engleski

Effects of Therapeutic Exercises on Pregnancy-Related Low Back Pain and Pelvic Girdle Pain

Abstract: Pregnancy related low back pain (LBP) and pelvic girdle pain (PGP) are defined as lower back and pelvis recurrent or continuous pain which lasts for more than one week. The term lumbopelvic pain is used where there is no distinction between LBP and PGP. The aim of this thesis was to investigate effects of supervised individualized structured therapeutic exercise programme consisting of aerobic and resistance exercises on the prevalence and severity of pregnancy-related lumbopelvic pain. Main outcomes were rate of self-reported lumbopelvic pain, results of Numeric Rating Scale (NRS), Roland-Morris Disability Questionnaire (RMDQ), Pelvic Girdle Questionnaire (PGQ) and frequency of sick leave. Forty-five pregnant women were randomly assigned into two groups: experimental group who performed therapeutic exercise (EG ; N = 20) and control group (CG ; N = 22) with standard antenatal care alone. Structured exercise programme was performed from the inclusion in the study till the end of pregnancy biweekly. Furthermore, pregnant women in EG performed at least 30 minutes of vigorous walk once per day. A total of 419 exercise sessions were performed during the trial, with 20.95 ± 7.56 sessions on average per subject and adherence to protocol was 83.70%. Results showed significant difference in PGQ scores in 30th week of pregnancy (P = 0.05, d = -0.64, r = -0.31) and NRS, PGQ and RMDQ scores in 36th week of pregnancy (P = 0.017, d = -0.80, r = -0.37 ; P = 0.005, d = -0.85, r = -0.39 ; P ˂ 0.001, d = -0.90, r = -0.41). EG had earlier onset of lumbopelvic pain (P = 0.013). There were no significant differences between groups in the rate of self-reported lumbopelvic pain, NRS and RMDQ score in 30th week of pregnancy and rate of sick leave. We also found positive dose-response relationship because number of sessions and duration of the intervention were negatively correlated with the severy of lumbopelvic pain. Our results clearly confirm positive effects of exercise programme on severity of lumbopelvic pain in pregnancy. Exercise did not have influence on prevalence of lumbopelvic pain but it reduced intensity of pain and disability.

pregnancy ; low back pain ; pelvic girdle pain ; therapeutic exercise ; training ; physical activity

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