Is pregnancy related pelvic girdle pain associated with altered kinematic, kinetic and motor control of the pelvis? A systematic review

To determine the level of evidence for altered mechanical and motor control of the pelvis being associated with pregnancy-related pelvic girdle pain (PPGP). This systematic review was undertaken by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six different databases were used for the electronic search. Observational cohorts, cross sectional or case-control studies focused on the association between altered kinematic/kinetic and motor control of the pelvis and PPGP during pregnancy were included. Study selection was conducted by two reviewers who firstly screened for titles, then for abstracts and finally for full articles. The Newcastle-Ottawa scale and the guidelines proposed by the Cochrane back review group were used to assess risk of bias and quality of evidence, respectively. 354 references were identified, and after excluding unwanted articles, 10 studies met the final inclusion criteria. Studies not related to motor control or pelvic mobility were the main reason for exclusion. Seven studies were case-control and three were prospective cohort studies. Seven studies were ranked as high while three were ranked as low quality. Among the high quality studies, six found association between PPGP and altered motor control and mobility of the pelvis. The level of evidence for an association between PPGP and altered motor control and kinematic or kinetic parameters of the pelvis was found to be moderate.