The inter-rater reliability of a standardised classification system for pregnancy-related lumbopelvic pain

Annelie Gutke, Gunilla Kjellby-Wendt and Birgitta Öberg

Pregnancy-related lumbopelvic pain has varying clinical presentations and effects among subgroups. Different lumbopelvic pain subgroups require different specific management approaches which require the differentiation between lumbar and pelvic girdle pain (PGP).  Thirty-one consecutive pregnant women with non-specific lumbopelvic pain were evaluated by two examiners and classified into lumbar pain, PGP, or combined pelvic girdle and lumbar pain. A standard history about different positions/activities of daily life such as bending, sitting, standing, walking, and lying, was followed by a standardised mechanical assessment of the lumbar spine, including tests of repeated end-range movements to standing and lying, pelvic pain provocation tests a hip-rotation range-of-motion test, the active straight-leg-raising test, and a neurological examination.

Agreement for the three syndromes was 87% with a kappa coefficient of 0.79. It was possible to perform the classification procedure throughout pregnancy. There was substantial agreement between the two examiners for the classification of non-specific lumbopelvic pain into lumbar pain and PGP in pregnant women.

Manual Therapy, 25 July 2009, online article ahead of print

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