Group training reduces the risk of pregnancy-related lumbopelvic pain.

Question: Does group exercise prevent lumbopelvic pain during and after pregnancy? Design: Randomised controlled trial. Setting: A University hospital clinic and three outpatient physiotherapy clinics in Norway. Participants: Three hundred and one healthy, nulliparous women at 20 weeks of pregnancy. Pregnancy complications and high risk for preterm labour were exclusion criteria. Interventions: Subjects were randomly allocated to a training group or a control group. Those in the training group attended a 60minute weekly group exercise session for 12 weeks. Exercises were supervised by a physiotherapist and included lowimpact aerobics, strengthening of pelvic floor, transversus abdominus, and upper/lower limb muscles, and stretches. Daily pelvic floor exercises at home were encouraged. Women in the control group were provided with usual GP or midwife care and were not discouraged from exercising. Outcomes: Outcomes were assessed at 36 weeks of pregnancy and three months after birth. Lumbopelvic pain was measured by self-report of pain in the lumbar spine, sacroiliac joints, or pubic symphysis ≥ once per week. Sick leave was measured by self-reported absence from work due to pain in pelvic girdle or lower back. Results: At 36 weeks of pregnancy, women in the training group were less likely to report lumbopelvic pain (absolute risk reduction 12.2%, 95% CI 1.0 to 23.3%). Three months after delivery the absolute risk reduction was 10.2% (95% CI –0.2 to 20.5%). The numbers needed to prevent lumbopelvic pain were one in eight women during pregnancy and one in 10 women after delivery. There was no significant difference between groups in self-reported sick leave at 36 weeks (absolute risk reduction 3.9%, 95% CI –5.6 to 13.2%). Compliance in the training group was high (81%). Conclusion: This study provides evidence that a 12-week physiotherapy exercise program provides a clinically worthwhile reduction in the risk of pregnancy-related lumbopelvic pain.