Lumbopelvic Pain Research Articles

Development of prediction model for risks of musculoskeletal chronic lumbopelvic pain in Indian women

Chronic lumbopelvic pain (CLPP) and its associated disabilities significantly affect women's social, professional, and personal lives. However, the specific factors contributing to CLPP in women remain unclear. To address this gap, this prospective cross-sectional study aims to identify the risk factors predicting CLPP in women and develop a prediction model that can predict CLPP in women. The study was conducted across Delhi, India, where free health camps were held, and 2400 women were assessed. Among the assessed individuals, the study revealed a high prevalence rate of CLPP among Indian women, standing at 70.4%. Seven risk factors namely, hamstring muscle tightness (> 20° on passive knee extension test), increased lumbar lordosis (> 11.5 cm of the lumbar lordotic index), reduced hip flexibility (> 15 cm on bent knee fallout test), altered foot posture (≥ 20 on foot posture index score), increased perception of psychological stress (> 25 on cohen’s perceived stress scale-10 score), reduced physical activity level (< 475 metabolic/minute on international physical activity questionnaire) and reduced performance of transversus abdominis muscle (≤ 5 on deep muscle contraction scale score) strongly predict the risks of CLPP in women. Identifying these risk factors is crucial for effectively preventing and managing CLPP symptoms, especially considering its high prevalence among Indian women. Health professionals should prioritize raising awareness about CLPP and its causative factors, as well as implementing strategies for early detection and intervention.

The Comparison of Scar Mobilization Techniques with and without Core Stability Exercises on Scar Tissue Mobility and Lumbopelvic Pain

Abdominal adhesions and lumbopelvic pain can occur after a caesarean section. Many treatment approaches, such as injections, massage, surgical release, soft tissue release, strengthening, stretching and core stability exercises are available for abdominal scars. Physiotherapy treatments are considered safer and more convenient. The study aims to compare the effects of scar mobilization techniques with and without core stability exercises on scar tissue mobility and lumbopelvic pain. The study was a randomized clinical trial conducted at the Rafiqa Hospital and Fatima Hospital, Sargodha, Pakistan. A sample of 30 participants was allocated in Group A and B. Group A received scar mobilization and core stability exercises, while Group B received only scar mobilization, with both groups undergoing 3 sessions per week for total three weeks. The groups were assessed at baseline after the 5th and 9th sessions, using Oswestry Low Back Pain Disability Questionnaire (ODI), Numeric Pain Rating Scale (NPRS), Manual Scar Mobility Testing (MSMT), and Vancouver Scar Scale (VSS). Moreover, the data were analyzed using SPSS 25. The mean age of participants was 27.22 ± 4.21, and their body mass index was 27.10 ± 3.53. Both groups showed significant differences within the subject’s scores of disability, pain and scar mobility (p&lt;0.05). Between-group comparison of both groups at post-treatment II showed considerable improvement in pain scores (NPRS score, p&lt;0.05). Whereas non-significant results were in other outcome measures (disability and scar mobility p&gt;0.05) in post-treatment II. Scar mobilization techniques with core stability exercises were more effective than scar mobilization techniques alone in the conservative treatment of females with lumbopelvic and scar pain after caesarean section.

Low back pain and kinesiophobia in pregnant women.

During pregnancy, many pregnant women experience lumbopelvic pain due to mechanical, systemic, and hormonal reasons and this pain and fear of movement (kinesiophobia) causes daily life limitations. To examine low back pain (LBP), kinesiophobia, disability, and related conditions that develop together during pregnancy. The was a cross-sectional and analytical study. The presence, severity, and duration of pain in the lumbopelvic region were questioned. Postpartum LBP was evaluated using a self-administered questionnaire, disability using the Oswestry Disability Index (ODI), pain intensity using a visual analog scale (VAS), physical activity levels using the physical activity level during pregnancy questionnaire and the international physical activity questionnaire short form, and kinesiophobia was evaluated using the Tampa Scale for Kinesiophobia. The study comprised 120 pregnant women with a mean age of 27.4 ± 6.1 years. It was observed that 42.3% of the pregnant had LBP (n= 69). The mean body mass index (BMI) was 73.6 ± 16.2 kg/m2, and the mean VAS score was 5.5 ± 2 cm. When we divided the group according to the presence of LBP, age (p= 0.49), gestational week (p= 0.75), and gravida (p= 0.81) were similar. BMI (p= 0.038) and ODI scores (p< 0.001) were higher in the group with LBP. LBP in pregnant women has a higher frequency than in the normal population, regardless of age, gestational week, and gravida. Obesity appears to be a risk factor for LBP and increases disability. Kinesiophobia in pregnant women is significantly associated with obesity and disability. Unless there are contraindications, a physically active pregnancy process and regular exercise should be recommend.

Examination of factors influencing lumbopelvic pain during pregnancy and in the first year post partum

Bevezetés: Gyakori jelenség a terhesség alatti hát- és kismedencei fájdalom, amely befolyásolja az anya közérzetét és jóllétét a terhesség ideje alatt, valamint a szülés után is. Célkitűzés: Célunk az volt a kutatásunk során, hogy vizsgáljuk a derék- és medenceövi fájdalmat befolyásoló tényezőket a terhesség alatt, valamint a szülést követő egy évben. Módszer: Keresztmetszeti kérdőíves kutatásunkban 220 (átlagéletkor: 40,44 ± 4,93 év) egy éven belül szült nő vett részt. A kérdőívcsomag általános és női egészségi állapotra irányuló kérdéseket foglalt magában, valamint önálló, validált kérdőívekként tartalmazta a Nemzetközi Fizikai Aktivitás Kérdőív rövidített változatát, az Oswestry Rokkantsági Indexet, valamint a Pelvic Girdle Questionnaire-t. Az általunk használt statisztikai szoftverek a Microsoft Office Excel 2016, valamint a Statistical Package for Social Sciences 28.0 verziók voltak, a szignifikanciaszint p&lt;0,05 értékként került meghatározásra. Eredmények: A terhesség előtti és alatti derékfájdalom erősségének mértékét mérő vizuális analóg skála pontszámai között szignifikáns különbség mutatkozott (p&lt;0,001), a terhesség alatti és utáni pontszámok között azonban nem jelentkezett szignifikáns eltérés (p = 0,201). Pozitív irányú, szignifikáns volt a kapcsolat a derékfájdalom mértéke és az Oswestry Rokkantsági Index pontszámai között (r = 0,679; p&lt;0,001), valamint a terhesség alatti derékfájás erősségének mértékét kifejező vizuális analóg skála pontszámai és a terhesség alatti testtömegindex között (r = 0,135; p = 0,045). A „rendszeresen sportoló” és „rendszeresen nem sportoló” csoportok Pelvic Girdle Pain Questionnaire pontszámait összehasonlítva szignifikáns különbség mutatkozott (p = 0,028). Megbeszélés: Kutatási eredményeink nagymértékben párhuzamba vonhatók, illetve alátámaszthatók a nemzetközi szakirodalomban fellelhető eredményekkel. Következtetés: A kutatás eredményei alapján megállapíthatjuk, hogy a terhesség alatti derék- és medenceövi fájdalmat befolyásolja és meghatározza a fizikai aktivitás szintje, valamint a testtömegindex. Beavatkozás nélkül a fájdalom a szülést követően is fennáll. Orv Hetil. 2024; 165(22): 859–865.

The Combined Influence of Infant Carrying Method and Motherhood on Gait Mechanics.

Postpartum mothers are susceptible to lumbopelvic pain which may be exacerbated by loading, like carrying their infant in arms and with baby carriers. Nulliparous women carrying infant mannequins may biomechanically mimic mother-infant dyad, but this has not been studied. The purpose of our study was to investigate biomechanical differences of 10 mothers carrying their infants and 10 nulliparous women carrying infant mannequins under 3 gait conditions: carrying nothing, carrying in arms, and carrying in a baby carrier (babywearing). Spatiotemporal gait parameters, peak ground reaction forces and impulses, and lower extremity and trunk kinematics were collected using motion capture and force plates and compared using a mixed 2 × 3 (parity × condition) analysis of variance (α ≤ .05). The largest differences occurred between carrying conditions: carrying in arms or babywearing increased vertical and anteroposterior ground reaction forces, trunk extension, ankle dorsiflexion, and hip and knee flexion. Kinematic differences were identified between arms and babywearing conditions. Together this suggests alterations in joint loading for both groups. Our study also contributes a novel understanding of postpartum health by demonstrating alterations in step time, anterior forces, and ankle and knee mechanics, suggesting that during gait, mothers carrying their own infants choose different propulsive strategies than nulliparous women carrying mannequins.

Does research support the current conservative care recommendations for pregnancy-related diastasis rectus abdominis? A scoping review

Pregnancy-related diastasis rectus abdominis (DRA) is a widespread condition. The current evidence for its conservative management is contradictory, as are the criteria for making a diagnosis, which has stimulated debate among practitioners. The aim of this scoping review was to synthesize the existing peer-reviewed literature to determine whether there is evidence to support or refute recently published recommendations for the conservative care of perinatal DRA. These guidelines suggest that it should be approached from the perspective of considering the linea alba (LA) as an integrative component of the thoracopelvic abdominal system, which assumes functional relationships between the structures of the thorax and pelvis. Specifically, the present authors explored whether relationships exist between: (1) the LA and breathing mechanics; (2) pelvic floor muscle (PFM) function; (3) lumbopelvic pain (LPP) control; and (4) aspects of the structure and function of the abdominal wall. Of the 31 studies included, none were found relating to the LA and breathing mechanics, 11 investigated PFM function, 10 explored LPP, and 18 examined the LA with respect to the structure and/or function of the abdominal wall. The research reviewed does not appear to substantiate several of the recommendations for the conservative care of DRA, but does align with cited gaps in knowledge about this condition. The studies included neither support nor necessarily refute the relationships between breathing, PFM function and LPP. This scoping review also highlights the limitations of the current characterization of DRA and related assessment strategies, particularly the reliance on heterogeneous measurements of inter-recti distance as the primary and sometimes only measurement to inform clinical reasoning with respect to the condition.

Ab. No. 96 Factors Associated With Lumbopelvic Pain Among Pregnant Women in Their Third Trimester

Introduction: With the increasing prevalence of lumbopelvic pain (LPP) among pregnant women, it is important to identify the factors associated with it. Previous studies have focused on the Western population. Hence, it is important to identify potential risk factors among the Indian population to find if the culture, or level of physical activity may influence the factors associated with pelvic girdle pain. Identification of risk factors will help in early screening and development of exercise intervention for the prevention of LPP. Methods: Primigravidae in third trimester aged between 18 to 40 years were included. Those with medical or obstetric complications were excluded. A cross-sectional study was conducted in which subjective measures were administered through questionnaires and objective measures by physical examinations were carried out to confirm LPP. Chi-square test was used to find the association between the variables. Univariate and multivariate logistic regression was performed to calculate the odds ratio. Results: Of the total 253 participants, 60.47% (n=153) were tested positive for LPP. Multivariate regression analysis (p &lt; 0.05) demonstrated that factors associated with a greater risk of developing LPP were increase in period of gestation and pain intensity. Conclusion: Factors associated with lumbopelvic pain were period of gestation and pain intensity. The strength of the study is that special tests were conducted to confirm the LPP rather than subjective measures. Limitations of the study were previous history of low back pain was not noted and usage of analgesics or other remedial measures were not considered. Future research may focus on Randomized controlled trials to find the effectiveness of structural intervention program to prevent or treat lumbo-pelvic pain. Implications: Antenatal exercise program must be included as an integral part of Physiotherapy program from first trimester which may prevent Lumbo-pelvic pain

Relationship Between Physical Activity Levels and Psychosocial Factors Affecting Pain Perception in Pregnant Women with Lumbopelvic Pain

Relationship Between Physical Activity Levels and Psychosocial Factors Affecting Pain Perception in Pregnant Women with Lumbopelvic Pain

Exercise for the Treatment of Postpartum Lumbopelvic Pain: A Critically Appraised Topic

Focused Clinical Question: In individuals reporting low back pain postpartum, is exercise an effective intervention to reduce symptoms? Clinical Bottom Line: There is moderate evidence to support the use of an exercise intervention to reduce pain and improve functional disability in postpartum females with low back pain.

The Emotional State During Cesarean Section and Vaginal Delivery

Alterations in emotional, social, or psychological factors of a woman's life in postpartum could lead to impairing mood disturbances. Depressed mood in mothers in the first days after delivery is named maternity blues and accepted as a common phenomenon in the postpartum phase. The aim of the present study is to determine the mood of the women with pregnancy after delivery. After approval of Clinical Research Ethics Committee, this cross-sectional designed study was enrolled women in postpartum period who underwent vaginal delivery or cesarean section in Department of Obstetrics and Gynaecology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey. All subjects were invited to complete the questionnaires including Pain Catastrophizing Scale, Beck Depression Inventory, Beck Anxiety Inventory and Short Form-36 in the first 24th hour of postpartum period. The lumbopelvic pain intensity associated with cesarean section incision or episiotomy was evaluated using visual analog scale. The mean age of the participants was 28.43∓5.14. In catastrophizing group, the mean role limitations due to physical health problems, Beck Depression Inventory-C, Beck Depression Inventory-S, Beck Depression Inventory, Beck Anxiety Inventory and visual analog scale in women with cesarean section, and general mental health in women with vaginal delivery were significantly higher compared to each other (p=0.037, p=0.002, p=0.003, p=0.01, p=0.042, p&amp;lt;0.01, p=0.005, respectively). The present study revealed that the psychological condition and quality of life of women may impair after cesarean section, hence it might be beneficial to provide emotional support for patients after cesarean section.

Optimising Rehabilitation Strategies for Postpartum Elderly Gravida with In Vitro Fertilisation Conception

Optimising Rehabilitation Strategies for Postpartum Elderly Gravida with In Vitro Fertilisation Conception

Prevalence of lumbopelvic pain during pregnancy: A systematic review and meta-analysis of cross-sectional studies.

Lumbopelvic pain (LPP) is common in pregnant women and has a significant negative effect on physical and psychological health. In this study, for the first time, we conduct a meta-analysis to estimate the overall prevalence of LPP among pregnant women and clarify the reasons for the differences in the estimated results. A systematic search of four databases (PubMed, Embase, Web of Science and Cochrane Central Register of Controlled Trials) was conducted from inception until October 2022. Two reviewers conducted a methodological quality assessment. Random-effects model analysis was used to estimate the pooled prevalence and the 95% confidence interval. Chi-square tests and I2 -values were used to assess the heterogeneity. Subgroup analysis (according to the participants' continent, age, body mass index [BMI], gestational age and study risk of bias), sensitivity analysis and random-effects meta-regression were used to explore the the sources of heterogeneity. Of the 1661 unique citations, 38 studies (21 533 pregnant participants) were included in this systematic review and meta-analysis. The overall pooled prevalence of LPP during pregnancy was 63% (95% CI: 0.57 to 0.69), with significant heterogeneity (I2 = 99.1%, P < 0.001). The prevalence differed by participants' continents, 71% (North America), 74% (South America), 63% (Asia), 64% (Europe), 59% (Africa) and 45% (Oceania). The prevalence differed by BMI, 64% (BMI <25), 64% (25 ≤ BMI ≤ 28), and 71% (BMI >28). The prevalence differed by age, 72% (age <25 years), 58% (25 ≤ age ≤ 30 years), and 69% (age >30 years). The prevalence were the same differed by study risk of bias, 63% (both low and moderate risk of bias studies). The prevalence were similar by gestational age, 62% (second trimester) and 63% (third trimester). Lumbopelvic pain during pregnancy is common; about three-fifths of pregnant women experience LPP. More prevention and intervention research for lumbopelvic should be conducted in pregnant women with different clinical characteristics.

Gap between the prevalence of and consultation rate for lumbopelvic pain in postnatal Japanese women

BackgroundWe aimed to assess the prevalence of lumbopelvic pain (LPP), including low back pain (LBP) and/or pelvic girdle pain (PGP), consultation rate, and desire for treatment of postnatal Japanese women. MethodsWe performed a cross-sectional study of 98 postnatal Japanese women within 1 year of childbirth. We retrospectively evaluated the prevalence of LBP before and during pregnancy and the prevalence of LPP after childbirth using a self-administered questionnaire. We used the distribution of pain to differentiate LBP and/or PGP after childbirth and its intensity was assessed using a visual analogue scale. The effects of LPP on daily life were assessed using the Oswestry disability index (ODI). In addition, we assessed the consultation rate for LPP and the desire to consult a healthcare professional, using self-administered questionnaires. ResultsThe prevalence of LPP after childbirth was 66%. Women with a history of LBP before and during pregnancy were more likely to have LPP following childbirth (both P < 0.001). The consultation rate among the postnatal women with LPP was 9%, but 56% of the women wished to consult a healthcare professional. The ODI score was significantly higher in postnatal women who wanted to consult a healthcare professional than in those who did not (P < 0.01). ConclusionsTwo thirds of the postnatal Japanese women who participated in this study had LPP, but the consultation rate was low. However, more than half of these women had the desire to consult a healthcare professional.

Effect of Concurrent Exercise program on Pregnancy-Related Lumbo-pelvic Pain: A Prospective Randomized Controlled Trial

Effect of Concurrent Exercise program on Pregnancy-Related Lumbo-pelvic Pain: A Prospective Randomized Controlled Trial

Influence of Osteopathic Manipulative Treatment on the Quality of Life and the Intensity of Lumbopelvic Pain in Pregnant Women in the Third Trimester: A Prospective Observational Study.

During pregnancy, the various changes women undergo can affect their health status. Manual therapies are important aids because they do not use medication. This study aimed to evaluate the influence of osteopathic manipulative treatment on the intensity of lumbar and pelvic pain and changes in quality of life. This prospective study included women over 18 years old and between 27 and 41 weeks pregnant, and excluded women with fetal malformations, multiple fetuses, premature rupture of membranes, and in labor. Forty-six pregnant women were selected and divided into two groups of ≤3 and ≥4 visits. Statistically significant improvements were observed in the intensity of maximum low back pain (7.54 ± 1.47 vs. 3.815 ± 1.73, p ≤ 0.01) and minimum low back pain (5.67 ± 2.03 vs. 3.111 ± 1.67, p ≤ 0.01), maximum pelvic pain (6.54 ± 2.22 vs. 2.77 ± 1.64, p = 0.01), and minimum pelvic pain (5.615 ± 2.21 vs. 2.615 ± 1.66, p = 0.01). Both groups achieved improvements in quality of life indices, with the improvements achieved by the ≥4-visits group being statistically significant. Osteopathic treatment was effective in reducing the intensity of lumbar and pelvic pain and in improving the quality of life of pregnant women in the third trimester.

Pregnancy-Related Lumbopelvic Pain and Current Physiotherapy Methods

Gebelikle ilişkili lumbopelvik ağrı, gebelik döneminde yaşanan bel ve pelvik kuşak ağrısının birlikte tanımlanması için kullanılan bir terimdir. Gebelikle ilişkili lumbopelvik ağrının insidansı %86’dır ve gebelikte yaygın görülen şikâyetlerden biridir. Lumbopelvik ağrı genellikle gebeliğin 24 ile 36. haftaları arasında en yüksek seviyeye ulaşmaktadır. Gebelikle ilişkili lumbopelvik ağrıya, relaksin hormonunun, gebelikte alınan kilonun neden olabileceği düşünülmektedir. Beden Kütle İndeksinin fazla olması, gebelikte depresyon, bel ağrısı öyküsünün bulunması ve gebelik sırasında ağır iş yükü öyküsü lumbopelvik ağrının gelişimi için bilinen risk faktörleridir. Lumbopelvik ağrı, gebelerin günlük aktivitelerini, yaşam kalitelerini ve cinsel yaşamını olumsuz etkilemektedir. Tedavi edilmediği takdirde ise kronik hale gelmektedir. Bu derlemenin amacı, gebeliğe bağlı lumbopelvik ağrının tedavisinde uygulanan güncel fizyoterapi yöntemlerini gözden geçirmek, etkinliklerini incelemek ve etkinlikleri hakkında bilgi vermektir. Gebelikle ilişkili lumbopelvik ağrının farklı birçok tedavi yönteminin olmasının yanı sıra fetüse ve kadına zarar vermemesi/komplikasyonu bulunmaması nedeniyle günümüzde fizyoterapi yöntemlerinin önemi artmaktadır. Su içi aerobik egzersiz, pelvik tilt, diz çekme, kegel egzersizi, squat, adduktör germe, pelvik elevasyon, pelvik rotasyon ve bacak kaldırma gibi germe ve güçlendirme egzersizleri, yoga, sakroiliak eklem mobilizasyonu, Transkutanöz Elektriksel Sinir Stimülasyonu (TENS), manuel terapi, ortez ve hasta eğitiminin, gebelikle ilişkili lumbopelvik ağrı tedavisinde uygulanan güncel fizyoterapi yöntemleri arasında bulunmaktadır. Ancak bu fizyoterapi yöntemlerinden hangisinin daha etkili olduğuna dair kesin kanıt bulunmamaktadır. Bu nedenle daha fazla randomize kontrollü çalışmalara ihtiyaç duyulmaktadır.

Ultrasound assessment of the abdominal, diaphragm, and pelvic floor muscles during the respiratory and postural tasks in women with and without postpartum lumbopelvic pain: a case-control study.

Postpartum lumbopelvic pain (PLPP) is common among women. Abdominal, diaphragm, and pelvic floor muscles (PFMs) modulate intraabdominal pressure as a part of the force closure mechanism. These muscles are exposed to changes during pregnancy that compromise the force closure mechanism. It was hypothesized that abdominal and PFMs activity, the direction of bladder base displacement, diaphragm thickness, and excursion might differ between women with and without PLPP during respiratory and postural tasks. Thirty women with and 30 women without PLPP participated in this case-control study. Ultrasound imaging was used to assess the abdominal, diaphragm, and PFMs during rest, active straight leg raising (ASLR) with and without a pelvic belt, and deep respiration. The bladder base descent was significantly greater in the PLPP group than in the controls during deep respiration and ASLR without a belt (p = 0.026; Chi-squared = 6.40). No significant differences were observed between the groups in the abdominal muscles activity and diaphragm muscle thickness. There was a significant interaction effect of the group and the task for diaphragm excursion (F (2, 116) = 6.08; p = 0.00) and PFM activity (F (2, 116) = 5.22; p = 0.00). In the PLPP group, wearing a belt compromised altered PFM activation and direction of bladder base displacement. The PFM activity, direction of bladder base displacement, and diaphragm excursion differed between groups during postural and respiratory tasks. Therefore, it is recommended to involve retraining of the PFMs and diaphragm muscle in the rehabilitation of women with PLPP.

Is Pregnancy-Related Lumbopelvic Pain Reported to Health Care Providers?

Background: Pregnancy-related lumbopelvic pain (PLPP) is a common ailment during pregnancy with physical, psychosocial, and economic consequences. Despite being common, prior literature has found that this symptom is widely underreported and therefore undertreated, especially in the United States. The objectives of this study were to determine the proportion of pregnant women who report PLPP during pregnancy to their health care providers (HCPs) and to determine what contributing factors for reporting exist. Materials and Methods: This is a cross-sectional survey design and was conducted at an academic medical center. All pregnant women attending a prenatal visit in obstetrical offices from July 2018 through March 2020 were asked to complete a questionnaire compiling demographic and socioeconomic information, answer validated survey instruments measuring physical and urinary function, and describe any pain, including intensity, frequency, and whether they told their HCPs about these symptoms and received any treatments. Results: Of the 538 respondents who had PLPP, only 43% (n = 233) reported PLPP to their provider. Of those who reported PLPP, 22% (n = 51) received treatment, of which 80% (n = 41) noted that treatment was effective. Factors that increased the likelihood of informing HCPs about PLPP were difficulty with daily mobility and a greater week of gestation. Conclusions: HCPs should inquire about PLPP throughout pregnancy. Any level of PLPP should be reported and monitored by a patient's HCP, and if it is interfering with activities of daily living, sleeping, or quality of life, it should be treated.

Effects of the combination of exercise and education in the treatment of low back and/or pelvic pain in pregnant women: Systematic review and meta-analysis.

Lumbopelvic pain is considered the most frequent complication during pregnancy. To compare whether the combination of exercise with education is more effective for the treatment of low back and/or pelvic pain (PP) than each of these interventions separately in pregnant women. A systematic review was performed in WOS, PEDro, PubMed, Cochrane, and ClinicalTrials.gov. The terms used were low back pain, PP, pregnancy, pregnant woman, exercise, exercise therapy, health education, and prenatal education. The PICO question was then chosen as follows: P-population: pregnant women with nonspecific low back pain or PP; I-intervention: exercise therapy plus health education; C-control: only exercise therapy or only health education; O-outcome: characteristics of pain, disability, and kinesophobia; S-study designs: randomized controlled trial. Two reviewers independently screened articles for eligibility. The following inclusion criteria were applied for the selection of studies: (i) published in the past 10 years; (ii) exercise plus health education was administered compared with a group receiving either exercise or education alone; and (iii) the sample consisted of pregnant women with nonspecific low back pain or PP. This review excluded: (i) nonrandomized controlled trials; and (ii) articles whose full text was not available. The meta-analysis was performed using the random-effects model, due to the observed heterogeneity. A total of 13 articles were selected. There is a significant decrease in pain in the combination of exercise and education compared with education alone (standardized mean difference, -0.29 [95% confidence interval, -0.47 to -0.11]). With respect to disability, there is a significant decrease in the exercise and education group compared with the group that only addressed education (standardized mean difference, -0.37 [95% CI, -0.60 to -0.14]). One article analyzed kinesophobia, reporting no significant changes. The combination of exercise and education seems to be more effective in reducing pain and disability in pregnant women with low back and/or PP than the use of education alone. In kinesophobia, the results found are not significant.

Impact of Socioeconomic Disparities, General Health, Reproductive, and Exercise Status in Indian Women with Lumbopelvic Pain

Background: Evidence suggests links between several health conditions and lumbopelvic pain (LPP) in women beyond the commonly associated musculoskeletal origins of LPP. Objective: This study explored the association of LPP with general health conditions, stress, exercise, and socioeconomic status in Indian women. Methods: In a cross-sectional study, 500 urban women from diverse socioeconomic backgrounds were asked to fill out a self-report questionnaire that sampled their health and reproductive status. Results: Women sampled were in the age range of 18-62 years. Overall, the prevalence of LPP was found to be 76.8% and was predominantly observed in women from the lower socioeconomic strata (70.5%), compared to women from the higher strata (29.4%). Multivariate logistic regression identified gynecological issues, such as menstrual problems (O.R.= 472.86, p&lt;0.0001); polycystic ovarian syndrome (O.R.= 125.04, p=0.010); and health issues, such as urinary incontinence (O.R.=3078.24, p=0.001); chronic cough (O.R.= 84.97, p&lt;0.0001); stress (O.R.= 474.27, p&lt;0.0001) as being significantly related to LPP. Additionally, ‘no exercise’ (O.R.= 360.15, p &lt;0.0001) was also strongly associated with LPP. Conclusion: Our data suggest that LPP is a significant problem in Indian women, with a greater prevalence in women from the lower strata of society. Importantly, given that several general, gynecological health issues, psychological stress, and a lack of exercise are associated with it, there is a need for LPP sensitization at a community and public health level. Regarding its prevention and long-term management, it is important to rule out and consider the impact of these factors on LPP, beyond its musculoskeletal origins.