Association Between Physical Activity, Weight Loss, Anxiety, and Lumbopelvic Pain in Postpartum Women

Abstract

Background: Lumbopelvic pain (LBPP) affects 45-81% of pregnant women, and 25 to 43% of these women report persistent LBPP beyond 3 months after giving birth. The objective of this study was to investigate the association between physical activity, weight status, anxiety and LBPP symptoms evolution in postpartum women.Methods: This is a prospective observational cohort study with 3 time point assessments (baseline (T0), 3 months (T3) and 6 months (T6) later). Women with persistent LBPP 3 to 12 months after delivery were recruited. At each time point, pain disability was assessed with the Pelvic Girdle Questionnaire (PGQ) and the Oswestry Disability Index (ODI), physical activity with Fitbit Flex monitors, and anxiety with the French-Canadian version of the State-Trait Anxiety Inventory (STAI). Weight was recorded using a standardized method. Pain intensity (0-100 point pain intensity numerical rating scale) and frequency were assessed using a standardized text message on a weekly basis throughout the study.Results: Thirty-two women were included (postpartum age: 6.6 ± 2.0 months; maternal age: 28.3 ± 3.8 years old; body weight: 72.9 ± 19.1 kg) and 27 completed the T6 follow-up. Disability, pain intensity and frequency improved at T6 (p<0.001). Women lost a mean of 1.9 ± 4.5 kg at T6 and this weight loss was correlated with reduction in LBPP intensity (r=.479; p= .011) and LBPP frequency (r=.386; p=.047), PGQ (r=.554; p=.003) and ODI scores (r=.494; p=.009). Improvement in ODI scores at T6 was correlated with the number of inactive minutes at T3 (r=-.453; p=.026) and T6 (r=-.457; p=.019), and with daily steps at T6 (r=.512; p=.006).

The effect of personality traits on pain perception and maternal self-confidence in the postpartum period: A cross-sectional study

“…In this study, it was found that pain was felt in the leg, abdomen, waist, chest, knee, hip and perineum region in the postpartum period, and that the majority of puerperal women experienced severe pain in the low back, perineum and head region. It was stated that 25-68 % of women experience low back pain in the postpartum period [13]. In this study, it was determined that 46.4 % of puerperant women had severe low back pain and 29 % had moderate low back pain.…”

“…Studies showed that those who delivered by cesarean section experience more pain [10], and vaginal delivery is more disadvantageous on postpartum chronic pain than cesarean section [11]. However, it is stated that the baby's weight, mother's age, education level and mood during pregnancy are effective factors on the postpartum pain perception experience [12], and that physical activity has a positive effect on the postpartum pain perception experience [13]. It is stated that maternal self-confidence is affected by factors such as being educated about baby care, having experience in baby care, and feeling ready for the role of motherhood, and that mothers need information in this special period [8,14].…”

“…The personal introduction form [8,13,16] created in line with the literature reviews made by the researchers consists of a total of 17 questions including socio-demographic and obstetric characteristics.…”

Risk Factors for Pain in Autosomal Dominant Polycystic Kidney Disease: A New Research Trajectory

“…The rationale behind the hypothesis is that, among the general population, greater BMI and central obesity are associated with greater pain intensity and chronic pain 12,13 . In addition, obesity is associated with increased pain sensitivity 14,15 , and weight loss has been shown to reduce some types of chronic pain 16,17 . As noted by Nowak et al: "a metabolic hypothesis of pain in obesity has gained increasing support as an important mechanism contributing to pain" 18 .…”

“… 12 , 13 In addition, obesity is associated with increased pain sensitivity, 14 , 15 and weight loss has been shown to reduce some types of chronic pain. 16 , 17 As noted by Nowak et al, “a metabolic hypothesis of pain in obesity has gained increasing support as an important mechanism contributing to pain.” 18 This observation led Nowak et al to examine the potential implications of this association for understanding pain in ADPKD patients in particular.…”