Prevention of low back and pelvic girdle pain during pregnancy: a systematic review and meta-analysis of randomised controlled trials with GRADE recommendations

Santos, Flávia Franciele dos; Lourenço, Bianca Martins; Souza, Mateus Bastos de; Maia, Laísa Braga; Oliveira, Vinícius Cunha; Oliveira, Murilo Xavier

doi:10.1016/j.physio.2022.09.004

Cited by 9 publications

(3 citation statements)

References 31 publications

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“…This is the limitation of this study. Recent meta-analysis and systematic reviews have shown that exercise programs for pregnant women included: pelvic stabilizing exercise, pelvic floor muscle training, and muscle strengthening that could reduce LBP during pregnancy 21,22 . This concluded that multimodality exercises had a benefit in reducing LBP during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Association of Low Back Pain Beyond Mid-Pregnancy with Maternal Physical Activity Prior to Pregnancy: A Cross-Sectional Study

Boonpradit,

Sudsaneha,

Khuancharee

et al. 2024

J Health Sci Med Res

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Objective: 1) To compare the proportions of low back pain (LBP) in pregnant women with adequate and inadequate physical activity (APA and IPA, respectively) prior to pregnancy. 2) To identify possible factors associated with LBP during pregnancy. Material and Methods: A cross-sectional analytic study was conducted. Pregnant women answered questions about their physical activity prior to and during pregnancy, using the Thai version of the short International Physical Activity Questionnaire (IPAQ), and assessed their lower back pain via the visual analog scale and the Thai version of the Oswestry Disability Index (ODI). Results: A total of 342 pregnant women were enrolled. APA and IPA prior to pregnancy were detected in 172 and 170 cases, respectively. The proportions of LBP during pregnancy in each group were 61.6% and 64.7%, respectively. No statistically significant difference was found between the two groups (p-value=0.555). When adjusted with multiple factors in logistic regression model, APA prior to pregnancy decreased the risk of LBP during pregnancy (p-value=0.02), with an adjusted odds ratio (aOR) (95% CI) of 0.51 (0.281–0.916). In contrast, APA during pregnancy (p-value=0.01), pelvic pain (p-value<0.001), and LBP in a previous pregnancy (p-value<0.001) increased the risk of LBP during pregnancy, with aORs (95% CI) of 2.53 (1.236–5.197), 4.83 (2.563–9.110), and 7.49 (3.390–16.570), respectively. Conclusion: APA prior to pregnancy and limiting some types of activity during pregnancy may have a protective effect on LBP during pregnancy.

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Section: Discussionmentioning

confidence: 99%

Association of Low Back Pain Beyond Mid-Pregnancy with Maternal Physical Activity Prior to Pregnancy: A Cross-Sectional Study

Boonpradit,

Sudsaneha,

Khuancharee

et al. 2024

J Health Sci Med Res

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“…The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach [ 19 , 20 ] was used to assess the certainty of evidence in primary outcomes and pulmonary function indexes. The assessment criteria in the previous study were referred [ 21 ]. The GRADE approach categorizes the quality of evidence on four levels ranging from high to very low, with low levels of evidence indicating that future trials with high quality are likely to change the estimates.…”

Section: Methodsmentioning

confidence: 99%

Azithromycin sequential therapy plus inhaled terbutaline for Mycoplasma Pneumoniae pneumonia in children: a systematic review and meta-analysis

Sheng,

Liang,

Zhao

et al. 2024

BMC Infect Dis

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Background An improper host immune response to Mycoplasma pneumoniae generates excessive inflammation, which leads to the impairment of pulmonary ventilation function (PVF). Azithromycin plus inhaled terbutaline has been used in the treatment of Mycoplasma pneumoniae pneumonia (MPP) in children with impaired pulmonary function, but previous randomized controlled trials (RCTs) showed inconsistent efficacy and safety. This study is aimed to firstly provide a systematic review of the combined therapy. Methods This study was registered at the International Prospective Register of Systematic Reviews (PROSPERO CRD42023452139). A PRISMA-compliant systematic review and meta-analysis was performed. Six English and four Chinese databases were comprehensively searched up to June, 2023. RCTs of azithromycin sequential therapy plus inhaled terbutaline were selected. The revised Cochrane risk of bias tool for randomized trials (RoB2) was used to evaluate the methodological quality of all studies, and meta-analysis was performed using Stata 15.0 with planned subgroup and sensitivity analyses. Publication bias was evaluated by a funnel plot and the Harbord’ test. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation recommendations. Results A total of 1,938 pediatric patients from 20 RCTs were eventually included. The results of meta-analysis showed that combined therapy was able to significantly increase total effectiveness rate (RR = 1.20, 95%CI 1.15 to 1.25), forced expiratory volume in one second (SMD = 1.14, 95%CIs, 0.98 to 1.29), the ratio of forced expiratory volume in one second/forced vital capacity (SMD = 2.16, 95%CIs, 1.46 to 2.86), peak expiratory flow (SMD = 1.17, 95%CIs, 0.91 to 1.43). The combined therapy was associated with a 23% increased risk of adverse reactions compared to azithromycin therapy alone, but no significant differences were found. Harbord regression showed no publication bias (P = 0.148). The overall quality of the evidence ranged from moderate to very low. Conclusions This first systematic review and meta-analysis suggested that azithromycin sequential therapy plus inhaled terbutaline was safe and beneficial for children with MPP. In addition, the combined therapy represented significant improvement of PVF. Due to lack of high-quality evidence, our results should be confirmed by adequately powered RCTs in the future.

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“…The causes for the development of such conditions in post-menopausal women is mainly unknown, but some associations with parity have been made ( Cevik et al, 2020 ), and risk factors for pregnancy-related pelvic girdle pain investigated ( Wuytack et al, 2020 ), as well as a focus on pregnancy-associated changes in motor control of the spine ( Desgagnes et al, 2022 ). Some evidence that exercise can help prevent development of low back pain has appeared, but it is not compelling as yet ( Santos et al, 2022 ). In addition, some evidence for the role of HRT in preventing developing of some post-menopausal spondylolisthesis has been generated ( Marty-Poumarat et al, 2012 ), potentially implicating the loss of estrogen in develop of the condition rather than a consequence of pregnancy-associated factors alone.…”

Section: Risk For Menopause-associated Msk Conditions and Diseasesmentioning

confidence: 99%

Sex differences in musculoskeletal injury and disease risks across the lifespan: Are there unique subsets of females at higher risk than males for these conditions at distinct stages of the life cycle?

Hart

2023

Front. Physiol.

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Sex differences have been reported for diseases of the musculoskeletal system (MSK) as well as the risk for injuries to tissues of the MSK system. For females, some of these occur prior to the onset of puberty, following the onset of puberty, and following the onset of menopause. Therefore, they can occur across the lifespan. While some conditions are related to immune dysfunction, others are associated with specific tissues of the MSK more directly. Based on this life spectrum of sex differences in both risk for injury and onset of diseases, a role for sex hormones in the initiation and progression of this risk is somewhat variable. Sex hormone receptor expression and functioning can also vary with life events such as the menstrual cycle in females, with different tissues being affected. Furthermore, some sex hormone receptors can affect gene expression independent of sex hormones and some transitional events such as puberty are accompanied by epigenetic alterations that can further lead to sex differences in MSK gene regulation. Some of the sex differences in injury risk and the post-menopausal disease risk may be “imprinted” in the genomes of females and males during development and sex hormones and their consequences only modulators of such risks later in life as the sex hormone milieu changes. The purpose of this review is to discuss some of the relevant conditions associated with sex differences in risks for loss of MSK tissue integrity across the lifespan, and further discuss several of the implications of their variable relationship with sex hormones, their receptors and life events.

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Prevention of low back and pelvic girdle pain during pregnancy: a systematic review and meta-analysis of randomised controlled trials with GRADE recommendations

Cited by 9 publications

References 31 publications

Association of Low Back Pain Beyond Mid-Pregnancy with Maternal Physical Activity Prior to Pregnancy: A Cross-Sectional Study

Association of Low Back Pain Beyond Mid-Pregnancy with Maternal Physical Activity Prior to Pregnancy: A Cross-Sectional Study

Azithromycin sequential therapy plus inhaled terbutaline for Mycoplasma Pneumoniae pneumonia in children: a systematic review and meta-analysis

Sex differences in musculoskeletal injury and disease risks across the lifespan: Are there unique subsets of females at higher risk than males for these conditions at distinct stages of the life cycle?

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