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Systematic review
Impact of exercise on musculoskeletal pain and disability in the postpartum period: a systematic review and meta-analysis
  1. Stephanie-May Ruchat1,
  2. Nicole Beamish2,
  3. Sophie Pellerin3,
  4. Muhammad Usman4,
  5. Sinead Dufour5,
  6. Sarah Meyer6,
  7. Allison Sivak7,
  8. Margie H Davenport6
  1. 1 Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
  2. 2 School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
  3. 3 University of Montreal Faculty of Medicine, Trois-Rivières, Quebec, Canada
  4. 4 McMaster Evidence Review and Synthesis Centre and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
  5. 5 McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
  6. 6 Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children’s Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
  7. 7 Geoffrey & Robyn Sperber Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada
  1. Correspondence to Dr Stephanie-May Ruchat; Stephanie-May.Ruchat{at}uqtr.ca

Abstract

Objective To examine the impact of exercise on musculoskeletal pain (low back pain (LBP), pelvic girdle pain (PGP), lumbopelvic pain (LBPP) and bodily pain) and kinesiophobia during the postpartum period.

Design Systematic review with random effects meta-analysis.

Study eligibility criteria Online databases were searched from database inception to 12 January 2024. Studies of all designs (except case studies) of any publication date or language were included if they contained information on the population (women and people in the first year postpartum), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone (‘exercise-only’) or in combination with other interventions (eg, electrotherapy, infrared irradiation, ultrasound; ‘exercise+cointervention’)), comparator (no exercise or different exercise measures) and outcome (symptom severity of LBP/PGP/LBPP, related disability, bodily pain and kinesiophobia).

Results 37 studies (N=3769 participants) from 15 countries were included. Moderate certainty evidence showed that exercise-only interventions, including various strengthening exercises targeting the trunk muscles, were associated with a greater reduction in LBPP symptom severity (4 randomised controlled trials (RCTs), n=210; mean difference −2.21 points (on a 0–10 Visual Analogue Scale) 95% CI −3.33 to −1.08) and related disability (6 RCTs, n=296; standardised mean difference −1.17, 95% CI −1.92 to −0.43; large effect size) as compared with no exercise. Similar results were found for bodily pain (2 RCTs, n=318). Evidence was limited and inconclusive regarding the impact of exercise interventions on kinesiophobia.

Conclusion Postnatal exercises, including a variety of muscular strengthening exercises targeting the trunk muscles, decrease the symptom severity of LBPP and related disability.

  • Exercise
  • Back
  • Meta-analysis
  • Women

Data availability statement

Data are available on reasonable request.

https://doi.org/10.1136/bjsports-2024-108488

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    Data availability statement

    Data are available on reasonable request.

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    Footnotes

    • X @nfbeamish, @ExercisePreg

    • Contributors MHD, S-MR and MU contributed to the conception of the study. MHD, S-MR, MU and AS contributed to the study’s design and development of the search strategy. AS conducted the systematic search. S-MR, SP and SM completed the data acquisition. S-MR performed the data analysis. MHD, S-MR, NB, MU and SD assisted with the interpretation. S-MR and MHD were the principal writers of the manuscript. All authors contributed to the drafting and revision of the final article. All authors approved the final submitted version of the manuscript. S-MR is the guarantor.

    • Funding SMR is funded by the Université du Québec à Trois-Rivières research chair in physical activity and maternal and neonatal health. MHD is funded by a Christenson Professorship in Active Healthy Living.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.