Incidence and physiotherapy assessment of sacroiliacal dysfunction using various tests in patients with sacroiliacal dysfunction during pregnancy – a cohort study

It will be assess sacroiliacal joints using specific tests: POSTERIOR PELVIC PAIN PROVOCATION TEST The test is performed supine and the patient's hip flexed to an angle of 90 degrees on the side to be examined: light manual pressure is applied to the patient's flexed knee along the longitudinal axisis of the femur while the pelvis is stabilized by the examiner's other hand resting on the patients contralateral superior anterior iliac spine. The test is positive when the patient feels localized pain deep in the gluteal area on the provoked side. PATRICK'S FABER TEST The patient lies supine: one leg is flexed, abducted and externally rotated so that the heel rests on the opposite knee. The examiner presses gently on the superior aspect of the tested knee joint. If pain is felt in the sacroiliacal joints or in the symphysis the test is considered positive. SYMPHYSIS PAIN PALPATION TEST The patient lies supine. The entire front side of the pubic symphysis is palpated gently. If the palpation causes pain that persists more than 5 s after removal of the examiner's hand, it is recorded as pain. If the pain disappears within 5 s it is recorded as tenderness. LONG DORSAL SACROILIAC LIGAMENT TEST The patient lies on her side with slight flexion in both hip and knee joints. If the palpation causes pain that persists for more than 5 seconds after removal of the examiner's hand, it is recorded as pain. If the pain disappears within 5 s it is recorded as tenderness. ACTIVE STRAIGHT LEG RAISE TEST (ASLR test) The patient lies supine with straight legs and feet 20 cm apart. The test is performed after the instruction „try to raise your legs, one after another, above the couch for 20 cm without bending the knee“. The patient is asked to score any feeling of impairment (on the both sides separately) on a 6-point scale: not difficult at all=0, minimally difficult=1, somewhat difficult=2, fairly difficult=3, very difficult=4, unable to do=5. The scores on both sides are added so that the sum score can range from 0 to 10. MODIFY TRENDELENBURG’S TEST The patient stands on one leg and flexes the hip and knee at 90 degrees. If pain is experienced in the symphysis the test is considered positive. VISUAL ANALOG PAIN SCALE Visual analog pain scale assesses the severity of pain on a numerical scale from 0 to 10, where 0 means absence of pain and 10 severe pain. QUEBEC SCALE Quebec scale assesses the degree of disability in activities of daily living in pregnant women. Estimated twenty daily activities (out of bed, sleeping during the night, turning in bed, driving, standing 20 to 30 minutes, sitting for hours, climbing stairs, short walk (300 to 400m), long walks (a few kilometres), reach items on shelves, throwing the ball, short running (100m), taking food from refrigerator, making beds, wear socks, bending in the tub, moving chairs, opening doors, carrying two bags from the store, lifting and carrying things) on scale from 0 to 5 where 0 means performing activities without difficulty, 1 means performing activities with minimal difficulty, 2 means performing activities with some difficulty, 3 means performing activities with moderate difficulty, 4 means performing activities with greater difficulty and 5 means inability to performing activities. All participants will undergo all of these tests.Tests will take a half an hour. Every day we will assess 12 participants every a half an hour over 6 months, at each individual session, supervised one on one with an physiotherapist. Each participants will only come in for a single visit, the test will take half an hour for each participants.