The Effects of Exercise Training on Low Back/Pelvic Girdle Pain During Pregnancy: A Systematic Review

Background: Forty-five percent of pregnant women report moderate to severe low back and/or pelvic girdle pain (LBP/PGP) during pregnancy. Exercise, specifically muscular fitness training, is effective for the prevention and treatment of LBP/PGP in the general population. However, its efficacy during pregnancy is unknown. Objectives: The goal of this review is to examine the evidence supporting muscular fitness training for prevention and treatment of LBP/PGP during pregnancy. Study Design: A systematic review. Methods: A systematic review was conducted from February 2021 to June 2022 using online databases and hand searching. Randomized control trials were included if the population was pregnant women, the intervention was exercise training, the comparison was a nonexercise control group, and the outcome was LBP/PGP. A risk of bias analysis using the Cochran Risk of Bias (RoB) tool and quality assessment were performed using the GRADE method. The included articles were compiled into exercise types for comparison. Results: Of the 1707 articles found, 26 (n = 3946 pregnant women) were included in the final analysis after removing duplicates, articles that did not meet inclusion criteria, and articles unavailable in English. Seventeen out of 26 articles found that exercise during pregnancy had a positive effect on pain, but the quality of the studies ranged from very low to moderate. None of the included articles utilized strength training for muscular fitness, 2 used hypertrophy training, and the remaining articles utilized muscular endurance programs for muscular fitness. Conclusion: Strength and hypertrophy training for LBP/PGP during pregnancy is largely unknown and understudied; however, many other modes of exercise for muscular endurance improved pain. More research is warranted to determine the benefits of traditional strength and hypertrophy training for LBP/PGP management during pregnancy.