Effect of Foot Manipulation on Pregnancy-Related Pelvic Girdle Pain: A Feasibility Study

• Published in: Journal of chiropractic medicine Vol. 16; no. 3; pp. 211 - 219
• Main Authors: Melkersson, Camilla, Nasic, Salmir, Starzmann, Karin, Bengtsson Boström, Kristina
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2017; Elsevier
• Subjects: Ankle Joint; Original Research; Osteopathic Manipulation; Physiotherapy; Pregnancy Pelvic Girdle Pain; Primary Health Care; Randomized Clinical Feasibility Study; Pregnancy Pelvic Girdle Pain; Osteopathic Manipulation; Ankle Joint; Randomized Clinical Feasibility Study; Primary Health Care; Physiotherapy
• ISSN: 1556-3707; 1556-3715
• DOI: 10.1016/j.jcm.2017.05.003

The objective of this study was to investigate if the research process to evaluate the effect of foot manipulation on pregnancy-related pelvic girdle pain (PPGP) is feasible.
A randomized, single-blind (patients and evaluators) pilot trial was performed to compare foot manipulation to a comparative group at 6-weekly treatment sessions at 5 physiotherapy outpatient clinics in Skaraborg primary care (Skövde, Sweden). Women at 12 to 31 weeks of pregnancy with well-defined PPGP (n = 97) and joint dysfunction or decreased range of movement in the feet were included. Women with a twin pregnancy, low back pain, rheumatoid arthritis, or other serious diseases and those who had previous foot manipulation were excluded. Visual analog scale scores were recorded before study start, before and after each treatment session, and 3 months after delivery.
One-hundred and two women were eligible, and 97 were included (group 1: foot manipulation, n = 47; group 2: comparative treatment, n = 50); 40 and 36 in the foot manipulation and comparative treatment groups, respectively, completed the study. The foot manipulation group had a nonsignificant pain relief score compared with that of the comparative group, which had higher pain relief scores. The difference was most pronounced at the first and second treatment sessions. A power analysis showed that at least 250 individuals would be needed in each group to confirm the effect of foot manipulation.
This study showed that it is feasible to assess the effect of foot manipulation on PPGP in a multicenter physical therapy outpatient clinic setting. A new larger study should choose a different comparative method and test this hypothesis in a full-scale trial.