Effects of water- and land- based exercise programmes on women experiencing pregnancy- related pelvic girdle pain: a randomized controlled feasibility study

Author(s): K. L. Scott, M. Hellawell - Pages: 21–29

Abstract

The aims of this study were to address: whether a water-based exercise programme decreased pain in pregnant patients with pelvic girdle pain (PGP), and improved their quality of life, in comparison to a land-based exercise programme; and the feasibility of undertaking a large-scale research project. Twenty-three participants with a diagnosis of PGP were recruited at St George’s Hospital, London, UK, and randomized into two groups, and prescribed either water- or land-based exercise. Each group received four, weekly exercise sessions on land or in water. The effects of the exercise on PGP were measured using the Pelvic Girdle Pain Questionnaire (PGPQ; the primary outcome), a visual analogue scale, the Patient-­Specific Functional Scale (PSFS) and the active straight-­leg raise (ASLR) test. Quality of life was measured using the Subjective Exercise Experience Scale (SEES). Outcomes were assessed at baseline and after 4 weeks of exercise. The results showed that there was a clinically significant improvement in all outcome measures in the water-based exercise group in comparison to the land-based one. A statistically significant difference between groups was shown for the ASLR (P = 0.036), and the Positive Well-Being (P = 0.000) and Fatigue subscales of the SEES (P = 0.011). No statistical differences were found between the scores for the PGPQ (P = 0.056), PSFS (P = 0.530) and Psychological Distress subscale of the SEES (P = 0.712). Exercise in water appears to offer greater clinical benefits to patients who are experiencing PGP in comparison to land-based exercise, particularly with regard to the SEES Fatigue and Positive Well-­Being subscales, and ASLR scores. The statistical significance of the differences between the two groups was limited by the small sample size, and because no power calculation was used. Nevertheless, the methodology and results suggest that a larger study of this kind could provide more-­definitive conclusions to support the use of water-­based exercise therapy for PGP.

Keywords: hydrotherapy, pelvic girdle pain, physical therapy, pregnancy, quality of life.