Supervised, Individualised Exercise Across Pregnancy and Postpartum for Pregnancy‐Related Lumbopelvic Pain: A Multicentre Pragmatic, Site‐Allocated Cluster Trial

OBJECTIVE: To evaluate the effectiveness of a face-to-face supervised, individualised exercise programme and pelvic belt in women with pregnancy-related low back and pelvic girdle pain (PLBP/PPGP) from pregnancy through the postpartum period. DESIGN: Multicentre, non-randomised, site-allocated pragmatic cluster trial. SETTING: Tertiary care hospitals and obstetrics and gynaecology clinics. POPULATION: Pregnant women with PLBP/PPGP at ≥ 28 weeks' gestation. METHODS: Participants were allocated by study site to one of three groups: (1) leaflet; (2) exercise; (3) exercise plus belt. All groups received exercise leaflets. The exercise and exercise plus belt groups received three 30-min, face-to-face, supervised sessions-during late pregnancy, 5 days postpartum, and 1 month postpartum. The exercise plus belt group additionally received a pelvic belt. MAIN OUTCOME MEASURES: Functional impairment was assessed by the Oswestry Disability Index (ODI) at 5 days, 1 month, and 3 months postpartum. RESULTS: A total of 127 participants were enrolled; 107 completed follow-up. At 1 month postpartum, lower ODI scores were observed in the exercise group (mean difference 5.4; 95% CI 3.3 to 7.6), and similarly in the exercise plus belt group (mean difference 4.9; 95% CI 2.6 to 7.2), compared with the leaflet group. At 3 months postpartum, mean differences were 4.4 (95% CI -7.1 to 15.9) for the exercise group and 3.7 (95% CI -7.9 to 15.2) for the exercise plus belt group. No clear differences were observed between the exercise and exercise plus belt groups. CONCLUSIONS: A face-to-face supervised, individualised exercise programme was associated with lower functional impairment at 1 month postpartum. TRIAL REGISTRATION: UMIN Clinical Trials Registry (UMIN000057866); https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000066135.