Faculty of Physiotherapy, University of San Jorge, Zaragoza, Spain.
Faculty of Physiotherapy, University of Vigo, Pontevedra, Spain.
Int J Gynaecol Obstet. 2024 Mar;164(3):811-822. doi: 10.1002/ijgo.15000. Epub 2023 Jul 21.
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.
腰骨盆疼痛被认为是妊娠期间最常见的并发症。
比较运动与教育相结合的治疗方式与单独使用这两种方法相比，对治疗孕妇腰背和/或骨盆疼痛（PP）是否更有效。
在 WOS、PEDro、PubMed、Cochrane 和 ClinicalTrials.gov 中进行了系统评价。使用的术语有下背痛、PP、妊娠、孕妇、运动、运动疗法、健康教育和产前教育。
然后选择 PICO 问题如下：P-人群：有非特异性下背痛或 PP 的孕妇；I-干预：运动疗法加健康教育；C-对照：仅运动疗法或仅健康教育；O-结局：疼痛、残疾和运动恐惧症的特征；S-研究设计：随机对照试验。
两名审查员独立筛选文章的资格。应用以下纳入标准选择研究：（i）发表于过去 10 年；（ii）运动加健康教育与接受单独运动或教育的组相比；（iii）样本由有非特异性下背痛或 PP 的孕妇组成。本综述排除了：（i）非随机对照试验；（ii）无法获取全文的文章。由于观察到异质性，因此使用随机效应模型进行荟萃分析。
共选择了 13 篇文章。与单独接受教育相比，运动和教育的结合可显著降低疼痛（标准化均数差，-0.29 [95%置信区间，-0.47 至-0.11]）。关于残疾，运动和教育组与仅接受教育的组相比，有显著降低（标准化均数差，-0.37 [95%CI，-0.60 至-0.14]）。有一篇文章分析了运动恐惧症，报告无显著变化。
与单独使用教育相比，运动与教育相结合似乎更能有效减轻孕妇腰背和/或骨盆疼痛和残疾。在运动恐惧症方面，结果并不显著。
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