A randomized assessor-blinded clinical trial was conducted. To compare 3 different physical therapy treatments with respect to pain and activity in women with pelvic girdle pain during pregnancy and 3, 6, and 12 months postpartum. In spite of the high prevalence of back pain during pregnancy, documented treatment programs are limited. Based on a clinical examination, 118 women with pelvic girdle pain diagnosed during pregnancy were randomized into 3 different treatment groups: Information Group, use of a nonelastic sacroiliac belt and oral/written information about pelvic girdle pain (n = 40); Home Exercise Group, same as in the Information Group, with the addition of a home exercise program (n = 41); and the In Clinic Exercise Group, same as in the Information Group, plus participation in a training program (n = 37). Pain intensity was rated on a visual analogue scale (0-100 mm) and marked on a pain drawing concerning localization. The activity ability was scored using the Disability Rating Index, covering 12 daily activity items. Outcome measures were obtained at inclusion, on average in gestation week 38, and 3, 6, and 12 months postpartum. There was no significant difference among the 3 groups during pregnancy or at the follow-ups postpartum regarding pain and activity. In all groups, pain decreased and the activity ability increased between gestation week 38 and at 12 months postpartum. Women with pelvic girdle pain seemed to improve with time in all 3 treatment groups. Neitherhome nor in clinic exercises had any additional value above giving a nonelastic sacroiliac belt and information.

Background: In chronic LBP (CLBP), guideline-endorsed treatment is to stay active, return to normal activity, and to exercise. Several reviews on various exercise types used in CLBP have been published. We aimed to identify systematic reviews of common exercise types used in CLBP, to appraise their quality, and to summarize and compare their effect on pain and disability.Methods: We searched the databases OVID MEDLINE, EMBASE, COCHRANE LIBRARY, and WEB OF SCIENCE (Core collection) for systematic reviews and meta-analyses on adults between 18 and 70 years of age suffering from chronic or recurrent LBP for a period of at least 12 weeks, which investigated the effects of exercises on pain and disability. All searches were conducted without language restriction. The search was performed up until 2022–01-26. The included reviews were grouped into nine exercise types: aerobic training, aquatic exercises, motor control exercises (MCE), resistance training, Pilates, sling exercises, traditional Chinese exercises (TCE), walking, and yoga. The study quality was assessed with AMSTAR-2. For each exercise type, a narrative analysis was performed, and the level of evidence for the effects of exercise was assessed through GRADE.Results: Our database search resulted in 3,475 systematic reviews. Out of the 253 full texts that were screened, we included 45 systematic reviews and meta-analyses. The quality of the included reviews ranged from high to critically low. Due to large heterogeneity, no meta-analyses were performed. We found low-to-moderate evidence of mainly short-term and small beneficial effects on pain and disability for MCE, Pilates, resistance training, TCE, and yoga compared to no or minimal intervention.Conclusions: Our findings show that the effect of various exercise types used in CLBP on pain and disability varies with no major difference between exercise types. Many of the included systematic reviews were of low-to-moderate quality and based on randomized controlled trials with high risk of bias. The conflicting results seen, undermine the certainty of the results leading to very-low-to-moderate quality of evidence for our results. Future systematic reviews should be of higher quality to minimize waste of resources.Trial registration: PROSPERO: Reg no 190409 Registration date 01AUG 2020.

Background: There is a lack of knowledge about the possible role of catastrophizing in lumbopelvic pain during and after pregnancy and in postpartum physical ability. Objective: The aims of this study were to explore how catastrophizing fluctuates over time during and after pregnancy and to investigate the associations between catastrophizing and lumbopelvic pain and between catastrophizing and postpartum physical ability. Design: A prospective questionnaire was used. Methods: The Pain Catastrophizing Scale was used to assess exaggerated negative thoughts about pain experiences in weeks 19 to 21 and weeks 34 to 37 of pregnancy and at 6 months postpartum. The Disability Rating Index was used to assess physical ability at 6 months postpartum. The occurrence of lumbopelvic pain was reported by participants. Parametric and nonparametric tests were used for the analyses. Results: A total of 242 of 324 women were categorized according to reported levels of catastrophizing. A majority of women (57.9%) reported not catastrophizing at all test occasions, whereas 10.3% reported catastrophizing at all occasions. For the remaining 31.8%, the levels of catastrophizing varied over time. Women who catastrophized at 1 or more of the occasions reported higher proportions of postpartum lumbopelvic pain and had more restricted postpartum physical ability than women who did not catastrophize. Limitations: The fact that some women did not complete the questionnaire at all test occasions might have reduced the generalizability of the results. Conclusions: The common idea that levels of catastrophizing are “stable” within personality should be reconsidered, because for 1 of 3 women, the levels of catastrophizing changed over time. A majority of women reported not catastrophizing. However, catastrophizing in relation to pregnancy seems to be associated with lumbopelvic pain and postpartum physical ability. The results indicated that the role of catastrophizing in this context should be studied further.