Impact of exercise on musculoskeletal pain and disability in the postpartum period: a systematic review and meta-analysis

Stephanie-May Ruchat; Nicole Beamish; Sophie Pellerin; Muhammad Usman Ali; Sinead Dufour; Sarah Meyer; Allison Sivak; Margie H Davenport

doi:10.1136/bjsports-2024-108488

journal article Feb 08, 2025

Impact of exercise on musculoskeletal pain and disability in the postpartum period: a systematic review and meta-analysis

Stephanie-May Ruchat

Sarah Meyer Allison Sivak

Margie H Davenport

British Journal of Sports Medicine Vol. 59 No. 8 pp. 594-604 · BMJ

View at Publisher Save 10.1136/bjsports-2024-108488

Abstract

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.

Topics

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Details

Published: Feb 08, 2025
Vol/Issue: 59(8)
Pages: 594-604

Authors

S

Stephanie-May Ruchat

Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada

N

Nicole Beamish

School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada

S

Sophie Pellerin

University of Montreal Faculty of Medicine, Trois-Rivières, Quebec, Canada

M

Muhammad Usman Ali

McMaster Evidence Review and Synthesis Centre and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada

S

Sinead Dufour

McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada

S

Sarah Meyer

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

A

Allison Sivak

Geoffrey & Robyn Sperber Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada

M

Margie H Davenport

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

Funding

Université du Québec à Trois-Rivières

Christenson Professorship in Active Healthy Living

Cite This Article

Stephanie-May Ruchat, Nicole Beamish, Sophie Pellerin, et al. (2025). Impact of exercise on musculoskeletal pain and disability in the postpartum period: a systematic review and meta-analysis. British Journal of Sports Medicine, 59(8), 594-604. https://doi.org/10.1136/bjsports-2024-108488

Impact of exercise on musculoskeletal pain and disability in the postpartum period: a systematic review and meta-analysis

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