***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background This pilot r and omized controlled trial evaluated the feasibility of conducting a full scale study and compared the efficacy of exercise , spinal manipulation , and a mind-body therapy called Neuro Emotional Technique for the treatment of pregnancy-related low back pain , a common morbidity of pregnancy . Methods Healthy pregnant women with low back pain of insidious onset were eligible to enroll in the study at any point in their pregnancy . Once enrolled , they remained in the study until they had their babies . Women were r and omly allocated into one of three treatment groups using opaque envelopes . The treatment schedule paralleled the prenatal care schedule and women received individualized intervention . Our null hypothesis was that spinal manipulation and Neuro Emotional Technique would perform no better than exercise in enhancing function and decreasing pain . Our primary outcome measure was the Rol and Morris Disability Question naire and our secondary outcome measure was the Numeric Pain Rating Scale . Intention to treat analysis was conducted . For the primary analysis , regression was conducted to compare groups on the outcome measure scores . In a secondary responder analysis , difference in proportions of participants in attaining 30 % and 50 % improvement were calculated . Feasibility factors for conducting a future larger trial were also evaluated such as recruitment , compliance to study protocol s , cost , and adverse events . Results Fifty-seven participants were r and omized into the exercise ( n = 22 ) , spinal manipulation ( n = 15 ) , and Neuro Emotional Technique ( n = 20 ) treatment arms . At least 50 % of participants in each treatment group experienced clinical ly meaningful improvement in symptoms for the Rol and Morris Disability Question naire . At least 50 % of the exercise and spinal manipulation participants also experienced clinical ly meaningful improvement for the Numeric Pain Rating Scale . There were no clinical ly meaningful or statistically significant differences between groups in any analysis . Conclusions This pilot study demonstrated feasibility for recruitment , compliance , safety , and affordability for conducting a larger study in the future . Spinal manipulation and exercise generally performed slightly better than did Neuro Emotional Technique for improving function and decreasing pain , but the study was not powered to detect the between-group differences as statistically significant . Trial registration Clinical Trials.gov ( Identifier : NCT00937365 ) Background Previous publications indicate that acupuncture is efficient for the treatment of pelvic girdle pain , PGP , in pregnant women . However , the use of acupuncture for PGP is rare due to insufficient documentation of adverse effects of this treatment in this specific condition . The aim of the present work was to assess adverse effects of acupuncture on the pregnancy , mother , delivery and the fetus/neonate in comparison with women that received stabilising exercises as adjunct to st and ard treatment or st and ard treatment alone . Methods In all , 386 women with PGP entered this controlled , single-blind trial . They were r and omly assigned to st and ard treatment plus acupuncture ( n = 125 ) , st and ard treatment plus specific stabilising exercises ( n = 131 ) or to st and ard treatment alone ( n = 130 ) for 6 weeks . Acupuncture that may be considered strong was used and treatment was started as early as in the second trimester of pregnancy . Adverse effects were recorded during treatment and throughout the pregnancy . Influence on the fetus was measured with cardiotocography ( CTG ) before-during and after 43 acupuncture sessions in 43 women . A st and ardised computerized method to analyze the CTG reading numerically ( Oxford 8000 , Oxford , Engl and ) was used . After treatment , the women rated their overall experience of the treatment and listed adverse events if any in a question naire . Data of  analgesia and oxytocin augmentation during labour , duration of labour , frequency of preterm birth , operative delivery , Apgar score , cord-blood gas/acid base balance and birth weight were also recorded . Results There were no serious adverse events after any of the treatments . Minor adverse events were common in the acupuncture group but women rated acupuncture favourably even despite this . The computerized or visually assessed CTG analyses of antenatal recordings in connection with acupuncture were all normal . Conclusion This study shows that acupuncture administered with a stimulation that may be considered strong led to minor adverse complaints from the mothers but had no observable severe adverse influences on the pregnancy , mother , delivery or the fetus/neonate Objective : The objective of this study was to investigate if the research process to evaluate the effect of foot manipulation on pregnancy‐related pelvic girdle pain ( PPGP ) is feasible . Methods : A r and omized , single‐blind ( patients and evaluators ) pilot trial was performed to compare foot manipulation to a comparative group at 6‐weekly treatment sessions at 5 physiotherapy outpatient clinics in Skaraborg primary care ( Skövde , Sweden ) . Women at 12 to 31 weeks of pregnancy with well‐defined PPGP ( n = 97 ) and joint dysfunction or decreased range of movement in the feet were included . Women with a twin pregnancy , low back pain , rheumatoid arthritis , or other serious diseases and those who had previous foot manipulation were excluded .  Visual analog scale scores were recorded before study start , before and after each treatment session , and 3 months after delivery . Results : One‐hundred and two women were eligible , and 97 were included ( group 1 :  foot manipulation , n = 47 ; group 2 : comparative treatment , n = 50 ) ; 40 and 36 in the foot manipulation and comparative treatment groups , respectively , completed the study . The foot manipulation group had a nonsignificant pain relief score compared with that of the comparative group , which had higher pain relief scores . The difference was most pronounced at the first and second treatment sessions . A power analysis showed that at least 250 individuals would be needed in each group to confirm the effect of foot manipulation . Conclusions : This study showed that it is feasible to assess the effect of foot manipulation on PPGP in a multicenter physical therapy outpatient clinic setting . A new larger study should choose a different comparative method and test this hypothesis in a full‐scale trial Background The aim of this study was to investigate the outcome of chiropractic management for a subgroup of pregnant women with dominating one-sided pelvic girdle pain ( PGP ) . Methods The study population was recruited from a prospect i ve longitudinal cohort study of pregnant women . Women reporting pelvic pain ( PP ) , and who were diagnosed with dominating one-sided PGP after a clinical examination , were invited to participate in the intervention study . Recruitment took place either at 18 weeks , or after an SMS-tracking up to week 29 . The women were r and omized into a treatment group or a control group . The treatment group received chiropractic treatment individualized to each woman with regards to treatment modality and number of treatments . The control group was asked to return to conventional primary health care . The primary outcome measure was new occurrence of full time and /or grade d sick leave due to PP and /or low back pain . Secondary outcome measures were self-reported PP , physical disability and general health status . Proportion of women reporting new occurrence of sick leave were compared using Chi squared tests . Differences in secondary outcome measures were estimated using linear regression analyses . Results Fifty-Six women were recruited , and 28 of them were r and omized into the treatment group , and 28 into the control group . There was no statistically significant difference in sick leave , PP , disability or general health status between the two groups during pregnancy or after delivery . Conclusion The study did not demonstrate superiority of chiropractic management over conventional care for dominating one-sided PGP during pregnancy . However , the analyses revealed wide confidence intervals containing both positive and negative clinical ly relevant effects . Trial registration The study was registered in Clinical Trials.gov ( NCT01098136 ; 22/03/2010 ) BACKGROUND Many pregnant women experience low back pain .  Acupuncture appears to be a safe , promising intervention but evidence is needed about its clinical effectiveness and cost-effectiveness . OBJECTIVES To assess the feasibility of a future large r and omised controlled trial ( RCT ) testing the additional benefit of adding acupuncture to st and ard care ( SC ) for pregnancy-related back pain . DESIGN Phase 1 : a question naire survey described current care for pregnancy-related back pain . Focus groups and interviews with midwives , physiotherapists and pregnant women explored acceptability and feasibility of acupuncture and the proposed RCT . Phase 2 : a single-centre pilot RCT . Participants were identified using six methods and r and omised to SC , SC plus true acupuncture or SC plus non-penetrating acupuncture . PARTICIPANTS Phase 1 : 1093 physiotherapists were surveyed and 15 midwives , 21 physiotherapists and 17 pregnant women participated in five focus groups and 20 individual interviews . Phase 2 : 125 women with pregnancy-related back pain participated . INTERVENTIONS SC : a self-management booklet and onward referral for one-to-one physiotherapy ( two to four sessions ) for those who needed it . SC plus true acupuncture : the self-management booklet and six to eight treatments with a physiotherapist comprising true ( penetrating ) acupuncture , advice and exercise . SC plus non-penetrating acupuncture : the self-management booklet and six to eight treatments with a physiotherapist comprising non-penetrating acupuncture , advice and exercise . MAIN OUTCOME MEASURES Pilot RCT outcomes included recruitment rates , treatment fidelity , follow-up rate , patient-reported pain and function , quality of life and health-care re source use . Birth and neonatal outcomes were also assessed . Staff overseeing outcome data collection were blind to treatment allocation . RESULTS Phase 1 : 629 ( 57.5 % ) physiotherapists responded to the survey , 499 were experienced in treating pregnancy-related back pain and reported 16 advice and 18 treatment options . Typical treatment comprised two to four individual sessions of advice and exercise over 6 weeks . Acupuncture was reported by 24 % . Interviews highlighted the impact of back pain and paucity of effective interventions . Women and midwives strongly supported a RCT and expressed few concerns . Physiotherapists ' concerns about acupuncture in pregnancy informed a training programme prior to the pilot RCT . Phase 2 : We recruited 125 of 280 potentially eligible women ( 45 % ) in 6 months and r and omised 41 to SC and 42 each to the SC plus true acupuncture and SC plus non-penetrating acupuncture arms . Analysis was conducted with 124 participants ( 41 , 42 and 41 , respectively ) as one participant was r and omised in error . Three of six recruitment methods were the most successful . In total , 10 % of women ( n = 4 ) r and omised to SC alone accessed one-to-one physiotherapy and received an average of two treatments . The average number of treatments was six for both SC plus true acupuncture and SC plus non-penetrating acupuncture . Treatments were in line with protocol s. Eight-week follow-up was 74 % . Patient-reported outcomes ( pain , function and quality of life ) favoured the addition of acupuncture . There was no evidence of serious adverse events on mothers or birth and neonatal outcomes . The Pelvic Girdle Question naire was found to be an appropriate outcome measure for a future trial . CONCLUSIONS A future main RCT is feasible and would be welcomed by women and clinicians . Longer-term follow-up and further follow-up efforts are recommended for a main trial . TRIAL REGISTRATION Current Controlled Trials IS RCT N49955124 . FUNDING This project was funded by the National Institute of Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol . 20 , No. 33 . See the NIHR Journals Library website for further project information Background . Low back and pelvic pain is common in pregnancy and postpartum , but there is no well documented effect of treatment in pregnancy . The aim of the study was to assess whether a group intervention program for pregnant women with pelvic girdle pain has any effect on pain and daily function postpartum . Methods . Pregnant women with pelvic pain between the 18th and 32nd week of gestation were invited to participate in a r and omized clinical study . Among 958 examined women , 569 ( 59 % ) fulfilled the inclusion criteria . Women r and omized to the intervention group ( n = 275 ) participated in an education program that consisted of information , ergonomics , exercises , pain management , advice for daily life movement , pelvic belt/crutches , and information about delivery . Women r and omized to the control group ( n = 285 ) were not offered any treatment , but were free to seek advice or other treatment . Clinical measures and self‐evaluated utility of the intervention were measured by a visual analogue scale 0–10 . Results . Mean debut of pelvic girdle pain in pregnancy was at week 15 . Altogether 42 % of the women reported problems with low back pain earlier , and 34 % reported a family history of pelvic girdle pain in pregnancy . Median visual analogue scale score for all activities at inclusion was 6 both in the control group and the intervention group . At 6 and 12 months postpartum the score was reduced to 1.7/1.6 and 1.1/0.9 . In the intervention group , 75 % marked a self‐evaluated utility visual analogue scale score > 7 . In the control group , 60 % had search ed for alternative treatment . Conclusions . Postpartum pelvic girdle pain improved with time both in the intervention group and the control group , but there were no statistically significant differences between the groups . Self‐evaluated utility of the intervention was , 
    Output:
    
‘ Pain ’ was the most commonly reported outcome in both pelvic girdle pain and lumbopelvic pain studies .
Conclusions A wide variety of outcomes and outcome measurements are used in studies on pelvic girdle pain and lumbopelvic pain .