The Role of Exercise in the Management of Pelvic Girdle and Low Back Pain in Pregnancy

Objective: Assess literature on exercise as treatment for pelvic girdle and low back pain in pregnancy. Study Design: A systematic review. Background: Pregnancy-related pelvic girdle and low back pain are common. Prevalence rates average near 50%. Assessment of exercise intervention studies may provide evidence to manage this dysfunction. Materials and Methods: Systematic review of prospective clinical trials on exercise for pregnancy-related pelvic and low back pain. CINAHL, MEDLINE, PEDro, and Cochrane databases were searched; reference screening was conducted. Three reviewers used consensus process to select articles for final review. Two of the reviewers independently reviewed the selected articles according to the PEDro Scale. Where available, the reviewer's results were compared against PEDro Reviews; reviewer scores were altered if both reviewers agreed that the published PEDro Score was more accurate. Results: Eleven studies were reviewed. Three were good quality (range, 7–8/10); 6, moderate quality (range, 4–6/10); and 2, poor quality (range, 0–3/10). High-quality studies support the intervention of exercise, either alone or combined with advice or other treatment (support belts, acupuncture) as a means of prevention or management of pelvic girdle and low back pain. One study found aquatic exercise to be of greater benefit than land-based exercise. Another found acupuncture superior to exercise, which was, in turn, more effective than “standard treatment.” Addition of pelvic support belts to exercise intervention did not further decrease pain. Utilization of sick leave conflicted across studies. Conclusions: Exercise may decrease low back or pelvic girdle pain in pregnancy. Heterogeneity of methodology and outcome assessment makes comparison difficult. Most studies were of moderate to poor quality.