(7):575-89. doi: 10.1007/s00586-003-0615-y. Epub 2004 Aug 27.

    PubMed 15338362
  • Wang SM, Dezinno P, Maranets I, Berman MR, Caldwell-Andrews AA, Kain ZN. Low back pain during pregnancy: prevalence, risk factors, and outcomes. Obstet Gynecol. 2004 Jul;104(1):65-70. doi: 10.1097/01.AOG.0000129403.54061.0e.

    PubMed 15229002
  • Noren L, Ostgaard S, Nielsen TF, Ostgaard HC. Reduction of sick leave for lumbar back and posterior pelvic pain in pregnancy. Spine (Phila Pa 1976). 1997 Sep 15;22(18):2157-60. doi: 10.1097/00007632-199709150-00013.

    PubMed 9322326
  • Gutke A, Sjodahl J, Oberg B. Specific muscle stabilizing as home exercises for persistent pelvic girdle pain after pregnancy: a randomized, controlled clinical trial. J Rehabil Med. 2010 Nov;42(10):929-35. doi: 10.2340/16501977-0615.

    PubMed 21031289
  • van de Pol G, de Leeuw JR, van Brummen HJ, Bruinse HW, Heintz AP, van der Vaart CH. The Pregnancy Mobility Index: a mobility scale during and after pregnancy. Acta Obstet Gynecol Scand. 2006;85(7):786-91. doi: 10.1080/00016340500456373.

    PubMed 16817074
  • Robinson HS, Mengshoel AM, Veierod MB, Vollestad N. Pelvic girdle pain: potential risk factors in pregnancy in relation to disability and pain intensity three months postpartum. Man Ther. 2010 Dec;15(6):522-8. doi: 10.1016/j.math.2010.05.007.

    PubMed 20621546
  • Fitzgerald CM, Santos LR, Mallinson T. The association between pelvic girdle pain and urinary incontinence among pregnant women in the second trimester. Int J Gynaecol Obstet. 2012 Jun;117(3):248-50. doi: 10.1016/j.ijgo.2012.01.014. Epub 2012 Mar 28.

    PubMed 22459920
  • Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008 Jun;17(6):794-819. doi: 10.1007/s00586-008-0602-4. Epub 2008 Feb 8.

    PubMed 18259783
  • Sawle L, Freeman J, Marsden J, Matthews MJ. Exploring the effect of pelvic belt configurations upon athletic lumbopelvic pain. Prosthet Orthot Int. 2013 Apr;37(2):124-31. doi: 10.1177/0309364612448806. Epub 2012 Jul 2.

    PubMed 22751218

Questions about this trial

What is this clinical trial studying?

A study testing Customised Dynamic Elastomeric Fabric Orthosis (DEFO) in people with Pelvic Girdle Pain and Symphysis Pubis Dysfunction, run by University of Plymouth at 2 sites in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 0 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 1 Nov 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pain Levels (time frame: Baseline (Pre intervention), 1 weekly intervals for 8, 9, 10 weeks (dependent on baseline randomisation), then a following 8,9,10 weeks Intervention (total 16 weeks)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02648607, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Nov 2017.

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