The effect of pelvic floor muscle-strengthening exercises on low back pain: a systematic review and meta-analysis on randomized clinical trials

Mohsen Kazeminia; Fatemeh Rajati; Mojgan Rajati

doi:10.1007/s10072-022-06430-z

The effect of pelvic floor muscle-strengthening exercises on low back pain: a systematic review and meta-analysis on randomized clinical trials

Neurol Sci. 2023 Mar;44(3):859-872. doi: 10.1007/s10072-022-06430-z. Epub 2022 Oct 7.

Authors

Mohsen Kazeminia¹, Fatemeh Rajati², Mojgan Rajati³

Affiliations

¹ Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
² Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
³ Department of Obstetrics and Gynecology, School of Medicine, Motazedi Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. mojgan.rajati@kums.ac.ir.

PMID: 36205811
DOI: 10.1007/s10072-022-06430-z

Abstract

Background: Low back pain is a musculoskeletal disorder (MSD), and Kegel exercise is considered as one of the non-surgical management methods. Therefore, the present systematic review and meta-analysis aimed to estimate the results of randomized clinical trials (RCT) about the effect of pelvic floor muscle-strengthening exercises on reducing low back pain‏.‏ METHODS: The present study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline (2020) to January 2022. The relevant studies were searched in the MagIran, SID, PubMed, Embase, Web of Science (WoS), Scopus, ClinicalTrials.gov databases and Google Scholar motor engine using related MeSH/Emtree terms, which were combined with free text word. The heterogeneity of the studies was checked using I² statistic.

Results: Finally, 19 RCTs with a sample size of 456 subjects in the intervention group and 470 in the control group were included in the meta-analysis. The low back pain intensity in the intervention group decreased up to 1.261 ± 0.213 (SMD ± 95% CI) with I² = 87.60 more than that in the control group (P <0.001). The low back pain intensity in postpartum women decreased up to 1.614 ± 0.312 (95% CI) followed by pregnant women as 1.282 ± 0.479 (SMD ± 95% CI) more than that in other populations. But due to high the heterogeneity in all sub-groups (I² > 80%) this result should be considered with caution. Meta-regression analysis showed the effect of pelvic floor muscle-strengthening exercises increased by increasing the year of publication, quality assessment score of the article, and the number of weeks of intervention (P<0.05).

Conclusion: Based on the results of the present meta-analysis, pelvic floor muscle-strengthening exercises significantly reduce the low back pain intensity. Therefore, these exercises can be regarded as a part of a low back pain management plan.

Keywords: Back pain; Exercise; Meta-analysis; Pelvic floor; Resistance training; Systematic review.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Back Pain
Exercise Therapy / methods
Female
Humans
Low Back Pain* / therapy
Pelvic Floor
Pregnancy
Randomized Controlled Trials as Topic