• Physiotherapy · Mar 2021

    Meta Analysis

    Is adding pelvic floor muscle training to an exercise intervention more effective at improving pain in patients with non-specific low back pain? A systematic review of randomized controlled trials.

    • Stéphanie Bernard, Evelyne Gentilcore-Saulnier, Hugo Massé-Alarie, and Hélène Moffet.
    • Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), 525 Wildrid-Hamel, Québec, Québec G1M 2S8, Canada; Université Laval, 1050 avenue de la Médecine, Pavillon Ferdinand-Vandry, Québec, Québec G1V 0A6, Canada.
    • Physiotherapy. 2021 Mar 1; 110: 15-25.

    BackgroundPelvic floor muscles (PFM) contribute to optimal control of the lumbopelvic spine. PFM function appears altered in some people with nonspecific low back pain (LBP).ObjectiveTo systematically review if adding PFM training (PFMT) to another exercise intervention can be more effective at improving pain and function in people with nonspecific LBP than without PFMT.Data SourcesThe authors conducted a literature search on Medline, Embase, CINAHL, Cochrane Central and Web of Sciences up to October 2018. ELIGIBILITY CRITERIA: (1) Participants with nonspecific LBP; (2) additional PFMT to an exercise intervention; (3) comparison to the same intervention without PFMT; (4) included minimally one planned outcome; and (5) a randomized controlled trial. Two reviewers performed screening, data extraction (primary outcome; pain severity, secondary outcome; physical function) and risk of bias assessment.Synthesis MethodsMeta-analysis was performed using mean difference and 95% confidence intervals.ResultsSix studies were included (n=200 participants). Participants with PFMT had lower pain severity in comparison with the group without PFMT (mean difference: -0.61, 95%CI [-0.91, -0.31], P<0.0001 and low heterogeneity: I2=0%). Subgroup analysis shows significant effect for interventions lasting longer than 8-weeks. No difference was found for function. Overall risk of bias was unclear.LimitationsSmall groups and high heterogenicity limit our findings.ConclusionThere is very low-quality evidence that there is a small benefit of adding PFMT to another exercise intervention on pain severity in nonspecific LBP. Longer duration for an integrated lumbopelvic exercise program including PFMT is likely to impact pain outcomes positively.Prospero RegistrationCRD42018114601.Copyright © 2020 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…