بررسی تأثیر تمرینات ورزشی در پیشگیری و کاهش کمردرد در بارداری: یک مرور سیستماتیک

نوع مقاله : مقاله مروری

نویسندگان

1 مرکز تحقیقات پرستاری مامایی جامعه‌نگر، دانشکده‌ی پرستاری و مامایی، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران.

2 استادیار، گروه مامایی، مرکز تحقیقات بهداشت باروری و مشاوره در مامایی، دانشگاه علوم پزشکی گلستان، گرگان، ایران.

3 مرکز تحقیقات داروهای گیاهی رازی، دانشکده‌ی پرستاری و مامایی، دانشگاه علوم پزشکی لرستان، خرم‌آباد، ایران

4 استادیار، دانشگاه اصفهان و مرکز آموزش عالی شهررضا، اصفهان، ایران.

5 دانشجو کارشناسی ارشد مامایی، مرکز تحقیقات پرستاری مامایی جامعه‌نگر، دانشکده‌ی پرستاری و مامایی شهرکرد، شهرکرد، ایران.

6 استادیار، گروه اپیدمیولوژی و آمار زیستی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران.

7 دانشجو کارشناسی ارشد مامایی، مرکز تحقیقات پرستاری مامایی جامعه‌نگر، دانشکده‌ی پرستاری و مامایی شهرکرد، شهرکرد، ایران

8 پزشک عمومی، دفتر کنترل و پیش‌گیری از بیماری‌های غیر واگیر، معاونت بهداشت، وزارت بهداشت درمان و آموزش پزشکی، تهران، ایران

10.48305/jims.v42.i798.1187

چکیده

مقاله مروری




مقدمه: کمردرد مشکل عضلانی- اسکلتی شایع در بارداری است و می‌تواند منجر به کاهش توانایی افراد و کیفیت زندگی شود. پیشگیری از ایجاد و بدتر شدن کمردرد حائز اهمیت است. لذا پژوهش حاضر با هدف بررسی تأثیر تمرینات ورزشی در پیشگیری و کاهش کمردرد در بارداری با رویکرد سیستماتیک انجام شد.
روش‌ها: جستجو با استفاده از کلید واژه‌های فارسی حاملگی، بارداری، کمردرد، درد کمربند لگنی، ورزش، هوازی، ایروبیک، یوگا، پیلاتس و معادل انگلیسی آنها در پایگاه‌های اطلاعاتی SID و Magiran،PubMed ،Scopus ،Elsevier ، Weily Online Library، Web of Sciences و موتور جستجوی Google Scholar در بازه‌ی زمانی 2010 تا 2023 صورت گرفت. از 473 ﻣﻘﺎﻟﻪ مورد بررسی، 19 ﻣﻘﺎﻟﻪ واﺟﺪ ﺷﺮاﯾﻂ پژوﻫﺶ ﺑﻮد و ﺑﺮای اﯾﻦ ﻣﻄﺎﻟﻌﻪ اﻧﺘﺨﺎب ﺷﺪ.
یافته‌ها: مداخلات ورزشی متعددی در مطالعات مورد بررسی شامل ورزش های قدرتی- کششی، ورزش‌های هوازی مقاومتی، یوگا، اصلاح پوزیشن و تیلت لگنی، برنامه ورزش در آب و ورزش با توپ مطرح شده بود. نتایج نشان داد بیشترین مداخلات مورد استفاده در تسکین کمردرد استفاده از ورزش های کششی بود.
نتیجه‌گیری: بررسی جامع مطالعات نشان داد که گرچه نوع ورزش به کار رفته متفاوت بوده و به دلیل تنوع مطالعات، مقایسه آن ها مشکل به نظر می رسد، اما می توان اظهار داشت اکثر مداخلات ورزشی می تواند منجر به بهبود و در برخی موارد پیشگیری از کمردرد در بارداری گردد. به نظر می رسد که تحقیقات بیشتری برای شناسایی بهترین روش‌های ورزشی؛ همچنین بهترین دوره در دوران بارداری برای شروع مداخله ورزشی، به منظور بهینه‌سازی درمان کمردرد زنان در دوران بارداری مورد نیاز است.

تازه های تحقیق

زیبا رئیسی دهکردی: Google Scholar, PubMed

حدیث سوری نژاد: Google Scholar, PubMed

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Investigating the Effect of Exercise in Preventing and Reducing Back Pain in Pregnancy: A Systematic Review

نویسندگان [English]

  • Ziba Raisi Dehkordi 1
  • Elham Adib Moghaddam 2
  • Hadis Sourinejad 3
  • Ahmadreza Raisi 4
  • Mohadese Ghaedi 5
  • Hadi Raeisi Shahraki 6
  • Simindokht Babaeifar 7
  • Fatemeh Hajivalizadeh 8
1 Assistant Professor of Reproductive Health, Community-Oriented Nursing Midwifery Research Center, Nursing and Midwifery School, Shahrekord University of Medical Sciences, Shahrekord, Iran
2 Assistant Professor of Reproductive Health, Counseling and Reproductive Health Research Centre, Golestan University of Medical Sciences, Gorgan, Iran
3 Razi Herbal Medicines Research Center, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
4 Assistant Professor, Department of Science, Shahreza Campus, University of Isfahan, Isfahan, Iran
5 MSc Student, Community-Oriented Nursing Midwifery Research Center, School of Nursing and Midwifery, Shahrekord, Iran
6 Assistant Professor, Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
7 MSc Student, Community-Oriented Nursing Midwifery Research Center, School of Nursing and Midwifery, Shahrekord, Iran
8 Musculoskeletal Disease Department, Center for Non-Communicable Diseases Prevention and Control, Ministry of Health of Iran, Ministry of Health & Medical Education, Tehran, Iran
چکیده [English]

Background: Back pain is a common musculoskeletal problem in pregnancy and can lead to a decrease in people's ability and quality of life. It is important to prevent the occurrence and worsening of back pain during pregnancy. Therefore, this systematic review study aimed to investigate the effect of exercises in preventing and reducing back pain during pregnancy.
Methods: Using the Persian keywords pregnancy, back pain, exercise, physical activity, aerobics, yoga and pilates and their English equivalents in PubMed, SID, Magiran, Scopus, Elsevier, Weily Online Library, Web of Sciences and Google Scholar search engine were searched in the period from 2010 to 2023. From 473 articles, 19 were eligible and selected for this study.
Findings: Several sports interventions were proposed in the reviewed studies, including strength-stretching sports, resistance aerobic sports, yoga, posture correction and pelvic tilt, water sports program, and ball sports. The results showed that the most interventions used in back pain relief were the use of stretching exercises.
Conclusion: A comprehensive review of studies showed that although the type of exercise used is different and due to the variety of studies, it seems difficult to compare them, but it can be stated that most of the exercise interventions can lead to improvement and in some cases prevention of back pain in become pregnant. It seems that more research is needed to identify the best exercise methods, as well as the best period to start exercise intervention, in order to optimize the treatment of women's low back pain during pregnancy.

کلیدواژه‌ها [English]

  • Pregnancy
  • Back pain
  • Exercise
  • Pelvic girdle pain
  1. Nicolian S, Butel T, Gambotti L, Durand M, Filipovic-Pierucci A, Mallet A, et al. Cost-effectiveness of acupuncture versus standard care for pelvic and low back pain in pregnancy: A randomized controlled trial. PLoS One 2019; 14(4): e0214195.
  2. Manyozo SD, Nesto T, Bonongwe P, Muula AS. Low back pain during pregnancy: Prevalence, risk factors and association with daily activities among pregnant women in urban Blantyre, Malawi. Malawi Med J 2019; 31(1): 71-6.
  3. Aparicio VA, Marín‐Jiménez N, Flor‐Alemany M, Acosta‐Manzano P, Coll‐Risco I, Baena‐García L. Effects of a concurrent exercise training program on low back and sciatic pain and pain disability in late pregnancy. Scand J Med Sci Sports 2023; 33(7): 1201-10.
  4. Mota MJ, Cardoso M, Carvalho A, Marques A, Sá-Couto P, Demain S. Women's experiences of low back pain during pregnancy. J Back Musculoskelet Rehabil 2015; 28(2): 351-7.
  5. Saccomanni B. Low back pain associated with pregnancy: a review of literature. Eur Orthop Traumatol 2011; 1: 169-74.
  6. Costa Carvalho MEC, Cavalcanti Lima L, de Lira Terceiro CA, Lacerda Pinto DR, Silva MN, Araújo Cozer G, et al . Low back pain during pregnancy [in Portuguese]. Rev Bras Anestesiol 2017; 67(3): 266-70.
  7. Caputo EL, Domingues MR, Bertoldi AD, Ferreira PH, Ferreira ML, Shirley D, et al. Are leisure-time and work-related activities associated with low back pain during pregnancy? BMC Musculoskelet Disord 2021; 22(1): 864.
  8. Berber MA, Satılmış İG. Characteristics of Low back pain in pregnancy, risk factors, and its effects on quality of life. Pain Manag Nurs 2020; 21(6): 579-86.
  9. Shijagurumayum Acharya R, Tveter AT, Grotle M, Eberhard-Gran M, Stuge B. Prevalence and severity of low back- and pelvic girdle pain in pregnant Nepalese women. BMC Pregnancy and Childbirth 2019; 19(1): 247.
  10. Burrows PE, Mason KP. Percutaneous treatment of low flow vascular malformations. J Vasc Interv Radiol 2004; 15(5): 431-45.
  11. Gorginzadeh M, Imani F, Safari S. Pregnancy-related pelvic pain: A neglected field in developing countries. Anesth Pain Med 2016; 6(1): e35506.
  12. Davenport MH, Marchand A-A, Mottola MF, Poitras VJ, Gray CE, Garcia AJ, et al. Exercise for the prevention and treatment of low back, pelvic girdle and lumbopelvic pain during pregnancy: a systematic review and meta-analysis. Br J Sports Med 2019; 53(2): 90-8.
  13. Mate A, Reyes-Goya C, Santana-Garrido Á, Vázquez CM. Lifestyle, maternal nutrition and healthy pregnancy. Curr Vasc Pharmacol 2021; 19(2): 132-40.
  14. Peterson CD, Haas M, Gregory WT. A pilot randomized controlled trial comparing the efficacy of exercise, spinal manipulation, and neuro emotional technique for the treatment of pregnancy-related low back pain. Chiropr Man Therap 2012; 20(1):18.
  15. Shah SF, Mumtaz SN, Kayani BA, Shah SH, Khan MWU, Khan AQ. A Study of Frequency of Low Backache in Pregnant Women. Pak Armed Forces Med J 2022; 72(3): 887-90.
  16. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Williams obstetrics. New York: McGraw-Hill Medical; 2022.
  17. group C. Reporting of noninferiority and equivalence randomized trials: extension of the CONSORT 2010 statement. JAMA 2012; 308(24): 2594-604.
  18. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke J. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies. Lancet 2014; 370(9596): 1495-9.
  19. Zare F, Ramezankhani A, Ghaffari M, Yarmohammadi S. The effect of educational empowerment interventions on IBD patients in worldwide: A systematic review of randomized clinical trials [in Persian]. Iran J Health Educ Health Promot 2022; 10(1): 93-108.
  20. Armijo-Olivo S, Stiles CR, Hagen NA, Biondo PD, Cummings GG. Assessment of study quality for systematic reviews: a comparison of the Cochrane Collaboration Risk of Bias Tool and the Effective Public Health Practice Project Quality Assessment Tool: methodological research. J Eval Clin Pract 2012; 18(1): 12-8.
  21. Abu MA, Abdul Ghani NA, Shan LP, Sulaiman AS, Omar MH, Ariffin MHM, et al. Do exercises improve back pain in pregnancy? Horm Mol Biol Clin Investig 2017; 32(3): 20170012.
  22. Khalednezhad M, Tavafian SS, Panahi R. The effect of Exercise Training on Disability due to Low Back Pain in Pregnant Women referred to the Health Centers of Karaj, Iran. International Journal of Musculoskeletal Pain Prevention 2017; 2(1): 223-9.
  23. Ozdemir S, Bebis H, Ortabag T, Acikel C. Evaluation of the efficacy of an exercise program for pregnant women with low back and pelvic pain: a prospective randomized controlled trial. J Adv Nurs 2015; 71(8): 1926-39.
  24. Queiroz BC, Cagliari MF, Amorim CF, Sacco IC. Muscle activation during four Pilates core stability exercises in quadruped position. Arch Phys Med Rehabil 2010; 91(1): 86-92.
  25. Sonmezer E, Özköslü MA, Yosmaoğlu HB. The effects of clinical pilates exercises on functional disability, pain, quality of life and lumbopelvic stabilization in pregnant women with low back pain: A randomized controlled study. J Back Musculoskelet Rehabil 2021; 34(1): 69-76.
  26. Hyun A-H, Cho J-Y, Koo J-H. Effect of home-based tele-pilates intervention on pregnant women: a pilot study. Healthcare (Basel) 2022; 10(1): 125.
  27. O’Connor PJ, Poudevigne MS, Cress ME, Motl RW, Clapp JF. Safety and efficacy of supervised strength training adopted in pregnancy. J Phys Act Health 2011; 8(3): 309-20.
  28. Zand S, Zamani A. The effect of simple exercise maneuvers and proper performance of daily activity on outcome of pregnancy [in Persian]. Iran J Obstet Gynecol Infertil 2010; 12(3): 51-7.
  29. Kokic IS, Ivanisevic M, Uremovic M, Kokic T, Pisot R, Simunic B. Effect of therapeutic exercises on pregnancy-related low back pain and pelvic girdle pain: Secondary analysis of a randomized controlled trial. J Rehabil Med 2017; 49(3): 251-7.
  30. Haakstad LAH, Bø K. Effect of a regular exercise programme on pelvic girdle and low back pain in previously inactive pregnant women: a randomized controlled trial. J Rehabil Med 2015; 47(3): 229-34.
  31. Martins RF, Pinto e Silva JL. Treatment of pregnancy-related lumbar and pelvic girdle pain by the yoga method: a randomized controlled study. J Altern Complement Med 2014; 20(1): 24-31.
  32. Holden SC, Manor B, Zhou J, Zera C, Davis RB, Yeh GY. Prenatal yoga for back pain, balance, and maternal wellness: a randomized, controlled pilot study. Glob Adv Health Med 2019; 8: 2164956119870984.
  33. Makmun I, Harahap AP, Amini A, Rizkia A, Amilia R, Ari Adiputri NW. Implications of Prenatal Gentle Yoga on Low Back Pain among Women in the Second and Third Trimesters of Pregnancy. Embrio: Jurnal Kebidanan 2022; 14(2): 221-6.
  34. Susanti NY, Madhav N. Exercise for pregnancy and pregnant women back pain. STRADA Jurnal Ilmiah Kesehatan 2022; 11(1): 15-9.
  35. Rani RH, Harmayetty H, Kusumaningrum T. The combination of benson relaxation and pelvic tilting on the scale of low back pain in pregnant women. Nursing Journal 2020; 6(2): 100-7.
  36. Eggen MH, Stuge B, Mowinckel P, Jensen KS, Hagen KB. 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. Phys Ther 2012; 92(6): 781-90.
  37. Podungge Y. Endhorpin massage and pregnancy exercise as a method to relieve lower back pain in trimester III pregnant women. Health Notions 2019; 3(4): 166-72.
  38. Backhausen MG, Tabor A, Albert H, Rosthøj S, Damm P, Hegaard HK. The effects of an unsupervised water exercise program on low back pain and sick leave among healthy pregnant women–A randomised controlled trial. PLoS One 2017; 12(9): e0182114.
  39. Yan C-F, Hung Y-C, Gau M-L, Lin K-C. Effects of a stability ball exercise programme on low back pain and daily life interference during pregnancy. Midwifery 2014; 30(4): 412-9.
  40. Owe KM, Nystad W, Bø K. Correlates of regular exercise during pregnancy: the Norwegian Mother and Child Cohort Study. Scand J Med Sci Sports 2009; 19(5): 637-45.
  41. Verbunt JA, Smeets RJ, Wittink HM. Cause or effect? Deconditioning and chronic low back pain. Pain 2010; 149(3): 428-30.
  42. Sedaghati P, Ziaee V, Ardjmand A. The effect of an ergometric training program on pregnants weight gain and low back pain. Gazzetta Medica Italiana Archivio per le Scienze Mediche 2007; 166(6): 209.
  43. Robinson HS, Vøllestad NK, Veierød MB. Clinical course of pelvic girdle pain postpartum – Impact of clinical findings in late pregnancy. Manual Therapy. 2014;19(3):190-6.
  44. Stuge B. Evidence of stabilizing exercises for low back- and pelvic girdle pain – a critical review. Braz J Phys Ther 2019; 23(2): 181-6.
  45. Rainville J, Hartigan C, Martinez E, Limke J, Jouve C, Finno M. Exercise as a treatment for chronic low back pain. Spine J 2004; 4(1): 106-15.
  46. Stafne SN, Salvesen KA, Romundstad PR, Stuge B, Mørkved S. Does regular exercise during pregnancy influence lumbopelvic pain? A randomized controlled trial. Acta Obstet Gynecol Scand 2012; 91(5): 552-9.
  47. Herrington L, Davies R. The influence of Pilates training on the ability to contract the Transversus Abdominis muscle in asymptomatic individuals. Journal of Bodywork and Movement Therapies 2005; 9(1): 52-7.
  48. Liposcki DB, da Silva Nagata IF, Silvano GA, Zanella K, Schneider RH. Influence of a Pilates exercise program on the quality of life of sedentary elderly people: A randomized clinical trial. J Bodyw Mov Ther 2019; 23(2): 390-3.
  49. Wong CM, Rugg B, Geere J-A. The effects of Pilates exercise in comparison to other forms of exercise on pain and disability in individuals with chronic non-specific low back pain: A systematic review with meta-analysis. Musculoskeletal Care 2023; 21(1): 78-96.
  50. Ochako R, Fotso J-C, Ikamari L, Khasakhala A. Utilization of maternal health services among young women in Kenya: insights from the Kenya Demographic and Health Survey, 2003. BMC Pregnancy Childbirth 2011; 11(1): 1-9.
  51. Dumas G, Reid J, Wolfe L, Griffin M, McGrath M. Exercise, posture, and back pain during pregnancy: Part 1. Exercise and posture. Clin Biomech (Bristol) 1995; 10(2): 98-103.
  52. Garshasbi A, Faghih Zadeh S. The effect of exercise on the intensity of low back pain in pregnant women. Int J Gynaecol Obstet 2005; 88(3): 271-5.
  53. Field T. Prenatal exercise research. Infant Behav Dev 2012; 35(3): 397-407.
  54. Richards E, van Kessel G, Virgara R, Harris P. Does antenatal physical therapy for pregnant women with low back pain or pelvic pain improve functional outcomes? A systematic review. Acta Obstet Gynecol Scand 2012; 91(9): 1038-45.
  55. Kihlstrand M, Stenman B, Nilsson S, Axelsson O. Water-gymnastics reduced the intensity of back/low back pain in pregnant women. Acta Obstet Gynecol Scand 1999; 78(3): 180-5.
  56. Granath AB, Hellgren MS, Gunnarsson RK. Water aerobics reduces sick leave due to low back pain during pregnancy. J Obstet Gynecol Neonatal Nurs 2006; 35(4): 465-71.
  57. Backhausen MG, Katballe M, Hansson H, Tabor A, Damm P, Hegaard HK. A standardised individual unsupervised water exercise intervention for healthy pregnant women. A qualitative feasibility study. Sex Reprod Healthc 2014; 5(4): 176-81.
  58. Shiri R, Coggon D, Falah‐Hassani K. Exercise for the prevention of low back and pelvic girdle pain in pregnancy: A meta‐analysis of randomized controlled trials. Eur J Pain 2018; 22(1): 19-27.
  59. Koukoulithras Sr I, Stamouli A, Kolokotsios S, Plexousakis Sr M, Mavrogiannopoulou C, Koukoulithras I, et al. The effectiveness of non-pharmaceutical interventions upon pregnancy-related low back pain: a systematic review and meta-analysis. Cureus 2021; 13(1): e13011.