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The Effectiveness of Exercise in Treatment of Pregnancy-Related Lumbar and Pelvic Girdle Pain: A Meta-Analysis and Evidence-Based Review

Belogolovsky, Inna PT, DPTc; Katzman, Wendy PT, DPTSc; Christopherson, Natalie DPT; Rivera, Monica PT, DPTSc; Allen, Diane D. PT, PhD

Journal of Women's Health Physical Therapy: May/August 2015 - Volume 39 - Issue 2 - p 53–64
doi: 10.1097/JWH.0000000000000032
Literature Review

Background: Low back pain (LBP) and pelvic girdle pain (PGP) frequently occur during pregnancy, limiting function, quality of life, and potentially leading to chronic pain and risk of long-term disability.

Purpose: To conduct a meta-analysis to determine whether exercise is effective, compared with no exercise, for LBP and PGP (LBPGP) in reducing pain and increasing function in pregnant women. To identify the most effective methods of intervention delivery.

Methods: A literature search in PubMed, CINAHL, PEDro, and Cochrane databases yielded 101 articles, of which 5 fit the criteria to be included in this review. Inclusion criteria—pregnant participants with LBP and/or PGP at baseline, managed with a land-based exercise program; articles classified as level of evidence 2b or higher, and written in English within the last 10 years. Exclusion criteria—studies that excluded women with PGP, or those that lacked a nonexercising comparison group. Effect sizes and 95% confidence intervals, Q statistics, and Z tests were calculated between and within groups for pain and functional ability outcomes and presented in forest plots.

Results: The grand effect size was statistically significant for relieving pain and nonsignificant for improving function. Four of the 5 studies reported statistically significant improvement in pain and 2 in function. Studies including stability ball exercise and progressive core stabilization showed significantly improved pain and function and had the highest total exercise time.

Discussion: To relieve pain and possibly improve function during advancing pregnancy, women with pregnancy-related LBPGP may benefit from a 10-week program of supervised, functional, progressive core-focused exercise and/or yoga program, including a home exercise component.

1UCSF/SFSU Graduate Program in Physical Therapy.

2Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of California, San Francisco.

This manuscript was completed as partial fulfillment of the Doctorate in Physical Therapy (DPT) degree.

Authors declare that there are no conflicts of interest.

Copyright © 2015 by the Section on Women's Health, American Physical Therapy Association.
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