Diagonal trunk muscle exercises in peripartum pelvic pain: a randomized clinical trial.
OBJECTIVE
Exercises for low back and pelvic pain are supposed to increase muscle force to reduce symptoms, but they could exacerbate symptoms by loading of the spinal and pelvic structures. The purpose of this study was to investigate the value of graded exercises of the diagonal trunk muscle systems.


METHODS
The subjects were 44 women with persistent pelvic pain after pregnancy (mean age=31.7 years, SD=3.2, range=23.6-37.5; mean period postpartum=4.1 months, SD=2.2, range=1.7-5.6).


METHODS
Subjects were randomly assigned to 1 of 3 groups: (1) a group that performed exercises to increase the force of the diagonal trunk muscle systems, (2) a group that received training of the longitudinal trunk muscle systems, and (3) a group that was instructed to refrain from exercises. Pain, fatigue, perceived general health, and mobility of the pelvic joints as measured with radiographs were the outcome measures.


RESULTS
After 8 weeks, no differences were found among the 3 groups.


CONCLUSIONS
In treating patients with persistent pelvic pain, training of the diagonal trunk muscle systems, without individual coaching, has no additional value above instructions and use of a pelvic belt without exercises. Whether the treatment is ineffective or whether exacerbation of symptoms due to loading of the spinal and pelvic structures obscures any potential benefit of increased muscle force cannot be determined from the study design.
Mens
J M
JM
Department of Spine Rehabilitation, Spine and Joint Centre, Westerlaan 10, 3016 CK, Rotterdam, The Netherlands. sjceco@wxs.nl
Snijders
C J
CJ
Stam
H J
HJ
D000009:Abdominal Muscles; D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D049590:Postpartum Period; D016896:Treatment Outcome; D014743:Videotape Recording