Pilates for the Prevention of Musculoskeletal Complaints During Pregnancy

Study Overview
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Brief Summary
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The goal of this pilot randomized controlled trial with economic evaluation is to evaluate the viability of Pilates in the prevention of musculoskeletal complaints, throughout the entire gestational period, in pregnant women. The main question it aims to answer is if it is feasible to perform exercises during the entire gestational period to prevent musculoskeletal disorders. Participants will be assessed primarily for acceptability, suitability, feasibility, and fidelity, and secondarily for the occurrence of musculoskeletal complaint and the number of days from randomization on which this musculoskeletal complaint occurred, type of delivery and costs. Then, participants will be randomized into two groups: the usual care group, which will receive an educational booklet with information about the usual care during pregnancy, and the Pilates group, which will receive the same educational booklet and will participate in a specific Pilates exercise program for the gestational period, twice a week, throughout the pregnancy.

Official Title
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Pilates Exercises for the Prevention of Musculoskeletal Complaints During Pregnancy: a Protocol of a Pilot Randomized Controlled Trial With Economic Evaluation

Conditions
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Pregnancy

Intervention / Treatment
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* Other: Pilates exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: pregnant women of usual risk in the 12th gestational week (gestational age determined by the date of the last menstruation or by the ultrasound examination) with medical clearance to practice physical activity Exclusion Criteria: practice of other physical activity during pregnancy any medical contraindications, such as diabetes and hypertension

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Usual care<br>Usual care group will perform the usual prenatal care indicated by the obstetrician and will receive an educational booklet. | |
| Active Comparator: Pilates<br>Pilates group will perform the usual prenatal care indicated by the obstetrician and will receive an educational booklet. Additionally, this group will receive an exercise program based on Pilates, twice a week, individually, throughout the gestational period. | Other: Pilates exercises<br>* Sessions will last 60 minutes: five minutes for warming up, 50 minutes for the practice of Pilates exercises, and five minutes for relaxing with the Swiss ball. The exercise protocol will be divided into three gestational phases, covering the entire gestational period, with different and specific objectives for each phase. In all phases, the exercises will be classified into three levels of difficulty: basic, intermediate, and advanced, according to the evolution of each pregnant woman throughout the practice of Pilates. Modifications will be allowed to facilitate or hinder the execution of the movement. The exercises will be performed in one or two sets of seven to 10 repetitions. The number of series, repetitions and exercises and interval time between them, as well as the level of difficulty of the exercises, will be gradually adjusted. The intensity of the exercises will vary between light and moderate and will be controlled by the Borg scale.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acceptability measured using a 11-point numerical scale (0 = completely dissatisfied with the treatment results; 10 = completely satisfied with the treatment results) | The participant's perception of the treatment result being satisfactory | 24th gestational week | 
| Acceptability measured using a 11-point numerical scale (0 = completely dissatisfied with the treatment results; 10 = completely satisfied with the treatment results) | The participant's perception of the treatment result being satisfactory | 36th gestational week | 
| Acceptability measured using a 11-point numerical scale (0 = completely dissatisfied with the treatment results; 10 = completely satisfied with the treatment results) | The participant's perception of the treatment result being satisfactory | From 7 to 15 days after delivery | 
| Suitability measured using 2 questions (one about the need of tailored exercises for the gestational needs and the other about the need of some adaptation during the execution of the exercises) | Assesses whether the exercise program is suitable for the target audience or needs some adaptation | 24th gestational week | 
| Suitability measured using 2 questions (one about the need of tailored exercises for the gestational needs and the other about the need of some adaptation during the execution of the exercises) | Assesses whether the exercise program is suitable for the target audience or needs some adaptation | 36th gestational week | 
| Suitability measured using 2 questions (one about the need of tailored exercises for the gestational needs and the other about the need of some adaptation during the execution of the exercises) | Assesses whether the exercise program is suitable for the target audience or needs some adaptation | From 7 to 15 days after delivery | 
| Viability measured using a form developed for this study and filled by the physical therapist responsible for the treatment | Assesses recruitment, retention, and participation rates, whether participants reached the end of the treatment program and, if not, why they dropped out | 24th gestational week | 
| Viability measured using a form developed for this study and filled by the physical therapist responsible for the treatment | Assesses recruitment, retention, and participation rates, whether participants reached the end of the treatment program and, if not, why they dropped out | 36th gestational week | 
| Viability measured using a form developed for this study and filled by the physical therapist responsible for the treatment | Assesses recruitment, retention, and participation rates, whether participants reached the end of the treatment program and, if not, why they dropped out | From 7 to 15 days after delivery | 
| Fidelity measured using an exercise checklist (list of all exercises that can be performed including the level of difficulty) | Assesses the level of difficulty of the selected exercises | 24th gestational week | 
| Fidelity measured using an exercise checklist (list of all exercises that can be performed including the level of difficulty) | Assesses the level of difficulty of the selected exercises | 36th gestational week | 
| Fidelity measured using an exercise checklist (list of all exercises that can be performed including the level of difficulty) | Assesses the level of difficulty of the selected exercises | From 7 to 15 days after delivery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Occurrence of musculoskeletal complaint |  | 24th gestational week, 36th gestational week, and from seven to 15 days after delivery | 
| Number of days from randomization on which the musculoskeletal complaint occurred |  | 24th gestational week, 36th gestational week, and from seven to 15 days after delivery | 
| Delivery mode (normal or caesarean section) |  | From 7 to 15 days after delivery | 
| Apgar score (0 to 10) | Reported at 1 minute and 5 minutes after birth, and at 5-minute intervals thereafter until 20 minutes for infants with a score less than 7 | From 7 to 15 days after delivery | 
| Baby's birth weight |  | From 7 to 15 days after delivery | 
| Kinesiophobia measured using the Tampa Scale of Kinesiophobia in the occurrence of musculoskeletal complaint | The total score ranges from 17 to 68 points, and the higher the score, the greater the degree of kinesiophobia. | 24th gestational week, 36th gestational week, and from 7 to 15 days after delivery | 
| Disability measured using the Patient Specific Functional Scale in the occurrence of musculoskeletal complaint | 11-point numerical scale (0 = unable to perform the activity; 10 = able to perform the activity at the same level as before the injury or problem) | 24th gestational week, 36th gestational week, and from 7 to 15 days after delivery | 
| Pain measured using the Pain Numerical Rating Scale in the occurrence of musculoskeletal complaint | 11-point numerical scale (0 = no pain; 10 = the worst possible pain) | 24th gestational week, 36th gestational week, and from 7 to 15 days after delivery | 
| Costs (healthcare costs, patient and family costs, and lost productivity costs) measured using a questionnaire specially developed for this study |  | Baseline, 24th gestational week, 36th gestational week, and from 7 to 15 days after delivery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pilates, Pregnancy, Randomized controlled trial, Pilot study, Musculoskeletal complaint, Economic evaluation