Effect of Adding Pelvic Floor Exercises to the Stabilization Exercises in Treating Low Back Pain During Pregnancy
Condition: Pregnancy Related
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      The purpose of the study is to know the effect of adding pelvic floor exercises to the
      stabilization exercises in treating low back pain during pregnancy.
    

Detailed description: 
      Low back pain (LBP) is a frequent condition in pregnancy, which may begin early, but the
      maximum pain out-put is typically found during the third trimester. (Adriana et al., 2020).
      LBP is pain or discomfort located between the 12th rib and the gluteal fold and PGP has been
      defined as 'pain experienced between the posterior iliac crest and the gluteal fold,
      particularly in the vicinity of the sacroiliac joints' (Margie et al., 2018). LBP is a common
      health concern among women during pregnancy worldwide. The prevalence of LBP during pregnancy
      varies from and within sub regions. Moderate to severe disability associated with LBP is
      often a burden in pregnancy. The negative impact of LBP during pregnancy has implications on
      maternal quality of life and satisfaction with pregnancy. The duration of LBP in pregnancy
      correlates directly with the duration of absenteeism, physical dysfunction and poor work
      performance (Njoku et al., 2021).

      The pelvic floor muscles (PFMs) are another component of the local stabilizing system, which
      in associated with deep abdominal and multifidus muscles play a critical role in lumbo-pelvic
      stability. Insufficiency can occur as a result of trauma, surgery, poor movement patterns,
      and childbirth. Previous studies reported that compared with healthy subjects, PFMs endurance
      time decreases in patients with pregnancy-related LBP (PRLBP). In addition, motor control of
      these muscles is altered in presence of sacroiliac join pain. Pregnancy can affect PFMs in
      several ways. The enhancement of hormonal level leads to muscle inhibition. Simultaneously,
      the growing of the uterus pushes pelvic organs downward and exert continuous strain on PFMs.
      Delivery itself changes the pelvic supportive system. These changes can impair PFMs function
      and load transferring in lumbo-pelvic area and lead to development of LBP. It was found that
      there is a synergistic relationship between local stabilizing muscles. Therefore, it could be
      supposed that a treatment program, which addresses local stabilizing muscles, can improve PFM
      function and decrease clinical symptoms in PRLBP (Zahra et al., 2018).

      They were divided randomly into two equal groups using coin toss method;Group A (Control
      Group): consisted of 24 pregnant women with LBP and treated by routine treatment
      (Stabilization exercise) only 3 times per week for 6 successive weeks. Group B (Study Group):
      consisted of 24 pregnant women with LBP and treated by same program for group A and pelvic
      floor exercise only 3 times per week for 6 successive weeks.
    

Intervention name(s): Stabilization exercise; Pelvic floor exercise
Intervention type(s): Other; Other
Intervention description(s): The exercise program included Bridging, Seated Marching Twist, Quadruped pelvic tilts, Modified Side Plank, and Bird dog for 6 successive weeks. .; The pelvic floor exercise protocol involved several steps. Prior to commencing the exercise, women were instructed to empty their bladders. The initial position for the woman was lying in a crook lying position. They were then guided to contract and hold their pelvic muscles for a duration of 5 to 6 seconds, followed by a relaxation period of 5 to 6 seconds. As the sessions progressed, patients were encouraged to perform the exercises in different positions: from a quadriped position, then sitting, followed by standing, and eventually while walking. Each session had a duration of 20 minutes, and the recommended frequency was three times a week for a span of 6 weeks. The repetitions were set at 10 to 15 per set, with two sets in total.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: PELVIC FLOOR EXERCISES; STABILIZATION EXERCISES; LOW BACK PAIN; PREGNANCY