Effectiveness of conservative therapy on pain, disability and quality of life for low back pain in pregnancy: A systematic review of randomized controlled trials

Maia, Laísa Braga; Amarante, Letícia Gonçalves do; Vitorino, Débora F.M.; Mascarenhas, Rodrigo Oliveira; Lacerda, Ana Cristina Rodrigues; Lourenço, Bianca Martins; Oliveira, Vinícius Cunha

doi:10.1016/j.bjpt.2021.06.007

Cited by 8 publications

(8 citation statements)

References 39 publications

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“…Since there was no non-exercise group, the improvements may not have been demonstrated at a significant level. Although low back pain severity and disability increased as pregnancy progressed [44], the fact that it did not increase in our study can be considered as a positive development.…”

Section: Discussioncontrasting

confidence: 60%

Significance of Physical Exercise in Pregnancy: Comparison of Short and Long Exercise Programs

Uzelpasacı,

Ozcakar,

Özgül

et al. 2024

Z Geburtshilfe Neonatol

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Background Several musculoskeletal changes occur in pregnancy, particularly in the abdominal region. The aim of this study was to search and compare the effects of long (LEP) and short exercise programs (SEP) in terms of the satisfaction of the needs of pregnant women. Methods This study consisted of 2 groups: LEP (n=16) and SEP (n=16). Muscle thickness measurements determined by ultrasound, the 6 minute walk test, Pregnancy Physical Activity Questionnaire, Visual Analogue Scale, Oswestry Disability Index, and Short Form-36 Quality of Life Questionnaire were the study variables. Evaluations were done at the 16th (baseline), 24th, and 32nd gestational weeks. The LEP consisted of 20 and the SEP consisted of 9 exercises, which were applied for 16 weeks until the 32nd gestational week. Results Emotional role limitation and pain scores of quality of life, 6 minute walk test, and occupational physical activity were found to be better in the LEP group at the 24th gestational week (p=0.043, p=0.049, p=0.049, p=0.026). At the 32nd gestational week, the 6 minute walk test and occupational physical activity were found to be higher in the LEP group (p=0.006, p=0.017). Additionally, rectus abdominis and bilateral diaphragm muscle thicknesses, “moderate intensity and sports physical activity” and “vitality and emotional well-being” were increased over time with the LEP (p+<+0.05 for all). On the other hand, unilateral diaphragm muscle thickness, sports physical activity level, and vitality were improved with the SEP (p+<+0.05 for all). Conclusions The SEP and LEP both have beneficial effects in pregnant women. However, the LEP increases physical activity level, functional capacity, and quality of life more than the SEP during the later stages of pregnancy.

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Section: Discussioncontrasting

confidence: 60%

Significance of Physical Exercise in Pregnancy: Comparison of Short and Long Exercise Programs

Uzelpasacı,

Ozcakar,

Özgül

et al. 2024

Z Geburtshilfe Neonatol

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“…This meta-analysis found that the ES of the benefit of exercise on pain decreased as the duration of the intervention increased. These results are consistent with the findings of Maia et al, 13 which found that the difference in pain ratings during pregnancy with exercise compared with routine care was greater in the short term (up to 12 weeks) than in the long term (>12 weeks). Previous literature has discussed the pattern of increased pain with the progression of pregnancy, 6 indicating that perhaps it is not the duration of the intervention that changes the ES, but rather the later stage of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…9 Recommended exercises are similar to those that are recommended for nonpregnant individuals with low back pain, with modifications such as avoiding a prone or prolonged supine position made as needed to accommodate pregnancy. 8 Previous systematic literature reviews have evaluated the impact of a variety of conservative interventions, such as pelvic support belts, 10,11 acupuncture, [10][11][12] postural education, 13 pharmacology, 14 manual therapies, [11][12][13] and exercise 11,12,15 on pregnancy-related lumbopelvic pain. These reviews have found benefits to pain, disability, and quality of life, ranging from none to significant with moderate-to low-quality evidence.…”

Section: Introductionmentioning

confidence: 99%

“…Previous systematic literature reviews have evaluated the impact of a variety of conservative interventions, such as pelvic support belts,10,11 acupuncture,10–12 postural education,13 pharmacology,14 manual therapies,11–13 and exercise11,12,15 on pregnancy-related lumbopelvic pain. These reviews have found benefits to pain, disability, and quality of life, ranging from none to significant with moderate- to low-quality evidence 10–15. Some studies have compared exercise to other conservative interventions, which does not allow for analysis of efficacy against routine prenatal care 13.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Exercise on Lumbopelvic Pain During Pregnancy: A Systematic Review and Meta-analysis

Tombers

Grob²,

Ollenburg

et al. 2023

Journal of Women's Health Physical Therapy

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Background: At least 50% of women experience lumbopelvic pain during pregnancy. Physical activity has moderate health benefits and no adverse outcomes for women with uncomplicated pregnancies. Physically active pregnant women have lower pain intensities than sedentary women. It is not clear whether common exercise types are equally beneficial for the management of lumbopelvic pain during pregnancy. Objective: The aim of this systematic review is to determine the effect of exercise on reducing lumbopelvic pain intensity in pregnant women. Study Design: A systematic review and meta-analysis. Methods: Seven databases (CINAHL, Medline, ScienceDirect, SportDiscus, ProQuest, Google Scholar, and Cochrane) were searched in October 2020 and again in February 2022. Studies investigating the effect of exercise on low back or pelvic pain in pregnant women were included, with no limitation on publication date. Primary data collected for quantitative analysis included pain intensity. Bias was assessed using the Cochrane bias tool. A meta-analysis was performed using individual study effect sizes (ES) using a random-effects model. Results: Initial search yielded 1,771 results and 21 articles were identified as meeting the inclusion criteria. One article utilized 2 intervention groups and was counted as separate studies. Meta-analysis on 22 studies yielded a statistically significant and large ES, indicating exercise intervention during pregnancy results in significantly lower pain reports compared with usual prenatal care (overall ES = 2.07; 95% confidence interval = 1.35-2.78; P < .001). Conclusion: Exercise is beneficial in the management of lumbopelvic pain in pregnant women.

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“…LBP is commonly reported during pregnancy, mainly after the 22nd week of pregnancy due to the physiological changes of pregnancy become more evident in this period (Berber et al, 2020). Gestational low back pain (GLBP) has a wide variation in incidence, estimated at 30 to 78% of pregnant women present GLBP at some point during pregnancy and can remain in the postpartum period (Liddle et al, 2015;Maia et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Impact of gestational low back pain intensity on quality of life, sleep quality, functional status, anxiety and depression

Ribeiro

Déa

Mattos

et al. 2023

RSD

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Introduction: Gestational low back pain (GLBP) have impact on performance of daily life activities, although it remains uncertain the impact of pain intensity in clinical outcomes. Aims: To verify the impact and relationship of pain intensity of GLBP on quality of life (QoL), sleep quality (SQ), functional status, anxiety and depression. Methods: Pregnant women above 20 weeks of gestation completed the sample characterization form and answered five questionnaires to assess pain (Visual Analogue Scale), QoL (Medical Outcomes Short Form Health Survey–36 item), SQ (Pittsburg Sleep Quality Index), functional status (Oswestry Disability Index), anxiety and depression (Hospital Anxiety and Depression Scale). Participants were divided in two groups, with GLBP (GLBP group) and without GLBP (CG). GLBP group was stratified according to pain intensity in two groups: mild pain (VAS≤3: M-GLBP) and moderate to severe pain (VAS>3: MS-GLBP). Results: 75 participants were included, 75% in the GLBP (n=56, 30[27-34] years) and 25% in CG (n=19, 32[30-34] years). GLBP presents worse QoL, SQ, functional status, anxiety and depression (p<0.05). MS-GLBP (n=32) had worse SQ (p=0.006), functional status (p<0.0001), anxiety and depression (p<0.05) compared to CG and present worse QoL (p<0.05) compared to M-GLBP (n=24). M-GLBP has worse functional status compared to CG (p<0.001). Pain intensity is moderately correlated to functional status (r=0.56; p<0.0001). Conclusion: Women with moderate to severe GLBP presented worse QoL, SQ, functional status, increased depression and anxiety compared to CG, even mild GLBP have impact on functional status and pain intensity have moderate correlation with functional status.

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Effectiveness of conservative therapy on pain, disability and quality of life for low back pain in pregnancy: A systematic review of randomized controlled trials

Cited by 8 publications

References 39 publications

Significance of Physical Exercise in Pregnancy: Comparison of Short and Long Exercise Programs

Significance of Physical Exercise in Pregnancy: Comparison of Short and Long Exercise Programs

Effects of Exercise on Lumbopelvic Pain During Pregnancy: A Systematic Review and Meta-analysis

Impact of gestational low back pain intensity on quality of life, sleep quality, functional status, anxiety and depression

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