Typically, initial clinical response was seen with three scheduled treatment sessions delivered within four weeks of randomization in patients who were determined to be clinical responders to OMT at the week 12 exit visit. Clinical response and relapse findings in several patient subgroups were consistent

with hypothesized actions of OMT; however, additional mechanistic research is needed to further address the latter findings. This study was funded by grants to JCL from the National Institutes of Health–National Center for Complementary and Alternative Medicine (K24-AT002422) and the Osteopathic Heritage Foundation. The authors thank the personnel at The Osteopathic Research Center for their contributions to this study. “
“Pelvic Girdle Pain (PGP) affects over 20% of pregnant women (Wu et al., 2004; Mulholland,

2005; Vleeming et al., 2008; Robinson et al., signaling pathway 2010; Gutke et al., 2010; Vermani et al., 2010), and may also occur in athletes with groin pain (Verrall et al., 2001), or after trauma (cf. Kanakaris et al., 2011). Several diagnostic examinations are commonly used, especially the Active Straight Leg Raise (ASLR) (Mens et al., 1999, 2001, 2002), during which the subjects are supine GSK126 mw and attempt to raise their leg by hip flexion, with the knee in extension. In subjects with PGP, the test maybe painful or limited (Mens et al., 2002). The ASLR was reported to have good reliability, sensitivity, and specificity (Mens et al., 2001). The ASLR assesses the ability to transfer load between the spine and the legs via the pelvis (Mens et al., 1999, 2001; cf. Beales et al., 2009a and Beales et al., 2009b; Beales et al., 2010a and Beales et al., 2010b; Hu et al., 2010a and Hu et al., 2010b; Jansen et al.,

2010), and can be used to differentiate PGP from hip or lumbar pain (Cowan et al., 2004; Mens et al., 2006; Roussel et al., 2007). During the test, subjects with PGP sometimes reported that they felt “as if the leg is paralyzed” (Mens et al., 1999). Relatedly, a “catching” sensation during walking was reported (Sturesson et al., 1997). These phenomena remain poorly understood. The ASLR appears to consist of raising check details one leg, requiring ipsilateral hip flexor activity. Nevertheless, bilateral activity of muscles in the lumbopelvic region has been reported (Hu et al., 2010a). Snijders and his colleagues proposed that the transversus abdominis (TA), obliquus abdominis internus (OI), and obliquus abdominis externus (OE) stabilize the pelvis by pressing the iliac bones against the sacrum, i.e., sacroiliac “force closure” (Vleeming et al., 1990a and Vleeming et al., 1990b; Snijders et al., 1993a and Snijders et al., 1993b). A pelvic belt maybe used to substitute, or partially substitute, the force required, which could be helpful when the ASLR is painful or limited (Mens et al., 1999).