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The Effects of Core and Lower Extremity Strengthening on Pregnancy-Related Low Back and Pelvic Girdle Pain: A Systematic Review

Lillios, Stacey PT, DPT1; Young, Jodi PT, DPT, OCS2

Journal of Women’s Health Physical Therapy: September/December 2012 - Volume 36 - Issue 3 - p 116–124
doi: 10.1097/JWH.0b013e318276fb16
Literature Review

Objective: To examine available evidence for core stabilization and lower extremity strengthening during pregnancy and its effect on pregnancy-related low back pain (PLBP) and pregnancy-related pelvic girdle pain (PPGP).

Study Design: Systematic review.

Background: Currently, there is no standard of care for PLBP and/or PPGP. Interventions are varied and may include activity modification, exercise, mobilization, aquatics, chiropractic care, acupuncture, bracing, and positioning. There is moderate research to support the use of any of these methods but none conclusively states one technique as superior.

Methods and Measures: Database searches included PubMed, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, MEDLINE, Google Scholar, and ProQuest. Seven studies that met the inclusion criteria were selected for this review and analyzed by 2 reviewers using the Physiotherapy Evidence Database scale. All the included studies evaluated the use of exercise in the treatment of PLBP and PPGP.

Results: The studies in this review were of fair to good methodological quality, with scores ranging from 5 to 8 on the Physiotherapy Evidence Database scale. Each study reported reduction in pain intensity or location when compared to the control or alternate intervention, but not all were statistically significant.

Conclusions: Although all the studies reported reduction in symptoms, there is no conclusive evidence to support exercise as a superior intervention for the treatment of PLBP and PPGP. None of the studies reported adverse affects on the women or fetuses as a result of the interventions.

1Concord Hospital Rehabilitation Services, New Hampshire.

2Department of Physical Therapy, Franklin Pierce University, Goodyear, Arizona.

The authors declare no conflicts of interest.

Copyright © 2012 Section on Women's Health, American Physical Therapy Association
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