Author Names

Liddle, Sarah D; Pennick, Victoria

Reviewer Name

Darice Upchurch, SPT

Reviewer Affiliation(s)

Duke University Doctor of Physical Therapy Division

 

Paper Abstract

More than two‐thirds of pregnant women experience low‐back pain and almost one‐fifth experience pelvic pain. The two conditions may occur separately or together (low‐back and pelvic pain) and typically increase with advancing pregnancy, interfering with work, daily activities and sleep.

 

NIH Risk of Bias Tool

Quality Assessment of Systematic Reviews and Meta-Analyses

  1. Is the review based on a focused question that is adequately formulated and described?
  • Yes
  1. Were eligibility criteria for included and excluded studies predefined and specified?
  • Yes
  1. Did the literature search strategy use a comprehensive, systematic approach?
  • Yes
  1. Were titles, abstracts, and full-text articles dually and independently reviewed for inclusion and exclusion to minimize bias?
  • Cannot Determine, Not Reported, Not Applicable
  1. Was the quality of each included study rated independently by two or more reviewers using a standard method to appraise its internal validity?
  • Yes
  1. Were the included studies listed along with important characteristics and results of each study?
  • Yes
  1. Was publication bias assessed?
  • Yes
  1. Was heterogeneity assessed? (This question applies only to meta-analyses.)
  • Yes

 

Key Finding #1

Exercise can significantly reduce low-back pain and functional disability more than just prenatal care alone.

Key Finding #2

No change in low back or pregnancy related pelvic pain who received spinal manipulations.

Key Finding #3

Multi-modal interventions such as manual therapy, exercise, and education can be a benefit to reduce low-back pain and functional disability short term.

Key Finding #4

 

Please provide your summary of the paper

This study did a randomized controlled trial to find methods of treatment used to prevent or treat pregnancy related pain. The results of this study was based on pregnant women ages 16-45 who are experiencing low-back, pelvic pain, or a combination of both. There is an understanding that as the pregnancy progresses, so does the pain and it tends to affect sleep, work, and daily activities. Each treatment method was added in addition to the usual prenatal care. Exercise was shown to be the most successful with reducing low back pain and functional disability for short-term treatment. There was no difference between group and independent exercise. Other interventions such as yoga, spinal manipulations, and TENS were assessed and no improvements in pain were noted.

Please provide your clinical interpretation of this paper.  Include how this study may impact clinical practice and how the results can be implemented.

There are many interventions that are given to patients who have an increase in low back pain and pelvic pain while pregnant. While some interventions may work it is only for a short amount of time and this will vary between patients. This study gave insight that although we may not be able to completely stop the pain, we are able to implement and instruct patients on how to minimize it in order to reduce the limitations. Improvements in pain and functional disability can have an effect on sleep, daily activities, and work.  This study could have been better organized if it was stated whether this was the first pregnancy or not, tracking how consistent the patients were with their intervention, and grouping the stage of the pregnancy (how far along in pregnancy). Pain increases the further along in pregnancy so it would be unique to note the difference between the pain during the different stages.