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Zwangerschapsgerelateerde bekkenpijn [richtlijn]

Alle aanbevelingen

Algemene informatie

(1) Zwangerschapsgerelateerde bekkenpijn (niveau 2)
Het is aannemelijk dat zwangerschapsgerelateerde bekkenpijn een normaal verschijnsel is met een snelle afname van de pijn kort na de bevalling.
Kwaliteit van de gevonden artikelen: A (Van der Pol et al., 200727; Bastiaenen et al., 20047, 20068, 200846 en Bastiaanssen et al., 20056), B (Hansen et al., 199947 en Ostgaard et al., 199219) en C (Svensson et al., 199044).

(2) Etiologische factoren (niveau 2)
Het is aannemelijk dat etiologische factoren leidend tot ZGBP niet beïnvloedbaar zijn door de fysiotherapeut. Aansluiting bij het advies te stoppen met roken voor iedere vrouw die zwanger wil worden is belangrijk.
Kwaliteit van de gevonden artikelen: A (Bastiaanssen et al., 20056), B (Kristiansson et al., 199018; Ostgaard et al., 199135), C (Saugstad et al., 199148) en D (Nwuga et al., 198230; Mantle et al., 197731; Endresen et al., 199540; Mens et al., 199649; Worku et al., 200050; Damen et al., 200129; Orvieto et al., 198737; Berg et al., 198816; Stapleton et al., 200251; Maclennan et al., 198639 en Svensson et al., 199044).

(3) Rol van de fysiotherapeut (niveau 1)
Het is aangetoond dat het stimuleren van zelfmanagement gericht op het omgaan met aspecifieke lage rugpijn effectief is.
Kwaliteit van de gevonden artikelen: A (Barlow et al., 200259; Moore et al., 200061 en Von Korff et al., 200562).

 

Diagnostisch proces

(4) Diagnostische tests (niveau 4)
Er is geen bewijs dat met de diagnostische tests die specifiek ontwikkeld zijn om ZGBP vast te stellen, ZGBP onderscheiden kan worden.
Kwaliteit van de gevonden artikelen: D (Ostgaard et al., 199778; Vleeming et al., 200279; Albert et al., 200080; Wormslev et al., 199481; Kristiansson et al., 199618; Mens et al., 199582 en Van der Wurff et al., 200084-85, 200486).

 

Therapeutisch proces

(5) Evidentie oefentherapeutische behandeling tijdens de zwangerschap (niveau 2 en 3)
Het is aannemelijk dat oefentherapie tijdens de zwangerschap niet effectief is (niveau 2).
Kwaliteit van de gevonden artikelen: A2 (Kihlstand et al., 199990 en Elden et al., 200593, 200894) en B (Wedenberg et al., 200091; Kvorning et al., 200492; Nillson-Wikmar et al., 200595 en Haugland et al., 200697).

Er zijn aanwijzingen dat wateraerobics het ziekteverzuim tijdens de zwangerschap kan terugdringen (niveau 3).
Kwaliteit van het gevonden artikel: A2 (Granath et al., 200696).

(6) Evidentie fysiotherapeutische behandeling na de bevalling (niveau 2)
Het is aannemelijk dat een fysiotherapeutische behandeling kort na de bevalling gebaseerd op zelfmanagement en graded exposuretechnieken in combinatie met stabiliserende oefeningen van de buikmusculatuur effectief is op korte termijn.
Kwaliteit van de gevonden artikelen: A2 (Stuge et al., 2004a99, 2004b100 en Bastiaenen et al., 20047, 20068, 200846)

(7) Het gebruik van hulpmiddelen (niveau 2 en 3)
Het is niet aannemelijk dat het dragen van een bekkenband tijdens de zwangerschap leidt tot het verminderen van pijn (niveau 2).
Kwaliteit van de gevonden artikelen: A2 (Elden et al., 200593, 200894) en B (Nillson-Wikmar et al., 200595 en Haugland et al., 200697). Er zijn geen aanwijzingen dat het dragen van een bekkenband na de bevalling leidt tot vermindering van pijn na de bevalling (niveau 3). Kwaliteit van het gevonden artikel: B (Mens et al., 200098)

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