January 21, 2022 – Pelvic girdle pain (PGP) is a common condition causing pain and physical impairment , which can occur during and/or after pregnancy and delivery. A new clinical practice guideline for physical therapy practice for PGP in the postpartum period (PGP-PP) is presented in the Journal of Women's Health Physical Therapy (JWHPT). The official journal of the Academy of Pelvic Health Physical Therapy (APHPT) of the American Physical Therapy Association , JWHPT is published in the Lippincott portfolio by Wolters Kluwer .
Created by the authors for the APHPT, the new document presents evidence-based recommendations for physical therapy management of clients with PGP-PP. The lead author is Adrienne H. Simonds, PT, PhD, of Rutgers, The State University of New Jersey, Blackwood, N.J. An executive summary appears in the journal's January/February issue. The complete guideline recommendations are available online at the JWHPT and APHPT websites.
Postpartum pelvic girdle pain: Guidelines and clinical practice for physical therapy management
PGP-PP appears to be distinct from the common condition of pelvic girdle pain developing during pregnancy (antepartum PGP). For some women with PGP-PP, pain becomes a persistent problem, accompanied by fear of movement and physical activity and sometimes by psychological symptoms beyond pain and disability.
Persistent PGP-PP presents a "more complex" problem that "impact[s] multiple areas of physical, cognitive, emotional, and social functioning, and often requiring a multidisciplinary care approach," according to the guideline document. Physical therapists are a key part of the professional team involved in managing this potentially debilitating condition.
Dr. Simonds and the guideline team followed a formal process to develop the first evidence-based clinical practice guideline for physical therapy management of PGP-PP. The guideline presents a total of 23 recommendations in six key areas, ranked by strength of supporting evidence:
The full guideline document presents a thorough review and discussion of each recommendation, linked to the supporting evidence. The guideline team also proposes a new "hybrid" diagnostic model and classification system for PP-PGP, identifying three categories of load transfer impairment. An accompanying Clinical Decision-Making flowchart facilitates selection of appropriate tests and intervention strategies for individual clients with PP-PGP.
The authors emphasize the limitations of the available evidence, pointing out recommendations for further research in each aspect of their review. "There is much work to be done to elevate postpartum health, and we believe physical therapists are important member of an interdisciplinary team," Dr. Simonds comments. "We hope these guidelines streamline what is known about PP-PGP and provide a jumping off point for more advancements in physical therapy care for the postpartum population."
DOI: 10.1097/JWH.0000000000000235
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About Journal of Women’s Health Physical Therapy Journal of Women’s Health Physical Therapy ( JWHPT ) is the official publication of the Section on Women's Health of the American Physical Therapy Association. JWHPT is a peer reviewed publication focused on the clinical interests of physical therapists practicing in women’s health and pelvic health as well as those of other health care providers who interface with physical therapists in the health care of women.
About the Academy of Pelvic Health Physical Therapy
The Academy of Pelvic Health Physical Therapy (formerly Section on Women’s Health) is a 501 (c) (6) non-profit professional association of more than 3,500 physical therapists (PTs), physical therapist assistants (PTAs) and student physical therapists (SPTs). Members provide the latest evidence-based physical therapy services to everyone from childbearing women to peri-menopausal mothers, young athletes to men with incontinence or other pelvic health complications.
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Journal of Womenʼs Health Physical Therapy