研究背景與目的：無論懷孕或是產後有妊娠相關之骨盆帶疼痛問題的婦女很多，疼痛會嚴重影響婦女之身心健康、日常活動、與生活品質。然而至今相關治療介入型實證研究仍很缺乏，且研究結果常呈現不一致。妊娠相關骨盆帶疼痛產生的原因目前仍不明確，普遍認為可能與雌激素的分泌及人體生物力學改變，造成骨盆不穩定有關係。因此，藉由提高骨盆帶穩定而減緩疼痛成為治療目標。彈性貼紮目前被廣泛應用在肌肉骨骼問題之相關物理治療當中，是一種輕便、快捷、安全性高的介入方式。近年來部分學者發現，彈性貼紮對懷孕期間的妊娠相關下背痛與骨盆帶疼痛有改善疼痛及失能的效果。然而，目前並沒有針對產後仍患有骨盆帶疼痛的婦女之相關研究。因此，本研究欲探討彈性貼紮對改善妊娠相關骨盆帶疼痛產後婦女的疼痛、失能程度、日常身體功能、生活品質、骨盆底肌功能、及自覺改善程度之即時效應及兩週介入後的效應。
研究方法：本研究為單盲隨機控制實驗，共招募33位產後一個月以上且仍患有妊娠相關骨盆帶疼痛的婦女，其中彈性貼紮組16名，及控制組17名。所有婦女接受兩週貼紮介入，每四天更換一次貼布。彈性貼紮組使用兩條15-25%張力的I型貼布，貼紮於兩側臀大肌、闊背肌、胸腰筋膜，以促進肌肉收縮；並使用兩條50%張力的I型貼布，橫向貼紮於雙側薦髂關節，以穩定關節。控制組則使用一條不拉任何張力的I型貼布橫向貼紮在雙側薦髂關節，作為對照效應組別。所有評估項目在介入前、第一次貼紮後及兩週介入後執行。介入前與兩週介入後之評估，包含疼痛程度(視覺類比量表)、失能程度(骨盆帶疼痛問卷量表、歐式下背痛失能量表及患者特定功能量表)、健康相關生活品質(SF-36生活品質量表總表及生理和心理健康分數)、日常身體功能(左腳與右腳自主性直膝抬腿疲勞測試、三公尺起立行走測試和十公尺快走測試)、骨盆底肌功能(牛津肌力測試、骨盆底肌收縮陰道壓力值)、與整體自覺改善程度。第一次貼紮後之評估只包含疼痛(視覺類比量表)、日常身體功能(左腳與右腳自主性直膝抬腿疲勞測試、三公尺起立行走測試、十公尺快走測試)、骨盆底肌功能(牛津肌力測試)、及整體自覺改善程度。資料統計使用二因子變異數重複測量，比較介入前與第一次貼紮後、及介入前與兩週介入後，不同貼紮方法之組別及時間對妊娠相關骨盆帶疼痛之產後婦女的影響。當有顯著組別及時間的交互作用出現時，則採用適當的事後比較檢定。
結果：所有婦女在第一次貼紮後的疼痛均有明顯改善，但兩組間並無差異存在。在日常身體功能中，所有婦女之三公尺起立行走測試皆有改善，但左腳自主性直膝抬腿疲勞測試的時間有下降。其餘日常身體功能測試、骨盆底肌功能、自覺改善程度分數皆無改變。在兩週介入後，彈性貼紮組相較於控制組在疼痛、失能、三公尺起立行走測試時間、SF-36生活品質之生理健康分數、與整體自覺改善程度上皆有更顯著地改善(P<0.05)，且效應量都有達到中度或高度效應以上(ES=0.745至1.403)。僅在骨盆底肌肌力與部分日常身體功能測試無顯著變化(P>0.05)。
結論：兩週的彈性貼紮介入可以明顯改善妊娠相關骨盆帶疼痛產後婦女的疼痛、失能、日常身體功能、與生活品質之生理健康。婦女們的整體自覺改善程度上也有顯著大幅度進步。但在生活品質之心理健康及骨盆底肌功能方面則無顯著改變。本研究提供了彈性貼紮對改善妊娠相關骨盆帶疼痛與相關問題之實證結果。建議未來臨床可以利用彈性貼紮的方便、快捷、價格適宜、副作用極小之特色，針對妊娠相關之產後骨盆帶疼痛提供一種即時的輔助治療，幫助產後婦女減緩疼痛，進而促進日常生活之恢復。

Pregnancy-related pelvic girdle pain (PPGP) is a common problem during pregnancy and postpartum, which significantly affect the physical and mental health, daily functions, and quality of life of the women. The underlying pathomechanism for PPGP are still uncertain, but it is generally believed that the secretion of relaxin and biomechanical changes of the body may result in the pelvic instability and contribute to the PPGP. To date only few researches tried to investigate the interventions for the PPGP on pain and disability, such as education, massage, modality, and exercise. Pelvic belt has been demonstrated to have positive effects on PPGP, but it is inconvenient and not suitable for hot weather. Kinesio taping (KT) has been widely used for musculoskeletal disorders and showed the effects on pain reduction and functional improvement. The KT is a safe, non-invasive, and convenient intervention which is possible to be an alternative treatment for postpartum women with PPGP. The main purposes for this study are to investigate the immediate effect and post-intervention effect of KT on pain, disability, physical functions, and quality of life, as well as pelvic floor muscle (PFM) functions in postpartum women with PPGP. A total of 37 women with PPGP were randomized into the KT group and control group, and both groups received assigned intervention for 2 weeks. For the KT group, two I-shaped elastic tapes with 15-25% tension were applied from the gluteus maximus muscle to the thoracolumbar fascia and the contralateral latissimus dorsi, and then two I-shaped elastic tapes with 50% tension were applied onto the bilateral sacroiliac joints. For the control group, one I-shaped elastic tape without tension was applied onto the bilateral sacroiliac joints. The outcomes were evaluated at the baseline, immediately after first taping session, and after 2-week intervention. The outcome measures included pain, disability, physical functions, quality of life, PFM functions and global rating of change score. Pain was significantly reduced after first taping session for all postpartum women although there were no group differences in other outcomes. After 2-week intervention, the KT group had significant more improvements in pan, disability, on the performance of timed up and go test, physical component score of SF-36 than the control group. Global rating of change score in the KT group was also larger than that in the control group. But no differences were observed in PFM functions, some physical functions, and mental component score of SF-36. The KT could be an effective and possible alternative treatment for the postpartum women with PPGP.

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