Exercise and pelvic girdle pain during pregnancy. Are there any associations?

Abstract

Background: To date, there is scant knowledge and inconsistent results about physical activity, exercise and job strain in relation to pelvic girdle pain (PGP). Hence, the aims of the present study were: 1) determine prevalence of PGP and severe PGP during pregnancy and 2) compare background and lifestyle factors in addition to total physical activity level (at work, commuting, housework and recreational exercise) in those who experienced PGP and those who did not in pregnancy. Methods: Healthy pregnant women (n = 467) were allocated to the study from Oslo University Hospital, Norway. The participants filled in a validated self-administered questionnaire, Physical-Activity-Pregnancy-Questionnaire (PAPQ) in gestation-week 32 - 36. The questionnaire contained 53 questions with nine specific questions addressing PGP. The key question on PGP was asked cross-sectionally and also posed retrospectively for pre-pregnancy, 1st and 2nd trimester (During this pregnancy, did you experience any PGP?) (“Yes versus No”). Results: More than half of the women (57.5%) reported to suffer from PGP, with 18.4% reporting severe PGP. Compared the no-PGP group, women with PGP were significantly more likely to be sick-listed, multiparous, they perceived their job to be physically demanding, as well as had physically demanding household chores, including childcare. In addition, they were more prone to have experienced PGP in previous pregnancies and suffered from urinary incontinence (UI) in the current pregnancy. Most women with severe PGP reported to be sedentary in the 3rd trimester; however they performed more strengthening exercises at home than the women without PGP. Severe PGP also showed an association with standing/walking ≥50% at work. Conclusion: Women who exercised regularly in the 3rd trimester were less likely to report PGP, while job strain was associated with higher prevalence of PGP. There is a need for a prospective study with larger sample size to further evaluate if exercise has any causal association with PGP.

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Haakstad, L. , Telenius, E. and Bø, K. (2013) Exercise and pelvic girdle pain during pregnancy. Are there any associations?. Open Journal of Obstetrics and Gynecology, 3, 520-527. doi: 10.4236/ojog.2013.37094.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] ACOG (2002) Exercise during pregnancy and the postpartum period. Obstetrics & Gynecology, 99, 171-173. doi:10.1016/S0029-7844(01)01749-5
[2] Artal, R. and O’Toole, M. (2003) Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. British Journal of Sports Medicine, 37, 6-12. doi:10.1136/bjsm.37.1.6
[3] Vleeming, A., Albert, H.B., Ostgaard, H.C., Sturesson, B. and Stuge, B. (2008) European guidelines for the diagnosis and treatment of pelvic girdle pain. European Spine Journal, 17, 794-819. doi:10.1007/s00586-008-0602-4
[4] Dorheim, S.K., Bjorvatn, B. and Eberhard-Gran, M. (2013) Sick leave during pregnancy: A longitudinal study of rates and risk factors in a Norwegian population. BJOG, 120, 521-530. doi:10.1111/1471-0528.12035
[5] Bjorklund, K. and Bergstrom, S. (2000) Is pelvic pain in pregnancy a welfare complaint? Acta Obstetricia et Gynecologica Scandinavica, 79, 24-30. doi:10.1080/j.1600-0412.2000.079001024.x
[6] Wu, W.H., Meijer, O.G., Uegaki, K., Mens, J.M., van Dieen, J.H., Wuisman, P.I. and Ostgaard, H.C. (2004) Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence. European Spine Journal, 13, 575-589. doi:10.1007/s00586-003-0615-y
[7] Vermani, E., Mittal, R. and Weeks, A. (2010) Pelvic girdle pain and low back pain in pregnancy: A review. Pain Practice, 10, 60-71. doi:10.1111/j.1533-2500.2009.00327.x
[8] Gutke, A., Sjodahl, J. and Oberg, B. (2010) Specific muscle stabilizing as home exercises for persistent pelvic girdle pain after pregnancy: A randomized, controlled clinical trial. Journal of Rehabilitation Medicine, 42, 929-935. doi:10.2340/16501977-0615
[9] Stuge, B., Laerum, E., Kirkesola, G. and Vollestad, N. (2004) The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: A randomized controlled trial. Spine, 29, 351-359. doi:10.1097/01.BRS.0000090827.16926.1D
[10] Nilsson-Wikmar, L., Holm, K., Oijerstedt, R. and HarmsRingdahl, K. (2005) Effect of three different physical therapy treatments on pain and activity in pregnant women with pelvic girdle pain: A randomized clinical trial with 3, 6, and 12 months follow-up postpartum. Spine, 30, 850-856. doi:10.1097/01.brs.0000158870.68159.d9
[11] Eggen, M.H., Stuge, B., Mowinckel, P., Jensen, K.S. and Hagen, K.B. (2012) Can supervised group exercises including ergonomic advice reduce the prevalence and severity of low back pain and pelvic girdle pain in pregnancy? A randomized controlled trial. Physical Therapy, 92, 781-790. doi:10.2522/ptj.20110119
[12] Morkved, S., Salvesen, K.A., Schei, B., Lydersen, S. and Bo, K. (2007) Does group training during pregnancy prevent lumbopelvic pain? A randomized clinical trial. Acta Obstetricia et Gynecologica Scandinavica, 86, 276-282. doi:10.1080/00016340601089651
[13] Gjestland, K., Bo, K., Owe, K.M. and Eberhard-Gran, M. (2012) Do pregnant women follow exercise guidelines? Prevalence data among 3482 women, and prediction of low-back pain, pelvic girdle pain and depression. British Journal of Sports Medicine, 47, 515-520.
[14] Mogren, I.M. (2005) Previous physical activity decreases the risk of low back pain and pelvic pain during pregnancy. Scandinavian Journal of Public Health, 33, 300-306.
[15] Juhl, M., Andersen, P.K., Olsen, J. and Andersen, A.M. (2005) Psychosocial and physical work environment, and risk of pelvic pain in pregnancy. A study within the Danish national birth cohort. Journal of Epidemiology & Community Health, 59, 580-585. doi:10.1136/jech.2004.029520
[16] Haakstad, L.A., Gundersen, I. and Bo, K. (2010) Selfreporting compared to motion monitor in the measurement of physical activity during pregnancy. Acta Obstetricia et Gynecologica Scandinavica, 89, 749-756. doi:10.3109/00016349.2010.484482
[17] Voldner, N., Froslie, K.F., Bo, K., Haakstad, L., Hoff, C., Godang, K., Bollerslev, J. and Henriksen, T. (2008) Modifiable determinants of fetal macrosomia: Role of lifestyle-related factors. Acta Obstetricia et Gynecologica Scandinavica, 87, 423-429. doi:10.1080/00016340801989825
[18] Voldner, N., Froslie, K.F., Haakstad, L.A., Bo, K. and Henriksen, T. (2009) Birth complications, overweight, and physical inactivity. Acta Obstetricia et Gynecologica Scandinavica, 88, 550-555. doi:10.1080/00016340902818162
[19] Caspersen, C.J., Powell, K.E. and Christenson, G.M. (1985) Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Reports, 100, 126-131.
[20] Haakstad, L.A., Voldner, N., Henriksen, T. and Bo, K. (2007) Physical activity level and weight gain in a cohort of pregnant Norwegian women. Acta Obstetricia et Gynecologica Scandinavica, 86, 559-564. doi:10.1080/00016340601185301
[21] Mousavi, S.J., Parnianpour, M. and Vleeming, A. (2007) Pregnancy related pelvic girdle pain and low back pain in an Iranian population. Spine, 32, 100-104. doi:10.1097/01.brs.0000254123.26649.6e
[22] Bo, K. and Backe-Hansen, K.L. (2007) Do elite athletes experience low back, pelvic girdle and pelvic floor complaints during and after pregnancy? Scandinavian Journal of Medicine & Science in Sports, 17, 480-487. doi:10.1111/j.1600-0838.2006.00599.x
[23] Robinson, H.S., Eskild, A., Heiberg, E. and EberhardGran, M. (2006) Pelvic girdle pain in pregnancy: The impact on function. Acta Obstetricia et Gynecologica Scandinavica, 85, 160-164. doi:10.1080/00016340500410024
[24] Albert, H.B., Godskesen, M. and Westergaard, J.G. (2002) Incidence of four syndromes of pregnancy-related pelvic joint pain. Spine, 27, 2831-2834. doi:10.1097/00007632-200212150-00020
[25] Stones, R.W. and Vits, K. (2005) Pelvic girdle pain in pregnancy. British Medical Journal, 331, 249-250. doi:10.1136/bmj.331.7511.249
[26] Cook, C., Massa, L., Harm-Ernandes, I., Segneri, R., Adcock, J., Kennedy, C. and Figuers, C. (2007) Interrater reliability and diagnostic accuracy of pelvic girdle pain classification. Journal of Manipulative and Physiological Therapeutics, 30, 252-258. doi:10.1016/j.jmpt.2007.03.008
[27] Endresen, E.H. (1995) Pelvic pain and low back pain in pregnant women—An epidemiological study. Scandinavian Journal of Rheumatology, 24, 135-141. doi:10.3109/03009749509099301
[28] Gutke, A., Ostgaard, H.C. and Oberg, B. (2006) Pelvic girdle pain and lumbar pain in pregnancy: A cohort study of the consequences in terms of health and functioning. Spine, 31, E149-E155. doi:10.1097/01.brs.0000201259.63363.e1
[29] Larsen, E.C., Wilken-Jensen, C., Hansen, A., Jensen, D.V., Johansen, S., Minck, H., Wormslev, M., Davidsen, M. and Hansen, T.M. (1999) Symptom-giving pelvic girdle relaxation in pregnancy. I: Prevalence and risk factors. Acta Obstetricia et Gynecologica Scandinavica, 78, 105-110. doi:10.1080/j.1600-0412.1999.780206.x
[30] Hansen, A., Jensen, D.V., Wormslev, M., Minck, H., Johansen, S., Larsen, E.C., Wilken-Jensen, C., Davidsen, M. and Hansen, T.M. (1999) Symptom-giving pelvic girdle relaxation in pregnancy. II: Symptoms and clinical signs. Acta Obstetricia et Gynecologica Scandinavica, 78, 111-115. doi:10.1080/j.1600-0412.1999.780207.x
[31] Albert, H.B., Godskesen, M., Korsholm, L. and Westergaard, J.G. (2006) Risk factors in developing pregnancyrelated pelvic girdle pain. Acta Obstetricia et Gynecologica Scandinavica, 85, 539-544. doi:10.1080/00016340600578415
[32] Ostergard, T., Jessen, N., Schmitz, O. and Mandarino, L.J. (2007) The effect of exercise, training, and inactivity on insulin sensitivity in diabetics and their relatives: What is new? Applied Physiology, Nutrition, and Metabolism, 32, 541-548. doi:10.1139/H07-031
[33] Agardh, E.E., Sidorchuk, A., Hallqvist, J., Ljung, R., Peterson, S., Moradi, T. and Allebeck, P. (2011) Burden of type 2 diabetes attributed to lower educational levels in Sweden. Population Health Metrics, 9, 60. doi:10.1186/1478-7954-9-60
[34] Adams, S.A., Matthews, C.E., Ebbeling, C.B., Moore, C.G., Cunningham, J.E., Fulton, J. and Hebert, J.R. (2005) The effect of social desirability and social approval on self-reports of physical activity. American Journal of Epidemiology, 161, 389-398. doi:10.1093/aje/kwi054

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