Can Clinical Postpartum Muscle Assessment Help Predict the Severity of Postpartum Pelvic Girdle Pain? A Prospective Cohort Study.

The sample was recruited by advertising and self-selection, and it was highly educated and had low to normal BMI compared with women giving birth in Sweden. Participants who did not complete follow-up were younger and had lower education levels. Questionnaire response declined from 93.7% at 6 months to 84.1% at 12 months. The clinical assessments relied on observation and palpation, which are subjective and less precise than technical devices. In a prior reliability study, involuntary pelvic floor muscle contraction and diastasis recti abdominis bulging showed only moderate agreement between assessors, with wide ranges of uncertainty. Pelvic girdle pain was measured by questionnaire, without confirmation by clinical tests. The diastasis recti abdominis finding of 35 mm or more came from a sub-analysis of 41 participants, and only 4 participants had both that width and middle to high pain. The model included middle to high pain level as a predictor, and this may explain much of the model because it is related to the outcome. Assessment at 8 to 12 weeks postpartum may miss ongoing recovery of pelvic floor muscles.

The study was funded by the Research and Development Centre Gothenburg and Södra Bohuslän. The funders played no role in the design, conduct, or reporting of the study.

Do not read these findings as evidence that pelvic floor muscle training or diastasis recti abdominis treatment reduces postpartum pelvic girdle pain. The paper reports assessment findings and pain scores, not treatment outcomes.