The effect of postural correction counseling on lordosis and low back pain in pregnancy: a quasi-experimental study

Abstract

Abstract Introduction: Lumbar Lordosis increases during pregnancy due to weight gain and abdominal volume increase, the center of gravity and tilt of the pelvis displaces and moves forward and lower which leads to back pain and functional disability. The aim of the present study is to determine the effect of posture correction counseling on Lumbar Lordosis and back pain in pregnant women. Materials and Methods: This quasi-experimental study was conducted on 66 pregnant women between 20-35 years old who referred to the selected health centers in Tabriz, 2020-2021. The lumbar lordosis angle was measured using a flexible ruler, and the participants completed demographic questionnaire and Oswestry disability index during 16-18 weeks of pregnancy. The participants were assigned into the intervention and control groups by stratified block randomization based on the normal body mass index and overweight with a block size of 4 and 6 with a ratio of 1:1. The intervention group received counseling and training of approved standard posture correction movements and exercises during pregnancy from 16-18 weeks of pregnancy in six sessions. Training of posture correction and exercises was provided by the first author under the supervision of trainer of birth preparation classes. Again, data were collected using flexible ruler, a visual analog scale, and Oswestry disability index during 28-30 and 35-37 weeks of pregnancy. The collected data were analyzed using SPSS25 software, and independent t-test, RMANOVA and ANCOVA tests were used. Results: The mean (SD) of lumbar lordosis increased from 45.12 (2.07) before intervention to 54.97 (2.20) in the intervention group at 35-37 weeks and changed from 44.28 (2.03) to 55.54 (3.39) in the control group at 35-37 weeks (AMD: -1.24, CI 95%: -2.48 to -0.005, P = 0.04). The mean (SD) of lumbar pain at 28-30 weeks was 2.80 (1.72) in the intervention group and 3.74 (2.23) in the control group (P = 0.09). However, mean (SD) of lumbar pain at 35-37 weeks in the intervention group 4.38 (2.45) was significantly lower than that in the control group 5.83 (2.96) (P = 0.04). Further, the mean (SD) of functional disability score in the intervention group changed from 29.80 (9.97) before intervention to 39.20 (10.78) during 35-37 weeks of pregnancy; and in control group it increased from 27.67 (12.19) before intervention to 42.64 (11.62) during 35-37 weeks of pregnancy [AMD: -5.57, 95% CI:- 3.96 to -7.40, P =0.01]. Conclusion: The posture correction and exercises are effective in controlling the enhancement of lumbar lordosis and reducing lumbar pain, and functional disability during pregnancy. Therefore, posture correction counseling and performing standard exercises are recommended to all pregnant women with no restrictions and prohibitions of exercise during pregnancy and even for women with previous history of cesarean section that are not willing to participate in childbirth preparation classes.