How do women’s health physiotherapists manage pelvic girdle pain in pregnancy? A UK-wide survey

Abstract
Pelvic girdle pain (PGP) affects approximately 20% of pregnant women, and can
have major physical and psychological effects. However, there is a lack of goodquality 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.