Expert advice about therapeutic exercise during pregnancy reduces the symptoms of sacroiliac dysfunction

Manuela Filipec 1  and Ratko Matijević 2 , 3
  • 1 Department of Physical Medicine and Rehabilitation, Clinical hospital “Sveti Duh”, Zagreb, Croatia
  • 2 Department of Obstetrics and Gynecology, University of Zagreb, Zagreb, Croatia
  • 3 School of Medicine, Merkur University Hospital, Zagreb, Croatia
Manuela Filipec
  • Corresponding author
  • Department of Physical Medicine and Rehabilitation, Clinical hospital “Sveti Duh”, Zagreb, Croatia
  • Email
  • Search for other articles:
  • degruyter.comGoogle Scholar
and Ratko Matijević
  • Department of Obstetrics and Gynecology, University of Zagreb, Zagreb, Croatia
  • School of Medicine, Merkur University Hospital, Zagreb, Croatia
  • Search for other articles:
  • degruyter.comGoogle Scholar

Abstract

Objectives

There are growing evidence that exercise improves sacroiliac dysfunction symptoms in pregnant women; but no data about the effect of expert advice regarding this matter. The aim of this study was to assess the effectiveness of expert advice about therapeutic exercise on sacroiliac dysfunction in pregnancy.

Methods

A total of 500 women with sacroiliac dysfunction diagnosed in pregnancy were randomized in study and control group. Study group has conducted expert advice on therapeutic exercise; while control group continued with their normal lifestyle. Pain intensity by Visual Analog Scale (VAS) and degree of functional disability by Quebec scale were assessed at enrolment and after 3 and 6 weeks.

Results

Significantly better reduction in pain intensity assessed by VAS (p=0.001) and degree of functional disability assessed by Quebec scale (p=0.001) was noted in study compared to control group. Better results for both outcome measures were obtained if intervention was implemented earlier i.e., in second (p=0.001; p=0.001) compared to third (p=0.005; p=0.001) trimester. Strong positive correlation was found between pain intensity and degree of functional disability in both groups.

Conclusions

Expert advice on therapeutic exercise is effective in reduction of sacroiliac dysfunction symptoms during pregnancy.

Trial registration

ACTRN12617000556347

  • 1.

    Homer, C, Oats, J. Clinical practice guidelines: pregnancy care. Canberra: Australian Government Department of Health; 2018:355–57 p.

  • 2.

    Walters, C, West, S. Nippita, TA. Pelvic girdle pain in pregnancy. The Royal Australian College of General Practitioners; 2018.

  • 3.

    Obstetric, P, Physiotherapy, G. Pregnancy-related pelvic girdle pain (PGP)-For health professionals. UK: POGP; 2015:1–10 p.

  • 4.

    Berra, K, Rippe, J, Manson, J. Making physical activity counselling a priority in clinical practice: the time for action is now. JAMA 2015;314:2617–28. https://doi.org/10.1001/jama.2015.16244.

    • Crossref
    • PubMed
    • Export Citation
  • 5.

    Writing Group for the Activity Counselling Trial Research Group. Effects of physical activity counselling in primary care. JAMA 2001;286: 677–87. https://doi.org/10.1001/jama.286.6.677.

    • Crossref
    • PubMed
    • Export Citation
  • 6.

    Lee, IM, Shiroma, EJ, Lobelo, F, Puska, P, Blair, SN, Katzmarzyk, PT, et al. Effect of physical in activity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 2012;380:219–29. https://doi.org/10.1016/S0140-6736(12)61031-9.

    • Crossref
    • PubMed
    • Export Citation
  • 7.

    Sanchez, A, Bully, P, Martinez, C, Grandes, G. Effectiveness of physical activity promotion interventions in primary care: a review of reviews. Prev Med 2015;76:S56–7. https://doi.org/10.1016/j.ypmed.2014.09.012.

    • Crossref
    • PubMed
    • Export Citation
  • 8.

    Management of pelvic girdle pain in pregnancy and post-partum. Chartered Physiotherapists Women‟s Health and Continence and Directorate of Strategy and Clinical Programmes. Health Service Executive. Version 1.0. public; 2012; rev. 2014.

  • 9.

    Laslett, M. Evidence-based diagnosis and treatment of the painful sacroiliac joint. J Man Manip 2008;16:142–52. https://doi.org/10.1179/jmt.2008.16.3.142.

    • Crossref
    • Export Citation
  • 10.

    Jensen, MP, Chen, C, Brugger, AM. Interpretation of visual analogue scale ratings and change scores: a reanalysis of two clinical trials of postoperative surgery pain. J Pain 2003;4:407–14. https://doi.org/10.1016/s1526-5900(03)00716-8.

    • Crossref
    • PubMed
    • Export Citation
  • 11.

    Davidson, M, Keating, JL. A Comparison of five low back pain disability questionnaires: realiability and responsiveness. Phys Ther 2012;82:8–24. https://doi.org/10.1093/ptj/82.1.8.

  • 12.

    Kopec, JA, Esdaile, JM, Abrahamowicz, M, Abenhaim, L, Wood-Dauphinee, S, Lamping, DL, et al. The quebec back pain disability scale. Spine 1995;20:341–52. https://doi.org/10.1097/00007632-199502000-00016.

    • Crossref
    • PubMed
    • Export Citation
  • 13.

    Davenport, MH, Marchand, A, Mottola, M, Poitras, VJ, Gray, CE, Garcia, AJ, et al. Exercise for the prevention and treatment of low back. pelvic girdle and lumbopelvic pain during pregnancy: a systematic review and meta analysis. BR J Sports Med 2019;53:90–8. https://doi.org/10.1136/bjsports-2018-099400.

    • Crossref
    • PubMed
    • Export Citation
  • 14.

    Van Kampen, M, Devoogdt, N, De Groef, A, Gielen, A,Geraerts, I. The efficacy of physiotherapy for the prevention and treatment of prenatal symptoms: a systematic review. Int Urogynecol J 2015;26:1575–86. https://doi.org/10.1007/s00192-015-2684-y.

    • Crossref
    • PubMed
    • Export Citation
  • 15.

    Shiri, R, Coggon, D, Falah-Hassani, K. Exercise for the prevention of low back and pelvic girdle pain in pregnancy: A meta-analysis of randomized controlled trials. Eur J Pain 2018;22:19–7. https://doi.org/10.1002/ejp.1096.

    • Crossref
    • PubMed
    • Export Citation
  • 16.

    Shim, MJ, Lee, YS, Oh, HE, Kim, JS. Effects of a back pain reducing program during pregnancy for Korean women: a non equivalent control group pretest-posttest study. Int J Nurs Stud 2005;44:19–8. https://doi.org/10.1016/j.ijnurstu.2005.11.016.

  • 17.

    Richards, E, van Kessel, G, Virgara, R, Harris, P. Does antenatal physical therapy for pregnant women with low back pain or pelvic pain improve functional outcomes? A systematic review. Acta Obstet Gynecol Scand 2012;91:1038–45. https://doi.org/10.1111/j.1600-0412.2012.01462.x.

    • Crossref
    • PubMed
    • Export Citation
  • 18.

    Ozdemir, S, Bebis, H, Ortabag, T, Acikel, C. Evaluation of the efficacy of an exercise program for pregnant women with low back and pelvic pain: a prospective randomized controlled trial. J Adv Nurs 2015;71:1926–39. https://doi.org/10.1111/jan.12659.

    • Crossref
    • PubMed
    • Export Citation
  • 19.

    Almousa, S, Lamprianidou, E, Kitsoulis, G. The effectiveness of stabilising exercises in pelvic girdle pain during pregnancy and after delivery: a systematic review. Physiother Res Int 2018;23:1–7. https://doi.org/10.1002/pri.1699.

  • 20.

    Bhardwaj, A, Nagandla, K. Musculoskeletal symptoms and orthopaedic complications in pregnancy: pathophysiology. Diagnostic approaches and modern management. Postgrad Med J 2014;90:450–60. https://doi.org/10.1136/postgradmedj-2013-132377.

    • Crossref
    • PubMed
    • Export Citation
  • 21.

    Vleeming, A, Albert, HB, Östgaard, HC, Sturesson, B, Stuge, B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J 2008;17:794–19. https://doi.org/10.1007/s00586-008-0602-4.

    • Crossref
    • PubMed
    • Export Citation
  • 22.

    Liddle, SD, Pennick, V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev 2013;2015:CD001139. https://doi.org/10.1002/14651858.CD001139.pub4.

  • 23.

    Mens, JM, Pool-Goudzwaard, A, Stam, HJ. Mobility of the pelvic joints in pregnancy-related lumbopelvic pain: a systematic review. Obstet Gynecol Surv. 2009;64:200–08. https://doi.org/10.1097/OGX.0b013e3181950f1b.

    • Crossref
    • Export Citation
  • 24.

    Vleeming, A, Stoeckart, R, Volkers, AC, Snijders, C. Relation between form and function in the sacroilaic joint. Part I: clinical anatomical aspects.Spine 1990;15:130–32. https://doi.org/10.1097/00007632-199002000-00016.

    • Crossref
    • PubMed
    • Export Citation
  • 25.

    Vleeming, A, Volkers, AC, Snijders, C, Stoeckart, R. Relation between form and function in the sacroiliac joint. Part 2.Biomechanical aspects. Spine 1990;15:133–36. https://doi.org/10.1097/00007632-199002000-00017.

    • Crossref
    • PubMed
    • Export Citation
  • 26.

    Robinson, HS, Vøllestad, NK,Veierød, MB. Clinical course of pelvic girdle pain postpartum–impact of clinical findings in late pregnancy. Man Ther 2014;19:190–96. https://doi.org/10.1016/j.math.2014.01.004.

    • Crossref
    • PubMed
    • Export Citation
Purchase article
Get instant unlimited access to the article.
$42.00
Log in
Already have access? Please log in.


or
Log in with your institution

Journal + Issues

The Journal of Perinatal Medicine is a truly international forum covering the entire field of perinatal medicine. It is an essential news source for all those obstetricians, neonatologists, perinatologists and allied health professionals who wish to keep abreast of progress in perinatal and related research.

Search