Prenatal Yoga for Back Pain, Balance, and Maternal Wellness: A Randomized, Controlled Pilot Study

Abstract

Background The objective was to assess the feasibility of a prenatal yoga randomized controlled trial (RCT) for gestational low back pain (LBP), mobility, and maternal well-being. Methods In this pilot, women aged 18 to 39 years with uncomplicated pregnancies at 12 to 26 weeks were randomized, stratified by presence of LBP, to attend a weekly yoga class or a time-matched educational support group for 12 weeks. Sample size was based on anticipated enrollment of 2 subjects per month. Primary outcomes were measures of feasibility and acceptability. Secondary outcomes included LBP disability, pregnancy symptom burden, childbirth self-efficacy, instrumented gait, balance, and falls at baseline, every 4 weeks, and 6 weeks postpartum. Results From April 2015 to December 2015, 168 women were contacted and 115 (68%) were eligible. Twenty women enrolled (N = 11 yoga; N = 9 control; mean gestational age 20.2 weeks). Retention at 12 weeks was 81% in yoga and 77% in control. There were no yoga-related adverse events. Exploratory analyses show no differences in back pain disability between groups. Significant groups effects were found on biomechanical assessments, including percentage change in gait speed ( F = 4.4, P = .04), double support time ( F = 23.6, P < .01), instrumented timed-up-and-go ( F = 8.6, P < .01), and turn time ( F = 5.7, P = .02) suggesting clinically relevant improvements with yoga. Pregnancy Symptom Inventory (PSI) scores improved (13.1 point difference, 95% confidence interval, 5.1–21.1) at 12 weeks in yoga compared to control, adjusted for baseline gestational age. Conclusion Conducting an RCT of prenatal yoga to improve gestational LBP and maternal well-being is feasible and safe. While no differences in back pain were observed, biomechanical measures were sensitive assessments for evaluating gestational LBP-related mobility impairment and showed group differences. Additionally, the PSI showed significant differences in symptom burden over 12 weeks, supporting the ongoing claims that yoga improves a pregnant woman’s overall well-being.

The Effectiveness of Non-Pharmaceutical Interventions Upon Pregnancy-Related Low Back Pain: A Systematic Review and Meta-Analysis

“…Three RCTs compared multiple interventions and only one of them was evaluated as of high methodological quality (Licciardone et al [ 24 ]) while the other two were evaluated as moderate (Keskin et al [ 23 ], Hensel et al [ 25 ]). Lastly, only one RCT for each of the following interventions was found: Kinesio tape (Kaplan et al [ 26 ]), yoga (Holden et al [ 27 ]), ear acupuncture (Vas et al [ 28 ]) and all of them were evaluated as moderate methodological quality.…”

“…The research showed that the intervention was statistically important (p<0.001), but further study is required in order to determine that effect. Furthermore, Holden et al [ 27 ] in a moderate quality study examined yoga in comparison to educational attention and no difference was found.…”

Risk factors for accidental falls during pregnancy – a systematic literature review

“…To date, only one study has been published that confirmed the positive effect of yoga during pregnancy on balance. Pregnant women that practised yoga had greater walking speed and were faster in the timed up-and-go test, had shorter double support and turn times during walking, which indicates they have better stability [50]. Pregnant women who exercised had beneficial adaptations to lower limb kinematics during gait [51].…”

The Effect of Hatha Yoga on Low Back Pain and Sleep Quality in Nulliparous Pregnant Women: A Clinical Trial Study

“…Therefore, Hatha yoga did not have a signi cant effect on the pain score in both groups. The study of Holden et al (2019) also showed that yoga did not have a signi cant effect on the rate of low back pain by expressing the low back pain score on the visual analog scale (VAS) between the control and intervention groups in the second trimester of pregnancy. These results were consistent with the results of the current study (13).…”

“…Furthermore, low back pain and sleep disorders during pregnancy have a major impact on pregnant women's ability to do their daily activities which worsens as pregnancy progresses (11). Unfortunately, despite the high prevalence of low back pain and sleep disorders during pregnancy (12) and their complications, there are limited or no treatments for them (13). In addition, these problems are often overlooked and not evaluated or treated by health care providers (12).…”