Can Supervised Group Exercises Including Ergonomic Advice Reduce the Prevalence and Severity of Low Back Pain and Pelvic Girdle Pain in Pregnancy? A Randomized Controlled Trial

Abstract

Background Many women have low back pain (LBP) or pelvic girdle pain (PGP) during pregnancy, but there is limited evidence of effective primary and secondary preventive strategies. Objective The purpose of this study was to investigate whether a group-based exercise program can reduce the prevalence and severity of LBP and PGP in pregnant women. Design An observer-blinded randomized controlled trial with equal assignments to a training group and a control group was conducted. Setting The study was conducted in primary care maternity units in 2 suburban municipalities in the southeastern part of Norway. Patients The participants were 257 pregnant women who were healthy and between 18 and 40 years of age before gestation week 20. Intervention The training group received supervised exercises in groups once a week, and the control group received standard care. Measurements The main outcome measures were self-reported LBP and self-reported PGP. Secondary outcome measures were pain intensity in the morning and evening, disability, and 8-Item Short-Form Health Survey (SF-8) Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. Follow-up measurements were performed at gestation weeks 24, 28, 32, and 36. Results Overall, there was no effect of the program on the prevalence of PGP (odds ratio=1.03, 95% confidence interval [CI]=0.66 to 1.59) or LBP (odds ratio=0.77, 95% CI=0.50 to 1.19). For the secondary outcomes, the estimated mean differences between the groups were −0.4 (95% CI=−0.8 to 0.1) for pain intensity in the morning, −0.4 (95% CI=−1.0 to 0.2) for pain intensity in the evening, −1.0 (95% CI=−2.2 to 0.0) for disability, 1.8 (95% CI=0.0 to 3.7) for the SF-8 PCS, and −0.6 (95% CI=−2.2 to 1.4) for the SF-8 MCS. Limitations Due to low statistical power, the estimates for the primary outcomes are imprecise. Conclusions Supervised group exercise did not reduce the prevalence of LBP or PGP in pregnancy.