title: Disturbed body perception, reduced sleep, and kinesiophobia in subjects with pregnancy-related persistent lumbopelvic pain and moderate levels of disability: An exploratory study.
abstract: BACKGROUND
  For a small but significant group, pregnancy-related lumbopelvic pain may become persistent. While multiple factors may contribute to disability in this group, previous studies have not investigated sleep impairments, body perception or mindfulness as potential factors associated with disability post-partum.
  
  
  OBJECTIVE
  To compare women experiencing no pain post-pregnancy with those experiencing pregnancy-related persistent lumbopelvic pain (either low- or high-level disability) across multiple biopsychosocial domains.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Participants completed questionnaires for thorough profiling of factors thought to be important in pregnancy-related lumbopelvic pain. Specific measures were the Urinary Distress Inventory, Medical Outcomes Study Sleep Scale, Back Beliefs Questionnaire, Tampa Scale for Kinesiophobia, Depression Anxiety Stress Scale, Coping Strategies Questionnaire, Pain Catastrophising Scale, The Fremantle Back Awareness Questionnaire and the Mindful Attention Awareness Scale. Women where categorised into three groups; pain free (n = 26), mild disability (n = 12) and moderate disability (n = 12) (based on Oswestry Disability Index scores). Non-parametric group comparisons were used to compare groups across the profiling variables.
  
  
  RESULTS
  Differences were identified for kinesiophobia (p = 0.03), body perception (p = 0.02), sleep quantity (p < 0.01) and sleep adequacy (p = 0.02). Generally subjects in the moderate disability group had more negative findings for these variables.
  
  
  CONCLUSIONS
  Disturbances in body-perception, sleep and elevated kinesiophobia were found in pregnancy-related lumbopelvic pain subjects with moderate disability, factors previously linked to persistent low back pain. The cross-sectional nature of this study does not allow for identification of directional pathways between factors. The results support the consideration of these factors in the assessment and management of pregnancy-related lumbopelvic pain.
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia. Electronic address: D.Beales@curtin.edu.au.
authors.forename: Darren
authors.initials: D
authors.lastname: Beales
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia. Electronic address: aliwroth@gmail.com.
authors.forename: Alison
authors.initials: A
authors.lastname: Lutz
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia. Electronic address: J.Thompson@curtin.edu.au.
authors.forename: Judith
authors.initials: J
authors.lastname: Thompson
authors.affiliation: The School of Physiotherapy, The University of Notre Dame Australia, PO Box 1225, Fremantle, Western Australia, 6959, Australia. Electronic address: benedict.wand@nd.edu.au.
authors.forename: Benedict Martin
authors.initials: BM
authors.lastname: Wand
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia. Electronic address: P.OSullivan@curtin.edu.au.
authors.forename: Peter
authors.initials: P
authors.lastname: O'Sullivan
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001828:Body Image / Q000523:psychology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D015444:Exercise / Q000523:psychology*; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology / Q000523:psychology*; D012649:Self Concept; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology*; D011795:Surveys and Questionnaires; D014904:Western Australia
keywords: Body image; Fear; Pelvic girdle pain; Pregnancy; Sleep