Low Back Pain, Pregnancy Complications
Conditions
Keywords
Pregnant, Low Back Pain, Postural Control
Brief summary
The relevance of this study is given by the feasibility to assess the effect of an intervention program based on the functionality and trunk neuromuscular activity and postural control in pregnant women with low back pain. The main outcomes will be computed by electromyography measurement so that to assess the trunk neuromuscular activation pattern as well as by force platform parameters for determining of postural control. Clinical symptoms such as pain intensity, perception of disability and fear and avoidance will also be computed. This is the first study to compare two intervention methods using the main biological outcomes related to trunk segment function.
Detailed description
For this study, a proposal of a 6-week intervention program will be carried out with lumbar stabilization exercises and clinical orientations, on 20 low back pregnant patients recruited by convenience and voluntaries from the community. Before intervention, all participantes will be evaluated by: electromoyography during three exercises, balance, and clinical outcomes such as pain, disability and psychological factors. All baseline testing and evaluation will be performed by a blinded evaluator to the study intervention. Afterwards, the participants will be randomized in two groups by a blinded evaluator (people not enroled to study): G1: exercises for lumbar stabilization; and G2: conventional therapy. The intervention will follow six weeks, with 50 minutes of duration each session of therapy including measurement of blood pressure, heart rate and the Visual Analogue Scale (VAS) before and after each session, and the perception of exercise intensity monitored by Borg Scale. Within this proposal, the exercise sessions will be twice a week, lasting 40 minutes each, and followed by 10 minutes of theoretical orientation. The intervention will follow the CONSORT recommendations for randomized controlled trials. The intervention will start in: G1 (n=10), which will perform therapy with specific exercises for lumbar stabilization including the Swiss ball as therapeutic resource; while G2 (n=10, control group) will perform conventional therapy including stretching of lower limbs and trunk. The participants will not be blind to the study due to the characteristic of the exercises that often reflect to the improvement of the symptoms. In case of eventual losses, the intention-to-treat method will be used for the analyses. After the intervention, all groups will be invited to come back to the laboratory to proceed the same evaluation from baseline (trunk activation during three exercises, balance, and clinical outcomes) For the analysis two-way ANOVA with repeated measures will be performed to compare the effects of the intervention (two groups) and times (baseline vs. end 6-weeks measurement)the effects of interaction (Groups x Times).
Interventions
OTHERSpecific exercises for lumbar stabilization
The Group 1 (G1) will perform therapy with specific exercises for lumbar stabilization whith the Swiss ball as a therapeutic resource, including warming; stretching of hamstrings, paraspinals, trapezes; phasic perineal exercise; tonic perineal exercise; pelvic lumbar synergism; trunk mobility; mobility of the shoulder girdle; balance; and slow pelvic balance.
OTHERConventional therapy
The Group 2 (G2) will perform conventional therapy including stretching of lower limbs and trunk, with passive stretching of hamstrings; gluteus maximus; piriform; paraspinals; lumbar square; latissimus dorsi; scalene; trapezius.
Sponsors
Universidade Norte do Paraná
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 42 Years
Healthy volunteers
Yes
Inclusion criteria
The inclusion criteria were: * Have between 19-29 weeks of pregnancy; * Have performed prenatal clinical monitoring; * Have chronic low back pain (\> 3 months) without irradiation for knees. * Not being under medication or physical therapy treatment for low back pain in the last three months; * To be able to perform physical activity consistent to the pregnancy; * To present normal conditions of responsiveness, cognition and speaking; * To be voluntary. The
Exclusion criteria
were: * Signs or symptoms of other pathology including coexisting pathology, a recent history (within 3 months) of surgery in the locomotor system; * Respiratory, neurological or cardiovascular diseases. * Several musculoskeletal disorders. * Limitations for physical exercise. * Allergic reaction to adhesive tape,
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Eletromyography measurement | Change from baseline muscular activation at 6 weeks | Level of muscular activaity of trunk from eletromyography surface processing. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Force platform measurement | Change from baseline balance performance at 6 weeks | Force platform measurement during balance performance using centre of pressure measures to assess balance performance. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Visual Analogic Scale | Change from baseline pain intensity at 6 weeks. | Pain measurement using Short Version of Pain Questionnaire Mc Gill and Visual Analogue Scale (VAS). |
| Disability questionnaire | Change from baseline disability status at 6 weeks. | Disability measurement using Roland Morris questionnaire. |
| Fear-avoidance questionnaire | Change from baseline Fear-avoidance status at 6 weeks. | Fear-avoidance model measurement using Waddel questionnaire related to work and physical activity. |
Countries
Brazil
Outcome results
None listed