Relaxation Exercises for Low Back Pain and Insomnia in the Third Trimester of Pregnancy
Condition: Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      The role of progressive muscle exercises has been widely explored. However, limited studies
      report its effectiveness in pregnant women in their third trimester suffering from pain and
      insomnia that may or may not be due to that pain. This study aims to determine the effects of
      relaxation exercises on low back pain and insomnia.
    

Detailed description: 
      In 2021 the research says that most women experience pubic pain, hip pain, knee pain, leg
      cramps, carpal tunnel syndrome, De Quervain's tenosynovitis, or at least one of these
      symptoms during pregnancy and approximately one-quarter of them have a temporary disability.
      Symptoms of LBP could start from early in pregnancy until giving birth, but usually, the pain
      becomes more severe during the third semester of pregnancy and is described as a dull pain.
      In most cases of LBP, the pain does not radiate to other parts of the body. The exercise was
      found to be a very common practice used to decrease LBP and the majority of the relative
      studies were categorized as of high methodological quality. The exercise components of the
      interventions included strength and stretching, endurance training, pelvic tilt exercises,
      stretching and mild isometric abdominal contractions, progressive muscle relaxation exercises
      accompanied by music as well as aerobic and stretching exercises.

      Another research in 2021 describe that one of the most common complaints during pregnancy is
      sleep disorders, such as insomnia, frequently waking up at night, high drowsiness during the
      day, mood swings, and unusual feelings during sleep results of the present study showed that
      counseling with a spiritual approach was effective in improving the sleep quality in pregnant
      women. In the intervention group, the mean score of sleep quality decreased in the second and
      third trimesters compared to the control group. In the present study, spiritual content
      counseling had a significant effect on all areas of sleep quality, except for habitual sleep
      efficiency.

      In 2018 one of research says that physiological and psychological changes in the third
      trimester of pregnancy make falling asleep at night more difficult for pregnant women.
      Studies also show that relaxation exercises reduce psychological tension, stress, and pain.
      The pregnant women in the relaxation exercises group of the present study reported falling
      asleep more comfortably as a result of the decrease in muscle tension, stress, and pain
      perception. The four-week relaxation exercises improved subjective sleep latency, duration,
      habitual sleep efficiency, sleep disturbances, daytime dysfunction, and sleep quality of the
      pregnant women in the third trimester.

      Another research in 2018 on the effects of breathing exercises on insomnia. This study
      finding revealed that, pre-intervention more than half of the pregnant women experienced
      severe insomnia this may be attributed to the inflammation process of pregnancy and the
      effect of pregnancy physiological and psychological changes and discomforts on the sleep
      cycle. The present study revealed that the total score of insomnia decreased for the majority
      of pregnant women after practicing walking with deep breathing exercises. This can be
      attributed to the positive effect of exercises i.e walking or breathing exercises on the
      overall health either physical or psychological by improving physical fitness, increasing the
      blood supply and the circulation to the brain to enhance the sleep cycle, and improving the
      quality of sleep and decrease the insomnia symptoms. It has a positive effect on the severity
      of insomnia during the third trimester of pregnancy, tension, and fatigue relief.

      Another research in 2014 says that relaxation therapy and progressive muscle relaxation (PMR)
      are forms of complementary and alternative medicine often used in pregnancy. There are
      several reasons why this therapy might produce the observed benefit. PMR-induced reduction in
      anxiety and decreased perception of pain may eventually improve QOL status in pregnant women.
      In one study, PMR intervention was compared with massage in pregnant women with leg and back
      pain. In that study, leg pain decreased significantly after the first and last treatments in
      both the PMR and massage groups, but back pain decreased only in the massage group. Pain
      decreased over time during the study in the intervention group, whereas the pain scores (and
      perceived pain) in the control group increased gradually. LBP is one of the most common
      symptoms in pregnancy. We conclude that PMR training can reduce LBP and improve QOL in
      pregnant women.

      Most of the research was conducted on low back pain with pelvic girdle pain, the effect of
      relaxation exercises with music on low back pain, the effect of relaxation exercises on
      insomnia, and quality of life. The objective of this research is to determine the effect of
      progressive relaxation exercises on low back pain and insomnia in the third trimester of
      pregnancy and show the combined effect of relaxation. Reviewing the previous literature on
      the effects of exercises on low back pain and insomnia provides sufficient data but there is
      not enough data on the effects of a combination of both exercise on insomnia and low back
      pain.
    

Intervention name(s): Conventional Physical Therapy; Relaxation exercises
Intervention type(s): Other; Other
Intervention description(s): Heating pad
A total of 3 sessions per week were given for 15 to 20 mins; The experimental group was given Progressive relaxation exercises along with Deep breathing exercises.
A total of 3 sessions per week were given for 15 to 20 mins.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: Pregnancy; Respiratory training; Sleep disturbance