Pelvic floor muscle training for women with lumbopelvic pain: A systematic review and meta‐analysis

Abstract

It has been suggested that pelvic floor dysfunction may contribute to the development of lumbopelvic pain as a result of changes in trunk muscle control. However, there is limited evidence that pelvic floor muscle training (PFMT) can improve clinical outcomes in women with lumbopelvic pain. Six databases were searched for randomized controlled trials (RCTs) comparing the effectiveness of PFMT to other conservative interventions (usual physiotherapy care or minimal intervention), no treatment or placebo interventions on pain and disability in women with lumbopelvic pain. We included eight RCTs totalling 469 participants. PFMT was more effective than minimal intervention for lumbopelvic pain [mean difference (MD) 15.9/100 (95% confidential interval (CI), 8.2 to 23.6; p=0.00; I2 =3.92%)] and disability [standardized mean difference (SMD) 0.5 (95% CI 0.1-0.9; p=0.00; I2 =0%)] during pregnancy. PFMT was more effective than usual physiotherapy care for pain (MD 11.7/100 [95% CI 7.5-15.9; p=0.00; I2 =94.14%]) and disability (SMD 0.3 (95% CI 0.0-0.6; p=0.01; I2 =82.54%]) in non-pregnant women. Effect sizes were in general of arguable clinical relevance. Overall, the certainty of the evidence was very low to low. There is no conclusive evidence that the addition of PFMT to usual physiotherapy care or minimal intervention is superior to minimal intervention and usual care alone given the small number of studies and high levels of heterogeneity of included studies. Further well-designed trials are needed to establish the effectiveness of PFMT for lumbopelvic pain in women.