Exercise for the prevention of low back and pelvic girdle pain in pregnancy: A meta‐analysis of randomized controlled trials

Shiri, Rahman; Coggon, David; Falah‐Hassani, Kobra

doi:10.1002/ejp.1096

Cited by 78 publications

(70 citation statements)

References 38 publications

(90 reference statements)

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“…Hence, exercise, a powerful mechanism to improve PF, could be effective in the prevention of low-back pain during pregnancy, reducing its intensity and associated disability, and sick leaves. 13,28 We have confirmed that greater overall PF is associated with less pain disability due to lumbar and sciatic pain, assessed by the ODI questionnaire, although lower pain intensity was not associated with greater overall PF.…”

Section: Discussionsupporting

confidence: 58%

Association of self‐reported physical fitness with pain during pregnancy: The GESTAFIT Project

Marín-Jiménez

Acosta‐Manzano

Borges-Cósic

et al. 2019

Scandinavian Med Sci Sports

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Aims To explore the association of self‐reported physical fitness with bodily, lumbar and sciatic pain, and pain disability during pregnancy. Methods The present study sample comprised 159 pregnant women (32.9 ± 4.7 years old). Self‐reported physical fitness was assessed with the International Fitness Scale (IFIS), where higher scores indicate greater physical fitness. Bodily pain was assessed with the 36‐Item Short Form Health Survey (SF‐36), where higher scores indicate lower pain. Lumbar and sciatic pain were measured with a visual analogue scale (VAS). The Oswestry Disability Index (ODI) questionnaire was employed to assess the disability resulting from pain. Measures were assessed at 16th and 34th gestational weeks (g. w.). Results Pregnant women showed low‐moderate pain during pregnancy course. Most of them showed medium self‐reported overall physical fitness. At 16th g. w., greater self‐reported overall physical fitness and cardiorespiratory fitness were associated with less bodily and lumbar pain, and pain disability (all, P < 0.05). Greater muscular strength was associated with less bodily pain and pain disability (both, P < 0.05). Greater speed‐agility was associated with less bodily pain (P < 0.01) and less pain disability (P < 0.05). Self‐reported flexibility was not associated with any outcome (P > 0.05). At 34th g. w., greater overall physical fitness and its components were associated with less bodily and sciatic pain (all, P < 0.05). Conclusion Greater self‐reported overall physical fitness and its components are associated with less bodily, lumbar and sciatic pain, and reduced pain disability during pregnancy. Future studies are needed to explore whether increasing physical fitness before and during pregnancy could decrease pain in this relevant stage.

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Section: Discussionsupporting

confidence: 58%

Association of self‐reported physical fitness with pain during pregnancy: The GESTAFIT Project

Marín-Jiménez

Acosta‐Manzano

Borges-Cósic

et al. 2019

Scandinavian Med Sci Sports

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“…Another meta-analysis found that even during and after pregnancy, osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy gave clinically relevant benefits [ 37 ]. A meta-analysis of randomized controlled trials (RCTs) published in 2018 showed that exercise decreased the risk of low back pain in pregnancy by 9% [pooled risk ratio (RR) = 0.91; 95% CI 0.83–0.99; I 2 = 0%, seven trials; n = 1175] [ 38 ]. However, there was no protective effect on pelvic girdle pain (RR = 0.99; CI 0.81–1.21; I 2 = 0%; four RCTs; n = 565), or on lumbar- pelvic pain (RR = 0.96; CI 0.90–1.02; I 2 = 0%; eight RCTs; n = 1737) [ 38 ].…”

Section: Pregnancymentioning

confidence: 99%

“…A meta-analysis of randomized controlled trials (RCTs) published in 2018 showed that exercise decreased the risk of low back pain in pregnancy by 9% [pooled risk ratio (RR) = 0.91; 95% CI 0.83–0.99; I 2 = 0%, seven trials; n = 1175] [ 38 ]. However, there was no protective effect on pelvic girdle pain (RR = 0.99; CI 0.81–1.21; I 2 = 0%; four RCTs; n = 565), or on lumbar- pelvic pain (RR = 0.96; CI 0.90–1.02; I 2 = 0%; eight RCTs; n = 1737) [ 38 ]. In lumbar-pelvic pain, exercise was able to prevent new episodes of sick leave (RR = 0.79; CI 0.64–0.99; I 2 = 0%; three RCTs; n = 1168) [ 38 ].…”

Section: Pregnancymentioning

confidence: 99%

Physical Therapy Approaches in the Treatment of Low Back Pain

Shipton

2018

Pain Ther

118

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Globally, in 2016, low back pain (LBP) contributed 57.6 million of total years lived with disability. Low Back Pain Guidelines regularly recommend the use of physical exercise for non-specific LBP. Early non-pharmacological treatment is endorsed. This includes education and self-management, and the recommencement of normal activities and exercise, with the addition of psychological programs in those whose symptoms persist. The aim of physical treatments is to improve function and prevent disability from getting worse. There is no evidence available to show that one type of exercise is superior to another, and participation can be in a group or in an individual exercise program. Active strategies such as exercise are related to decreased disability. Passive methods (rest, medications) are associated with worsening disability, and are not recommended. The Danish, United States of America, and the United Kingdom Guidelines recommend the use of exercise on its own, or in combination with other non-pharmacological therapies. These include tai chi, yoga, massage, and spinal manipulation. Public health programs should educate the public on the prevention of low back pain. In chronic low back pain, the physical therapy exercise approach remains a first-line treatment, and should routinely be used.

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“…The clinical efficacy of exercise therapy for preventing low back pain in pregnancy has been reported recently (Shiri et al, 2018). Exercise also alleviates stress and depression that are often associated with chronic pain conditions (Sigwalt et al, 2011;Lima et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Short‐term swimming exercise attenuates the sensitization of dorsal horn neurons in rats with NGF‐induced low back pain

Azambuja

Hortscht

Hoheisel

et al. 2018

European Journal of Pain

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Exercise for the prevention of low back and pelvic girdle pain in pregnancy: A meta‐analysis of randomized controlled trials

Cited by 78 publications

References 38 publications

Association of self‐reported physical fitness with pain during pregnancy: The GESTAFIT Project

Association of self‐reported physical fitness with pain during pregnancy: The GESTAFIT Project

Physical Therapy Approaches in the Treatment of Low Back Pain

Short‐term swimming exercise attenuates the sensitization of dorsal horn neurons in rats with NGF‐induced low back pain

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