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

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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.‏


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, 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.


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).


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.

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Data availability

Datasets are available through the corresponding author upon reasonable request.



Scientific Information Database

WoS :

Web of Science

MeSH :

Medical Subject Headings


Joanna Briggs Institute


Preferred Reporting Items for Systematic Reviews and Meta-Analysis


Randomized clinical trial


Visual analogue scale


Numerical Pain Rating Scale


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This study is the result of research project No. 50000996 approved by the Student Research Committee of Kermanshah University of Medical Sciences. We would like to thank the esteemed officials of that center for accepting the financial expenses of this study. We also thank the officials of the Systematic Review and Meta-Analysis Center (SYRMAN) for their guidance and advice in conducting this research.


This study is funded by the Deputy for Research and Technology, Kermanshah University of Medical Sciences (IR) (50000996). This deputy has no role in the study process.

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M.K. and F.R. contributed to the design. M.K. and M.R. participated in most of the study steps. M.K. and F.R. prepared the manuscript. M.K. and M.R. assisted in designing the study and helped in the, interpretation of the study. All authors have read and approved the content of the manuscript.

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Correspondence to Mojgan Rajati.

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Ethics approval was received from the ethics committee of deputy of research and technology, Kermanshah University of Medical Sciences (IR.KUMS.REC.1400.788).

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Kazeminia, M., Rajati, F. & Rajati, M. The effect of pelvic floor muscle-strengthening exercises on low back pain: a systematic review and meta-analysis on randomized clinical trials. Neurol Sci 44, 859–872 (2023).

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