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Therapeutic Exercise Regarding Musculoskeletal Health of the Pregnant Exerciser and Athlete

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Exercise and Physical Activity During Pregnancy and Postpartum

Abstract

Physical activity during pregnancy is recommended and has been shown to benefit most women. However, some modifications to exercise routines may be necessary due to normal anatomic and physiologic changes and fetal requirements. Therefore, knowledge about the systemic changes of pregnancy should be considered when counseling women who wish to exercise through their pregnancy and should be complemented by the knowledge about the potential effect of exercise (therapeutic exercise) for the prevention and resolution of some common pregnancy-related musculoskeletal conditions. Therapeutic exercise is the systematic and planned performance of exercises that aims to improve and restore physical function.

This chapter presents the scientific evidence foundation on the effect of therapeutic exercises on the prevention and resolution of three commonly pregnancy-related musculoskeletal conditions: pelvic floor dysfunction, diastasis recti abdominis, and low back and pelvic girdle pain. The chapter emphasizes the potential effect of exercise on the prevention and resolution of these musculoskeletal conditions and provides useful information when tailoring therapeutic exercise programs for pregnant women.

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References

  1. American College of Obstetricians and Gynecologists. Physical Activity and Exercise During Pregnancy and the Postpartum Period. ACOG Committee Opinion No. 650. Obstet Gynecol. 2015;126(6):e135–e42.

    Google Scholar 

  2. Hay-Smith J, Mørkved S, Fairbrother KA, Herbison GP. Pelvic floor muscle training for prevention and treatment of urinary and fecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2008;(4):CD007471. https://doi.org/10.1002/14651858.CD007471.

  3. Kegel AH. Progressive resistance exercise in the functional restoration of the perineal muscles. Am J Obstet Gynecol. 1948;56(2):238–48.

    CAS  PubMed  Google Scholar 

  4. Kegel AH. Stress incontinence and genital relaxation; a nonsurgical method of increasing the tone of sphincters and their supporting structures. Ciba Clin Symp. 1952;4(2):35–51.

    CAS  PubMed  Google Scholar 

  5. Bø K. Pelvic floor muscle training is effective in treatment of female stress urinary incontinence, but how does it work? Int Urogynecol J Pelvic Floor Dysfunct. 2004;15(2):76–84. https://doi.org/10.1007/s00192-004-1125-0.

    PubMed  Google Scholar 

  6. Ashton-Miller JA, DeLancey JO. Functional anatomy of the female pelvic floor. Ann N Y Acad Sci. 2007;1101:266–96. https://doi.org/10.1196/annals.1389.034.

    PubMed  Google Scholar 

  7. DeLancey JO. Structural aspects of the extrinsic continence mechanism. Obstet Gynecol. 1988;72(3 Pt 1):296–301.

    CAS  PubMed  Google Scholar 

  8. DeLancey JO. Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis. Am J Obstet Gynecol. 1994;170(6):1713–20; discussion 20-3.

    CAS  PubMed  Google Scholar 

  9. Ashton-Miller JA, Howard D, DeLancey JO. The functional anatomy of the female pelvic floor and stress continence control system. Scand J Urol Nephrol Suppl. 2001;207:1–7; discussion 106-25.

    Google Scholar 

  10. Miller JM, Ashton-Miller JA, DeLancey JOL. A pelvic muscle Precontraction can reduce cough-related urine loss in selected women with mild SUI. J Am Geriatr Soc. 1998;46(7):870–4. https://doi.org/10.1111/j.1532-5415.1998.tb02721.x.

    CAS  PubMed  Google Scholar 

  11. Miller JM, Sampselle C, Ashton-Miller J, Hong GR, DeLancey JO. Clarification and confirmation of the knack maneuver: the effect of volitional pelvic floor muscle contraction to preempt expected stress incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(6):773–82. https://doi.org/10.1007/s00192-007-0525-3.

    PubMed  PubMed Central  Google Scholar 

  12. Miller JM, Perucchini D, Carchidi LT, Delancey JOL, Ashton-Miller J. Pelvic floor muscle contraction during a cough and decreased vesical neck mobility. Obstet Gynecol. 2001;97(2):255–60.

    CAS  PubMed  PubMed Central  Google Scholar 

  13. Peschers UM, Vodusek DB, Fanger G, Schaer GN, DeLancey JO, Schuessler B. Pelvic muscle activity in nulliparous volunteers. NeurourolUrodyn. 2001;20(3):269–75.

    CAS  Google Scholar 

  14. Bø K. Pelvic floor muscle exercise for the treatment of stress urinary incontinence: an exercise physiology perspective. Int Urogynecol J. 1995;6(5):282–91. https://doi.org/10.1007/bf01901527.

    Google Scholar 

  15. DiNubile NA. Strength training. Clin Sports Med. 1991;10(1):33–62.

    CAS  PubMed  Google Scholar 

  16. Åstrand PO. Textbook of work physiology: physiological bases of exercise. In: Human Kinetics; 2003.

    Google Scholar 

  17. Bø K, Kvarstein B, Hagen R, Larsen S. Pelvic floor muscle exercise for the treatment of female stress urinary incontinence: I. reliability of vaginal pressure measurements of pelvic floor muscle strength. NeurourolUrodyn. 1990;9(5):471–7. https://doi.org/10.1002/nau.1930090503.

    Google Scholar 

  18. Bø K, Kvarstein B, Hagen RR, Larsen S. Pelvic floor muscle exercise for the treatment of female stress urinary incontinence: II. Validity of vaginal pressure measurements of pelvic floor muscle strength and the necessity of supplementary methods for control of correct contraction. NeurourolUrodyn. 1990;9(5):479–87. https://doi.org/10.1002/nau.1930090504.

    Google Scholar 

  19. Benvenuti F, Caputo GM, Bandinelli S, Mayer F, Biagini C, Sommavilla A. Reeducative treatment of female genuine stress incontinence. Am J Phys Med. 1987;66(4):155–68.

    CAS  PubMed  Google Scholar 

  20. Bø K, Jørgensen J, Larsen S, Oseid S, Kvarstein B, Hagen R. Knowledge about and ability to correct pelvic floor muscle exercises in women with urinary stress incontinence. NeurourolUrodyn. 1988;7:261–2.

    Google Scholar 

  21. Bump RC, Hurt WG, Fantl JA, Wyman JF. Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. Am J Obstet Gynecol. 1991;165(2):322–7. discussion 7-9

    CAS  PubMed  Google Scholar 

  22. Messelink B, Benson T, Berghmans B, Bø K, Corcos J, Fowler C, et al. Standardization of terminology of pelvic floor muscle function and dysfunction: report from the pelvic floor clinical assessment group of the international continence society. NeurourolUrodyn. 2005;24(4):374–80. https://doi.org/10.1002/nau.20144.

    Google Scholar 

  23. Bø K, Sherburn M. Measurement of pelvic floor muscle function and strength and pelvic organ prolapse. In: Bø K, Berghmans B, Mørkved S, Kampen MV, editors. Evidence-based physical therapy for the pelvic floor. Edinburgh: Churchill Livingstone; 2007. p. 45–112.

    Google Scholar 

  24. Bø K, Mørkved S. Pelvic floor and exercise science. In: Bø K, Berghmans B, Mørkved S, Kampen MV, editors. Evidence-based physical therapy for the pelvic floor. Edinburgh: Churchill Livingstone; 2007. p. 113–32.

    Google Scholar 

  25. Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39(8):1423–34. https://doi.org/10.1249/mss.0b013e3180616b27.

    PubMed  Google Scholar 

  26. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334–59. https://doi.org/10.1249/MSS.0b013e318213fefb.

    PubMed  Google Scholar 

  27. Bø K, Aschehoug A. Pelvic floor and exercise science: strength training. In: Bø K, Berghmans B, Mørkved S, Kampen MV, editors. Evidence-based physical therapy for the pelvic floor. Edinburgh: Churchill Livingstone; 2007. p. 119–32.

    Google Scholar 

  28. Kraemer WJ, Ratamess NA. Fundamentals of resistance training: progression and exercise prescription. Med Sci Sports Exerc. 2004;36(4):674–88.

    PubMed  Google Scholar 

  29. Dumoulin C, Hay-Smith EJC, Mac Habée-Séguin G. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2014;(5). https://doi.org/10.1002/14651858.CD005654.pub3.

  30. Moore K, Dumoulin C, Bradley C, Burgio K, Chambers T, Hagen S, et al. Adult conservative management. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence: 5th International Consultation on Incontinence. Paris: SRC—GoogleScholar, ICUD-EAU; 2013. p. 1101–305.

    Google Scholar 

  31. Boyle R, Hay-Smith EJC, Cody JD, Mørkved S. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2012;(10). https://doi.org/10.1002/14651858.CD007471.pub2.

  32. Kruger JA, Dietz HP, Murphy BA. Pelvic floor function in elite nulliparous athletes. Ultrasound Obstet Gynecol. 2007;30(1):81–5. https://doi.org/10.1002/uog.4027.

    CAS  PubMed  Google Scholar 

  33. Du Y, Xu L, Ding L, Wang Y, Wang Z. The effect of antenatal pelvic floor muscle training on labor and delivery outcomes: a systematic review with meta-analysis. Int Urogynecol J. 2015;26(10):1415–27. https://doi.org/10.1007/s00192-015-2654-4.

    PubMed  Google Scholar 

  34. Bø K, Artal R, Barakat R, Brown W, Davies GAL, Dooley M, et al. Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 1—exercise in women planning pregnancy and those who are pregnant. Br J Sports Med. 2016;50(10):571.

    PubMed  Google Scholar 

  35. Mota PG, Pascoal AGBA, Carita AIAD, Bø K. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Man Ther. 2015;20(1):200–5. https://doi.org/10.1016/j.math.2014.09.002.

    Google Scholar 

  36. Boissonnault JS, Blaschak MJ. Incidence of diastasis recti abdominis during the childbearing year. Phys Ther. 1988;68(7):1082–6.

    CAS  PubMed  Google Scholar 

  37. Fast A, Weiss L, Ducommun EJ, Medina E, Butler JG. Low-back pain in pregnancy. Abdominal muscles, sit-up performance, and back pain. Spine. 1990;15(1):28–30.

    CAS  PubMed  Google Scholar 

  38. Gilleard WL, Brown JM. Structure and function of the abdominal muscles in primigravid subjects during pregnancy and the immediate postbirth period. Phys Ther. 1996;76(7):750–62.

    CAS  PubMed  Google Scholar 

  39. Coldron Y, Stokes MJ, Newham DJ, Cook K. Postpartum characteristics of rectus abdominis on ultrasound imaging. Man Ther. 2008;13(2):112–21. https://doi.org/10.1016/j.math.2006.10.001.

    PubMed  Google Scholar 

  40. Mota P, Pascoal AG, Carita AI, Bo K. The immediate effects on inter-rectus distance of abdominal crunch and drawing in exercises during pregnancy and the postpartum period. J Orthop Sports Phys Ther. 2015:1–24. https://doi.org/10.2519/jospt.2015.5459.

  41. Benjamin DR, van de Water ATM, Peiris CL. Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review. Physiotherapy. 2014;100(1):1–8. https://doi.org/10.1016/j.physio.2013.08.005.

    CAS  PubMed  Google Scholar 

  42. Akram J, Matzen SH. Rectus abdominis diastasis. J Plast Surg Hand Surg. 2014;48(3):163–9. https://doi.org/10.3109/2000656X.2013.859145.

    PubMed  Google Scholar 

  43. Emanuelsson P, Gunnarsson U, Strigard K, Stark B. Early complications, pain, and quality of life after reconstructive surgery for abdominal rectus muscle diastasis: a 3-month follow-up. J Plast Reconstr Aesthet Surg. 2014;67(8):1082–8. https://doi.org/10.1016/j.bjps.2014.04.015.

    CAS  PubMed  Google Scholar 

  44. Mesquita LA, Machado AC, Andrade AV. Fisioterapia para Redução da Diástase dos Músculos Retos Abdominais no Pós-Parto. Rev Bras Ginecol Obstet. 1999;21(5):267–72. https://doi.org/10.1590/S0100-72031999000500004.

    Google Scholar 

  45. Walton LM, Costa A, LaVanture D, McIlrath S, Stebbins B. The effects of a 6 week dynamic core stability plank exercise program compared to a traditional supine core stability strengthening program on diastasis recti abdominis closure, pain, oswestry disability index (ODI) and pelvic floor disability index scores (PFDI). Phys Ther Rehabil. 2016;3(1):3. https://doi.org/10.7243/2055-2386-3-3.

    Google Scholar 

  46. Kamel DM, Yousif AM. Neuromuscular electrical stimulation and strength recovery of postnatal diastasis recti abdominis muscles. Ann Rehabil Med. 2017;41(3):465–74. https://doi.org/10.5535/arm.2017.41.3.465.

    PubMed  PubMed Central  Google Scholar 

  47. Carrera Pérez C, Da Cuña CI, González González Y. ¿Cuál es el mejor ejercicio para la rehabilitación de la diástasis abdominal? Rehabilitación. 2019;53(3):198–210. https://doi.org/10.1016/j.rh.2018.12.004.

    PubMed  Google Scholar 

  48. Gluppe SB, Engh ME, Bø K. Immediate effect of abdominal and pelvic floor muscle exercises on Interrecti distance in women with diastasis recti abdominis who were parous. Phys Ther. 2020;100(8):1372–83. https://doi.org/10.1093/ptj/pzaa070.

    PubMed  Google Scholar 

  49. Gluppe SL, Hilde G, Tennfjord MK, Engh ME, Bø K. Effect of a postpartum training program on the prevalence of diastasis recti abdominis in postpartum Primiparous women: a randomized controlled trial. Phys Ther. 2018;98(4):260–8. https://doi.org/10.1093/ptj/pzy008.

    PubMed  PubMed Central  Google Scholar 

  50. Theodorsen NM, Strand LI, Bo K. Effect of pelvic floor and transversus abdominis muscle contraction on inter-rectus distance in postpartum women: a cross-sectional experimental study. Physiotherapy. 2019;105(3):315–20. https://doi.org/10.1016/j.physio.2018.08.009.

    PubMed  Google Scholar 

  51. Mota P, Pascoal AG, Sancho MF, Bo K. Test-retest and intra-observer reliability of 2D ultrasound measurements of distance between rectus abdominis in women. J Orthop Sports Phys Ther. 2012;42(11):940–6.

    PubMed  Google Scholar 

  52. Sancho MF, Pascoal AG, Mota P, Bo K. Abdominal exercises affect inter-rectus distance in postpartum women: a two-dimensional ultrasound study. Physiotherapy. 2015;101(3):286–91. https://doi.org/10.1016/j.physio.2015.04.004.

    CAS  PubMed  Google Scholar 

  53. Lee D, Hodges PW. Behavior of the Linea Alba during a curl-up task in diastasis rectus abdominis: an observational study. J Orthop Sports Phys Ther. 2016;46(7):580–9. https://doi.org/10.2519/jospt.2016.6536.

    PubMed  Google Scholar 

  54. Smith BE, Littlewood C, May S. An update of stabilisation exercises for low back pain: a systematic review with meta-analysis. BMC Musculoskelet Disord. 2014;15:416. https://doi.org/10.1186/1471-2474-15-416.

    PubMed  PubMed Central  Google Scholar 

  55. Bø K, Artal R, Barakat R, Brown WJ, Davies GAL, Dooley M, et al. Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC Expert Group Meeting, Lausanne. Part 3—exercise in the postpartum period. Br J Sports Med. 2017;50:571.

    Google Scholar 

  56. Fell DB, Joseph KS, Armson BA, Dodds L. The impact of pregnancy on physical activity level. Matern Child Health J. 2008;13(5):597. https://doi.org/10.1007/s10995-008-0404-7.

    PubMed  Google Scholar 

  57. Owe KM, Nystad W, Bo K. Correlates of regular exercise during pregnancy: the Norwegian mother and child cohort study. Scand J Med Sci Sports. 2009;19(5):637–45. https://doi.org/10.1111/j.1600-0838.2008.00840.x.

    CAS  PubMed  Google Scholar 

  58. Pennick V, Liddle SD. Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Syst Rev. 2013;(8):CD001139. https://doi.org/10.1002/14651858.CD001139.pub3.

  59. Haakstad LA, Bo K. Effect of a regular exercise programme on pelvic girdle and low back pain in previously inactive pregnant women: a randomized controlled trial. J Rehabil Med. 2015;47(3):229–34. https://doi.org/10.2340/16501977-1906.

    PubMed  Google Scholar 

  60. Mogren IM. Previous physical activity decreases the risk of low back pain and pelvic pain during pregnancy. Scand J Public Health. 2005;33(4):300–6.

    PubMed  Google Scholar 

  61. Bø K, Backe-Hansen KL. Do elite athletes experience low back, pelvic girdle and pelvic floor complaints during and after pregnancy? Scand J Med Sci Sports. 2007;17(5):480–7. https://doi.org/10.1111/j.1600-0838.2006.00599.x.

    PubMed  Google Scholar 

  62. Thorell E, Kristiansson P. Pregnancy related back pain, is it related to aerobic fitness? A longitudinal cohort study. BMC Pregnancy Childbirth. 2012;12:30. https://doi.org/10.1186/1471-2393-12-30.

    PubMed  PubMed Central  Google Scholar 

  63. Boissonnault JS, Klestinski JU, Pearcy K. The role of exercise in the management of pelvic girdle and low back pain in pregnancy: a systematic review of the literature. J Women Health Phys Ther. 2012;36:69–77.

    Google Scholar 

  64. Ho SSM, Yu WWM, Lao TT, Chow DHK, Chung JWY, Li Y. Effectiveness of maternity support belts in reducing low back pain during pregnancy: a review. J Clin Nurs. 2009;18(11):1523–32. https://doi.org/10.1111/j.1365-2702.2008.02749.x.

    PubMed  Google Scholar 

  65. Kanakaris NK, Roberts CS, Giannoudis PV. Pregnancy-related pelvic girdle pain: an update. BMC Med. 2011;9:15. https://doi.org/10.1186/1741-7015-9-15.

    PubMed  PubMed Central  Google Scholar 

  66. Katonis P, Kampouroglou A, Aggelopoulos A, Kakavelakis K, Lykoudis S, Makrigiannakis A, et al. Pregnancy-related low back pain. Hippokratia. 2011;15(3):205–10.

    CAS  PubMed  PubMed Central  Google Scholar 

  67. Lillios S, Young J. The effects of core and lower extremity strengthening on pregnancy_related low back and pelvic girdle pain: a review. J Women Health Phys Ther. 2012;36:116–24.

    Google Scholar 

  68. Richards E, Van Kessel G, Virgara R, Harris P. Does antenatal physical therapy for pregnant women with low back pain or pelvic pain improve functional outcomes? A systematic review. Acta Obstet Gynecol Scand. 2012;91(9):1038–45. https://doi.org/10.1111/j.1600-0412.2012.01462.x.

    PubMed  Google Scholar 

  69. Stuge B, Hilde G, Vollestad N. Physical therapy for pregnancy-related low back and pelvic pain: a systematic review. Acta Obstet Gynecol Scand. 2003;82(11):983–90.

    PubMed  Google Scholar 

  70. Vermani E, Mittal R, Weeks A. Pelvic girdle pain and low back pain in pregnancy: a review. Pain Pract. 2010;10(1):60–71. https://doi.org/10.1111/j.1533-2500.2009.00327.x.

    PubMed  Google Scholar 

  71. Verstraete EH, Vanderstraeten G, Parewijck W. Pelvic girdle pain during or after pregnancy: a review of recent evidence and a clinical care path proposal. Facts Views Vis Obgyn. 2013;5(1):33–43.

    CAS  PubMed  PubMed Central  Google Scholar 

  72. Vleeming A, Albert HB, Östgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008;17(6):794–819. https://doi.org/10.1007/s00586-008-0602-4.

    PubMed  PubMed Central  Google Scholar 

  73. Shiri R, Coggon D, Falah-Hassani K. Exercise for the prevention of low back and pelvic girdle pain in pregnancy: a meta-analysis of randomized controlled trials. Eur J Pain. 2018;187:1093–101. https://doi.org/10.1002/ejp.1096.

    Google Scholar 

  74. Benten EV, Pool J, Mens J, Pool-Goudzwaard A. Recommendations for physical therapists on the treatment of Lumbopelvic pain during pregnancy: a systematic review. J Orthop Sports Phys Ther. 2014;44(7):464–A15. https://doi.org/10.2519/jospt.2014.5098.

    PubMed  Google Scholar 

  75. Close C, Sinclair M, Liddle SD, Madden E, McCullough JEM, Hughes C. A systematic review investigating the effectiveness of complementary and alternative medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy. J Adv Nurs. 2014;70(8):1702–16. https://doi.org/10.1111/jan.12360.

    PubMed  Google Scholar 

  76. Jiang Q, Wu Z, Zhou L, Dunlop J, Chen P. Effects of yoga intervention during pregnancy: a review for current status. Am J Perinatol. 2015;32(6):503–14. https://doi.org/10.1055/s-0034-1396701.

    PubMed  Google Scholar 

  77. Gjestland K, Bø K, Owe KM, Eberhard-Gran M. Do pregnant women follow exercise guidelines? Prevalence data among 3482 women, and prediction of low-back pain, pelvic girdle pain and depression. Br J Sports Med. 2013;47(8):515.

    PubMed  Google Scholar 

  78. Ferreira CWS, Alburquerque-Sendin F. Effectiveness of physical therapy for pregnancy-related low back and/or pelvic pain after delivery: a systematic review. Physiother Theory Pract. 2013;29(6):419–31. https://doi.org/10.3109/09593985.2012.748114.

    PubMed  Google Scholar 

  79. Stuge B, Laerum E, Kirkesola G, Vollestad N. The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: a randomized controlled trial. Spine. 2004;29(4):351–9.

    PubMed  Google Scholar 

  80. Mens JM, Snijders CJ, Stam HJ. Diagonal trunk muscle exercises in peripartum pelvic pain: a randomized clinical trial. Phys Ther. 2000;80(12):1164–73.

    CAS  PubMed  Google Scholar 

  81. Bastiaenen CH, de Bie RA, Vlaeyen JW, Goossens ME, Leffers P, Wolters PM, et al. Long-term effectiveness and costs of a brief self-management intervention in women with pregnancy-related low back pain after delivery. BMC Pregnancy Childbirth. 2008;8:19. https://doi.org/10.1186/1471-2393-8-19.

    PubMed  PubMed Central  Google Scholar 

  82. Gutke A, Sjödahl J, Öberg B. Specific muscle stabilizing as home exercises for persistent pelvic girdle pain after pregnancy: a randomized, controlled clinical trial. J Rehabil Med. 2010;42(10):929–35. https://doi.org/10.2340/16501977-0615.

    PubMed  Google Scholar 

  83. Chaudry S, Rashid F, Shah S. Effectiveness of core stabilization exercises along with postural correction in postpartum back pain. Rawal Med J. 2013;38:256–9.

    Google Scholar 

  84. Backhausen MG, Tabor A, Albert H, Rosthøj S, Damm P, Hegaard HK. The effects of an unsupervised water exercise program on low back pain and sick leave among healthy pregnant women—a randomised controlled trial. PLoS One. 2017;12(9):e0182114. https://doi.org/10.1371/journal.pone.0182114.

    CAS  PubMed  PubMed Central  Google Scholar 

  85. Eggen MH, Stuge B, Mowinckel P, Jensen KS, Hagen KB. Can supervised group exercises including ergonomic advice reduce the prevalence and severity of low back pain and pelvic girdle pain in pregnancy? A randomized controlled trial. Phys Ther. 2012;92(6):781–90. https://doi.org/10.2522/ptj.20110119.

    PubMed  Google Scholar 

  86. Mørkved SIV, Salvesen KÅ, Schei B, Lydersen S, BØ K. Does group training during pregnancy prevent lumbopelvic pain? A randomized clinical trial. Acta Obstet Gynecol Scand. 2007;86(3):276–82. https://doi.org/10.1080/00016340601089651.

    PubMed  Google Scholar 

  87. Stafne SN, Salvesen KA, Romundstad PR, Stuge B, Morkved S. Does regular exercise during pregnancy influence lumbopelvic pain? A randomized controlled trial. Acta Obstet Gynecol Scand. 2012;91(5):552–9. https://doi.org/10.1111/j.1600-0412.2012.01382.x.

    PubMed  Google Scholar 

  88. Dankaerts W, O'Sullivan P. The validity of O’Sullivan’s classification system (CS) for a sub-group of NS-CLBP with motor control impairment (MCI): overview of a series of studies and review of the literature. Man Ther. 2011;16(1):9–14. https://doi.org/10.1016/j.math.2010.10.006.

    PubMed  Google Scholar 

  89. Stuge B, Bergland A. Evidence and individualization: important elements in treatment for women with postpartum pelvic girdle pain. Physiother Theory Pract. 2011;27(8):557–65. https://doi.org/10.3109/09593985.2010.551802.

    PubMed  Google Scholar 

  90. van Tulder M, Koes B. Low back pain (acute). Clin Evid. 2004;12:1643–58.

    Google Scholar 

  91. Liddle SD, David Baxter G, Gracey JH. Physiotherapists’ use of advice and exercise for the management of chronic low back pain: a national survey. Man Ther. 2009;14(2):189–96. https://doi.org/10.1016/j.math.2008.01.012.

    PubMed  Google Scholar 

  92. Brumitt J, Matheson JW, Meira EP. CCore stabilization exercise prescription, part 2: a systematic review of motor control and general (global) exercise rehabilitation approaches for patients with low back pain. Sports Health. 2013;5(6):510–3. https://doi.org/10.1177/1941738113502634.

    PubMed  PubMed Central  Google Scholar 

  93. Bruno P. The use of “stabilization exercises” to affect neuromuscular control in the lumbopelvic region: a narrative review. J Can Chiropr Assoc. 2014;58:119–30.

    PubMed  PubMed Central  Google Scholar 

  94. McGill S. Low back disorders: evidence-based prevention and rehabilitation. 2nd ed. Champaign, IL: Human Kinetics; 2007.

    Google Scholar 

  95. Richardson C, Hodges P, Hides J. Therapeutic exercise for lumbopelvic stabilization. Edinburgh: Churchill Livingstone; 2004.

    Google Scholar 

  96. Stuge B, Saetre K, Ingeborg HB. The automatic pelvic floor muscle response to the active straight leg raise in cases with pelvic girdle pain and matched controls. Man Ther. 2013;18(4):327–32. https://doi.org/10.1016/j.math.2012.12.004.

    PubMed  Google Scholar 

  97. Hayden JA, van Tulder MW, Tomlinson G. Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med. 2005;142(9):776–85. https://doi.org/10.7326/0003-4819-142-9-200505030-00014.

    PubMed  Google Scholar 

  98. Gomes-Neto M, Lopes JM, Conceicao CS, Araujo A, Brasileiro A, Sousa C, et al. Stabilization exercise compared to general exercises or manual therapy for the management of low back pain: a systematic review and meta-analysis. Phys Ther Sport. 2017;23:136–42. https://doi.org/10.1016/j.ptsp.2016.08.004.

    PubMed  Google Scholar 

  99. Wang X-Q, Zheng J-J, Yu Z-W, Bi X, Lou S-J, Liu J, et al. A meta-analysis of core stability exercise versus general exercise for chronic low Back pain. PLoS One. 2012;7(12):e52082. https://doi.org/10.1371/journal.pone.0052082.

    CAS  PubMed  PubMed Central  Google Scholar 

  100. O'Sullivan PB, Beales DJ. Changes in pelvic floor and diaphragm kinematics and respiratory patterns in subjects with sacroiliac joint pain following a motor learning intervention: a case series. Man Ther. 2007;12(3):209–18. https://doi.org/10.1016/j.math.2006.06.006.

    PubMed  Google Scholar 

  101. Boissonnault JS. A review of self-report functional outcome measures in selected obstetric physical therapy interventions. J Women Health Phys Ther. 2009;33(1):7–12.

    Google Scholar 

  102. Stuge B, Garratt A, Krogstad Jenssen H, Grotle M. The pelvic girdle questionnaire: a condition-specific instrument for assessing activity limitations and symptoms in people with pelvic girdle pain. Phys Ther. 2011;91(7):1096–108. https://doi.org/10.2522/ptj.20100357.

    PubMed  Google Scholar 

  103. Grotle M, Garratt AM, Krogstad Jenssen H, Stuge B. Reliability and construct validity of self-report questionnaires for patients with pelvic girdle pain. Phys Ther. 2012;92(1):111–23. https://doi.org/10.2522/ptj.20110076.

    PubMed  Google Scholar 

  104. Stuge B, Jenssen HK, Grotle M. The pelvic girdle questionnaire: responsiveness and minimal important change in women with pregnancy-related pelvic girdle pain, low back pain, or both. Phys Ther. 2017;97(11):1103–13. https://doi.org/10.1093/ptj/pzx078.

    PubMed  Google Scholar 

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Pascoal, A.G., Stuge, B., Mota, P., Hilde, G., Bø, K. (2022). Therapeutic Exercise Regarding Musculoskeletal Health of the Pregnant Exerciser and Athlete. In: Santos-Rocha, R. (eds) Exercise and Physical Activity During Pregnancy and Postpartum. Springer, Cham. https://doi.org/10.1007/978-3-031-06137-0_12

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