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Pelvic floor muscle training for women with lumbopelvic pain: A systematic review and meta‐analysis
Author(s) -
Vesentini Giovana,
Prior Joanna,
Ferreira Paulo H.,
Hodges Paul W.,
Rudge Marilza,
Ferreira Manuela L.
Publication year - 2020
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.1636
Subject(s) - medicine , physical therapy , randomized controlled trial , psychological intervention , pelvic floor muscle , placebo , intervention (counseling) , pelvic pain , low back pain , meta analysis , pelvic floor , alternative medicine , surgery , nursing , pathology
Background and Objective It has been suggested that pelvic floor dysfunction may contribute to the development of lumbopelvic pain as a result of changes in trunk muscle control. However, there is limited evidence that pelvic floor muscle training (PFMT) can improve clinical outcomes in women with lumbopelvic pain. Databases and Data Treatment Six databases were searched for randomized controlled trials (RCTs) comparing the effectiveness of PFMT to other conservative interventions (usual physiotherapy care or minimal intervention), no treatment or placebo interventions on pain and disability in women with lumbopelvic pain. Results We included eight RCTs totalling 469 participants. PFMT was more effective than minimal intervention for lumbopelvic pain [mean difference (MD) 15.9/100 (95% confidential interval (CI), 8.2 to 23.6; p = 0.00; I 2 = 3.92%)] and disability [standardized mean difference (SMD) 0.5 (95% CI 0.1–0.9; p = 0.00; I 2 = 0%)] during pregnancy. PFMT was more effective than usual physiotherapy care for pain (MD 11.7/100 [95% CI 7.5–15.9; p = 0.00; I 2 = 94.14%]) and disability (SMD 0.3 (95% CI 0.0–0.6; p = 0.01; I 2 = 82.54%]) in non‐pregnant women. Effect sizes were in general of arguable clinical relevance. Conclusions Overall, the certainty of the evidence was very low to low. There is no conclusive evidence that the addition of PFMT to usual physiotherapy care or minimal intervention is superior to minimal intervention and usual care alone given the small number of studies and high levels of heterogeneity of included studies. Further well‐designed trials are needed to establish the effectiveness of PFMT for lumbopelvic pain in women.