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Exercise for the prevention of low back and pelvic girdle pain in pregnancy: a meta-analysis of randomized controlled trials

Exercise for the prevention of low back and pelvic girdle pain in pregnancy: a meta-analysis of randomized controlled trials
Exercise for the prevention of low back and pelvic girdle pain in pregnancy: a meta-analysis of randomized controlled trials
Background and objective: the effect of exercise in prevention of low back and pelvic girdle pain during pregnancy is uncertain. This study aimed to assess the effect of exercise on low back pain, pelvic girdle pain and associated sick leave.

Databases and data treatment: literature searches were conducted in PubMed, EMBASE, Cochrane Library, Google Scholar, ResearchGate and ClinicalTrials.gov databases from their inception through May 2017. Randomized controlled trials (RCTs) were eligible for inclusion in the review if they compared an exercise intervention with usual daily activities and at least some of the participants were free from low back pain and/or pelvic girdle pain at baseline. Methodological quality of included studies was evaluated using the Cochrane Collaboration's tool. A random-effects meta-analysis was performed, and heterogeneity and publication bias were assessed.

Results: eleven randomized controlled trials (2347 pregnant women) qualified for meta-analyses. Exercise reduced the risk of low back pain in pregnancy by 9% (pooled risk ratio (RR) = 0.91, 95% CI 0.83–0.99, I2 = 0%, seven trials, N = 1175), whereas it had no protective effect on pelvic girdle pain (RR = 0.99, CI 0.81–1.21, I2 = 0%, four RCTs, N = 565) or lumbopelvic pain (RR = 0.96, CI 0.90–1.02, I2 = 0%, eight RCTs, N = 1737). Furthermore, exercise prevented new episodes of sick leave due to lumbopelvic pain (RR = 0.79, CI 0.64–0.99, I2 = 0%, three RCTs, N = 1168). There was no evidence of publication bias.

Conclusion: exercise appears to reduce the risk of low back pain in pregnant women, and sick leave because of lumbopelvic pain, but there is no clear evidence for an effect on pelvic girdle pain.

Significance: exercise has a small protective effect against low back pain during pregnancy.
1090-3801
19-27
Shiri, R.
49c1a0c0-a798-44f9-8237-2b6e39e36795
Coggon, David
2b43ce0a-cc61-4d86-b15d-794208ffa5d3
Falah-Hassani, K.
8a52f083-7d58-49ee-8444-fdbc1fb8fb4c
Shiri, R.
49c1a0c0-a798-44f9-8237-2b6e39e36795
Coggon, David
2b43ce0a-cc61-4d86-b15d-794208ffa5d3
Falah-Hassani, K.
8a52f083-7d58-49ee-8444-fdbc1fb8fb4c

Shiri, R., Coggon, David and Falah-Hassani, K. (2018) Exercise for the prevention of low back and pelvic girdle pain in pregnancy: a meta-analysis of randomized controlled trials. European Journal of Pain, 22 (1), 19-27. (doi:10.1002/ejp.1096).

Record type: Article

Abstract

Background and objective: the effect of exercise in prevention of low back and pelvic girdle pain during pregnancy is uncertain. This study aimed to assess the effect of exercise on low back pain, pelvic girdle pain and associated sick leave.

Databases and data treatment: literature searches were conducted in PubMed, EMBASE, Cochrane Library, Google Scholar, ResearchGate and ClinicalTrials.gov databases from their inception through May 2017. Randomized controlled trials (RCTs) were eligible for inclusion in the review if they compared an exercise intervention with usual daily activities and at least some of the participants were free from low back pain and/or pelvic girdle pain at baseline. Methodological quality of included studies was evaluated using the Cochrane Collaboration's tool. A random-effects meta-analysis was performed, and heterogeneity and publication bias were assessed.

Results: eleven randomized controlled trials (2347 pregnant women) qualified for meta-analyses. Exercise reduced the risk of low back pain in pregnancy by 9% (pooled risk ratio (RR) = 0.91, 95% CI 0.83–0.99, I2 = 0%, seven trials, N = 1175), whereas it had no protective effect on pelvic girdle pain (RR = 0.99, CI 0.81–1.21, I2 = 0%, four RCTs, N = 565) or lumbopelvic pain (RR = 0.96, CI 0.90–1.02, I2 = 0%, eight RCTs, N = 1737). Furthermore, exercise prevented new episodes of sick leave due to lumbopelvic pain (RR = 0.79, CI 0.64–0.99, I2 = 0%, three RCTs, N = 1168). There was no evidence of publication bias.

Conclusion: exercise appears to reduce the risk of low back pain in pregnant women, and sick leave because of lumbopelvic pain, but there is no clear evidence for an effect on pelvic girdle pain.

Significance: exercise has a small protective effect against low back pain during pregnancy.

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Accepted/In Press date: 29 July 2017
e-pub ahead of print date: 4 September 2017
Published date: January 2018

Identifiers

Local EPrints ID: 414953
URI: https://eprints.soton.ac.uk/id/eprint/414953
ISSN: 1090-3801
PURE UUID: 18bc607d-6a65-41d2-af65-b7cf6e1bfefb
ORCID for David Coggon: ORCID iD orcid.org/0000-0003-1930-3987

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Date deposited: 18 Oct 2017 16:30
Last modified: 10 Dec 2019 05:45

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Contributors

Author: R. Shiri
Author: David Coggon ORCID iD
Author: K. Falah-Hassani

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