The effects of an unsupervised water exercise program on low back pain and sick leave among healthy pregnant women: A randomised controlled trial

TY - JOUR

T1 - The effects of an unsupervised water exercise program on low back pain and sick leave among healthy pregnant women

T2 - A randomised controlled trial

AU - Backhausen, Mette G

AU - Tabor, Ann

AU - Albert, Hanne

AU - Rosthøj, Susanne

AU - Damm, Peter

AU - Hegaard, Hanne K

PY - 2017/9

Y1 - 2017/9

N2 - Background: Low back pain is highly prevalent among pregnant women, but evidence of an effective treatment are still lacking. Supervised exercise–either land or water based–has shown benefits for low back pain, but no trial has investigated the evidence of an unsupervised water exercise program on low back pain. We aimed to assess the effect of an unsupervised water exercise program on low back pain intensity and days spent on sick leave among healthy pregnant women. Methods: In this randomised, controlled, parallel-group trial, 516 healthy pregnant women were randomly assigned to either unsupervised water exercise twice a week for a period of 12 weeks or standard prenatal care. Healthy pregnant women aged 18 years or older, with a single fetus and between 16–17 gestational weeks were eligible. The primary outcome was low back pain intensity measured by the Low Back Pain Rating scale at 32 weeks. The secondary outcomes were self-reported days spent on sick leave, disability due to low back pain (Roland Morris Disability Questionnaire) and self-rated general health (EQ-5D and EQ-VAS). Results: Low back pain intensity was significantly lower in the water exercise group, with a score of 2.01 (95% CI 1.75–2.26) vs. 2.38 in the control group (95% CI 2.12–2.64) (mean difference = 0.38, 95% CI 0.02–0.74 p = 0.04). No difference was found in the number of days spent on sick leave (median 4 vs. 4, p = 0.83), disability due to low back pain nor self-rated general health. There was a trend towards more women in the water exercise group reporting no low back pain at 32 weeks (21% vs. 14%, p = 0.07). Conclusions:Unsupervised water exercise results in a statistically significant lower intensity of low back pain in healthy pregnant women, but the result was most likely not clinically significant. It did not affect the number of days on sick leave, disability due to low back pain nor self-rated health. Trial registration: ClinicalTrials.gov

AB - Background: Low back pain is highly prevalent among pregnant women, but evidence of an effective treatment are still lacking. Supervised exercise–either land or water based–has shown benefits for low back pain, but no trial has investigated the evidence of an unsupervised water exercise program on low back pain. We aimed to assess the effect of an unsupervised water exercise program on low back pain intensity and days spent on sick leave among healthy pregnant women. Methods: In this randomised, controlled, parallel-group trial, 516 healthy pregnant women were randomly assigned to either unsupervised water exercise twice a week for a period of 12 weeks or standard prenatal care. Healthy pregnant women aged 18 years or older, with a single fetus and between 16–17 gestational weeks were eligible. The primary outcome was low back pain intensity measured by the Low Back Pain Rating scale at 32 weeks. The secondary outcomes were self-reported days spent on sick leave, disability due to low back pain (Roland Morris Disability Questionnaire) and self-rated general health (EQ-5D and EQ-VAS). Results: Low back pain intensity was significantly lower in the water exercise group, with a score of 2.01 (95% CI 1.75–2.26) vs. 2.38 in the control group (95% CI 2.12–2.64) (mean difference = 0.38, 95% CI 0.02–0.74 p = 0.04). No difference was found in the number of days spent on sick leave (median 4 vs. 4, p = 0.83), disability due to low back pain nor self-rated general health. There was a trend towards more women in the water exercise group reporting no low back pain at 32 weeks (21% vs. 14%, p = 0.07). Conclusions:Unsupervised water exercise results in a statistically significant lower intensity of low back pain in healthy pregnant women, but the result was most likely not clinically significant. It did not affect the number of days on sick leave, disability due to low back pain nor self-rated health. Trial registration: ClinicalTrials.gov

KW - Adult

KW - Delivery, Obstetric

KW - Exercise Therapy

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Infant, Newborn

KW - Low Back Pain

KW - Pregnancy

KW - Sick Leave

KW - Time Factors

KW - Treatment Outcome

KW - Water

KW - Journal Article

KW - Randomized Controlled Trial

U2 - 10.1371/journal.pone.0182114

DO - 10.1371/journal.pone.0182114

M3 - Journal article

C2 - 28877165

SN - 1932-6203

VL - 12

JO - PLoS Computational Biology

JF - PLoS Computational Biology

IS - 9

M1 - e0182114

ER -