ARTICLE INFO

Article Type

Original Research

Authors

Karimzadeh   R. (*1)
Rahnama   N. (2)






(*1) Human Sciences Department, Physical Education & Sport Sciences Faculty, sfahan Branch, Islamic Azad University, Isfahan, Iran
(2) Human Sciences Department, Physical Education & Sport Sciences Faculty, Isfahan University, Isfahan, Iran

Correspondence

Address: Daneshgah Boulevard, Arqavanieh, East Jey Street, Isfahan, Iran
Phone: +98 (31) 52220601
Fax: +98 (31) 35354060
raziehkarimzadeh@gmail.com

Article History

Received:  August  27, 2017
Accepted:  April 11, 2019
ePublished:  July 6, 2019

BRIEF TEXT


As one of the most common postpartum pregnancy complications with a prevalence of 50-90%, low back pain can have disturbing psychiatric effects.

... [1-3]. Pain is usually initiated between the fifth and seventh months of pregnancy and continues. It has shown that 75% of pregnant women with low back pain had no history of low back pain and associated low back pain to their first pregnancy. In addition to the effects of pregnancy on low back pain in pregnant women, the effects of pregnancy on quality of life have also been identified [4]. … [5]. Studies have indicated the positive impact of exercise on chronic low back pain [6]. Exercise is one of the most common methods of prevention and treatment for improving low back pain with unknown cause. Studies have shown that exercise therapy is effective in improving chronic low back pain and there is no report on it’s the adverse effects during pregnancy [7]. … [8-14].

The aim of the present study was to investigate the comparison of the effect of eight weeks of aquagymnastic, kegel, and combined exercises on low back pain in primiparous pregnant women.

This research was a semi-experimental study with pre-test post-test design with control group.

This research was conducted on 60 primiparous pregnant women aged 25-40 years in the second trimester of pregnancy in 2016.

45 Primiparous pregnant women referring to Tehran Sarem Hospital were randomly divided into two experimental (aquagymnastic and combined exercises) and the control group (n=15 for each group) and 4 primiparous women who referred to the Mehrab-e-Eshgh Yoga Institute, Isfahan were assigned into the Kegel training group. The subjects in the experimental (training group) and control groups were selected by purposive sampling method and their gestational age was set above 41 weeks of gestation based on the last menstrual period (LMP) and ultrasound at the time of referral and they no weekly exercise before entering the study. For aquatic exercises there was no need to swim and also blood pressure and fetal heart rate were measured before exercise. Other inclusion criteria included normal baseline fetal heart rate (110–160 beats/min) [15] and complaints of low back pain by the subject. In the next step, a more accurate diagnosis of their low back pain was made by a specialist physician. A history of systemic disease or using medications for its treatment, a history of any pregnancy related complications, such as preterm labor, miscarriage, being absent for more than two sessions continuously and non-continuous absence in three sessions were the exclusion criteria.

The subjects' low back pain was measured using the Visual Analogue Scale (VAS). The aims and process of the research were explained and the subjects completed the consent form and their personal information, including age, gestation week, height, weight, blood pressure, fetal heart rate, LMP, education level and training date were recorded. Then, after explaining how to fill in the scale, each subject completed the questionnaire. The subjects in the first experimental group performed trainings in water for 16 sessions (8 week, 2 days a week for 1 h). Blood pressure and heart rate of all pregnant mothers participating in aquagymnastic training were assessed by a midwifery expert before each session and they were allowed to participate in the program if they had no medical problems. The second experimental group performed Kegel exercises for 16 sessions (8 week, 2 days a week for 1 h). The third experimental group performed a combination of aquagymnastic and kegel exercises for 16 sessions (8 week, 2 days a week for 1 h). It should be noted that the training sessions were designed according to the individual characteristics of the subjects and was intensified with regard to their performance improvement based on the overload principle and training progression (duration and intensity of training). The control group did not perform any exercise and was only monitored by physicians at Sarem Hospital. Finally, low back pain in the experimental and control groups were re-evaluated after eight weeks of aquagymnastic and kegel exercises. The results were analyzed by descriptive and inferential statistics using SPSS 20 software. Kolmogorov-Smirnov and Shapiro-Wilks tests were used to ensure natural distribution of data. One way ANOVA and LSD test were used for data analysis.

There was a significant difference between the mean scores of pain in the studied groups. The level of low back pain was decreased in all three experimental groups after trainings, which was significant in the combined exercise group. However, in the control group, there was an increase in low back pain in the post-test compared to the pre-test (Table 1). In the paired comparison, there was a significant difference between the combined group and aquagymnastic (p = 0.002), kegel training (p = 0.0001) and control groups (p = 0.0001). There was also a significant difference between two groups in aquagymnastic and kegel training groups (p = 0.0001), however, there was no significant difference between aquagymnastic and kegel groups (p = 0.519).

… [16-17]. Zand et al. [18] examined the effect of simple exercise movements and the correct state of daily work on low back pain during pregnancy. Their results showed that exercise during pregnancy does not eliminate low back pain, but it can reduce or delay the incidence of low back pain during this period, which is consistent with our results. Kashanian et al. [19] also reported a decrease in low back pain as a result of exercise training in pregnant women. Intveld et al. [20] examined the impact of physiotherapy in the water on low back pain in pregnant women. The results showed that pregnant women with low back pain can be managed once a week. The results of this study are consistent with the present study, although there are differences in the duration of exercise. … [21-23].

It is suggested to study the effect of aquagymnastic training on physiological childbirth.

Limitations of this study were insufficient access to ergonomic pools for pregnant women and high costs.

Aqua gymnastics, kegel, and combined exercises after 8 weeks are effective in reducing low back pain in primiparous pregnant women, but combined exercises have a more significant effect than aqua gymnastics and kegel exercises.

The Professor Nader Rahnama, Dr. Abutaleb Saremi, the staff of the Sarem Hospital and the subjects are appreciated.

None declared.

This study was approved by the Isfahan University of Medical Sciences.

This study was supported by the first author

TABLES and CHARTS

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CITIATION LINKS

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