BACKGROUND: Lumbopelvic pain (LPP) is common during pregnancy. However, there is a lack of strong systematic reviews summarizing the evidence on conservative care.
AIMS: To evaluate the effectiveness of physiotherapy interventions compared to standard obstetric care (SOC) or other treatments for physical function, pain intensity, and quality of life in pregnant women with LPP.
METHODS: Medline, Emcare, Embase, Emcare, Physiotherapy Evidence Database (PEDro), Web of Science, and Cochrane Central Register were searched for randomized controlled trials evaluating physiotherapy interventions for pregnancy-related LPP. Risk of bias was assessed using Cochrane Risk of Bias 2, and evidence was summarized using the GRADE framework. When appropriate, a meta-analysis was conducted to synthesize the available evidence.
RESULTS: Thirty-one trials were included (n = 3279 screened): 23 investigated exercise, 7 manual therapy, 3 electrophysical modalities, and 2 education. Exercise was not better than SOC for the short-term pain (low certainty evidence, MD = -18.80, 95 % CI -45.97 to 8.33), but was superior at 6-12 weeks (moderate certainty evidence, MD = -25.84, 95 % CI -35.04 to -16.64). After a sensitivity analysis, exercise significantly improved physical function compared to SOC at 0-5 weeks (low certainty evidence, SMD= -0.65 95 % CI -1.25 to -0.04). Exercise was superior to SOC at 6-12 weeks (very-low certainty evidence, SMD -2.79 95 % CI -4.64 to -0.95).
CONCLUSION: Exercise interventions show low certainty evidence for improving pain and physical function in pregnancy-related LPP over medium-term periods. Higher quality research is necessary, and future studies should adhere to standardized reporting guidelines and include larger sample sizes.
