Evaluation of a birth preparation program on lumbopelvic pain, urinary incontinence, anxiety and exercise: a randomized controlled trial

Abstract

BackgroundAntenatal preparation programmes are recommended worldwide to promote a healthy pregnancy and greater autonomy during labor and delivery, prevent physical discomfort and high levels of anxiety. The objective of this study was to evaluate effectiveness and safety of a birth preparation programme to minimize lumbopelvic pain, urinary incontinence, anxiety, and increase physical activity during pregnancy as well as to compare its effects on perinatal outcomes comparing two groups of nulliparous women.MethodsA randomized controlled trial was conducted with 197 low risk nulliparous women aged 16 to 40 years, with gestational age ≥ 18 weeks. Participants were randomly allocated to participate in a birth preparation programme (BPP; n=97) or a control group (CG; n=100). The intervention was performed on the days of prenatal visits, and consisted of physical exercises, educational activities and instructions on exercises to be performed at home. The control group followed a routine of prenatal care. Primary outcomes were urinary incontinence, lumbopelvic pain, physical activity, and anxiety. Secondary outcomes were perinatal variables.ResultsThe risk of urinary incontinence in BPP participants was significantly lower at 30 weeks of pregnancy (BPP 42.7%, CG 62.2%; relative risk [RR] 0.69; 95% confidence interval [CI] 0.51-0.93) and at 36 weeks of pregnancy (BPP 41.2%, CG 68.4%; RR 0.60; 95%CI 0.45-0.81). Participation in the BPP encouraged women to exercise during pregnancy (p=0.009). No difference was found between the groups regarding to anxiety level, lumbopelvic pain, type or duration of delivery and weight or vitality of the newborn infant.ConclusionsThe BPP was effective in controlling urinary incontinence and to encourage the women to exercise during pregnancy with no adverse effects to pregnant women or the fetuses.Trial registrationClinicaltrials.gov, (NCT01155804)

Therapeutic exercise for pregnancy low back and pelvic pain: a systematic review

“…Two studies (37,38) included in this systematic review used protocols with at home exercises -which had different results, and two others (41,42) associated at home exercises with exercises done at the clinic, and also had conflictive results. In the same sense, other studies (11,26,30) that used at home exercises in their interventions showed there was no consensus about the effects on pregnancy low back and pelvic pain. The study by Schim et al (26) found positive results regarding pain intensity, but did not find significant differences regarding functional limitations.…”

“…The study by Kordi et al (11) found significant results as to the improvement of functional capacity and reduction in pain intensity. Finally, the study by Miquelutti et al (30) did not find significant effects on the lumbopelvic pain of pregnant women.…”

“…Among them, 25 were considered to be potentially relevant. After assessing the complete articles, 16 were excluded because they did not report interventions that were supervised or guided by physical therapists (9-11, 24-28); because they associated the exercises to manual therapy (29,30); because they were unpublished (theses and dissertations) (31)(32)(33); for lack of data (34); or because they did not relate the outcomes or interventions of interest (8,35). Thus, eight studies (36)(37)(38)(39)(40)(41)(42)(43), published between the years of 2005 and 2014, were included in this systematic review (Tables 2, 3 Eight RCT (36 -43) were included; one about low back pain (36), two about pelvic pain (37,38) and five about low back and/or pelvic pain (39 -43) .…”

Intervenções para prevenção da incontinência urinária durante o pré-natal: revisão integrativa

“…No tocante ao tipo de intervenção educativa a ser realizada, a seleção da mesma deve levar em consideração as características específicas de cada população ou serviço. Um exemplo disso é a evidência de que gestantes mais velhas se beneficiam mais de intervenções comportamentais com oficinas educativas (12) , enquanto que as gestantes mais jovens, das intervenções cognitivas utilizando lembretes (14) . Nesse sentido, para que ocorram mudanças de conhecimento, são necessárias intervenções educativas à população em geral e aos profissionais de saúde generalistas que promovam a reflexão e tragam elucidações sobre a IU, seu Bezerra impacto sobre a qualidade de vida.…”

Efectos del ejercicio físico programado durante el embarazo en las variables intra-parto maternas y del recién nacido/a. Ensayo clínico aleatorizado

“…Mientras otros estudios informan justamente en sentido contrario, esto es un mayor tiempo para las tareas de parto en mujeres activas, eso sí, con tareas de alta intensidad 100 . Pero la mayoría de investigaciones realizadas en estos parámetros (tiempo de las tareas de parto) encuentran que el ejercicio físico no produce efectos significativos 12,56,68,103 . …”