The relationship between pelvis inclination, exercise and low back pain (LBP) during pregnancy [Vztah mezi bolestí zad, sklonem pánve a vhodnou pohybovou aktivitou v těhotenství]

BACKGROUND: Pain in the lower region of the back and pelvis – also called "Low Back Pain" (LBP) - is very frequent during pregnancy. According to many authors it is a major complaint of more than half of all pregnant women; it causes mental and physical discomfort. The etiology of LBP during pregnancy is still not fully known. OBJECTIVE: The main aim of our research was to objectify the relationship between the presence of LBP, the training level of the postural muscles and the degree of the pelvic inclination of women in the third trimester of pregnancy. That is why the relationship between pelvic inclination and LBP occurrence is compared within the context of two groups – reasonable physically active as compared to physically inactive women. METHODS: Twenty-seven pregnant probands aged 20 – 35 years and in the second half of their third trimester were included in the experiment. All of them complained of pain in their lumbar spine and in the pelvicarea. They were divided into two groups: 14 physically inactive women and 13 physically active women, who have been performing physical activity for at least 135 minutes per week for at least 1 year before conception and for at least 90 minutes per week during pregnancy. The exercises were focused on the functioning of the postural system, e.g. yoga, Pilatespilatek and exercises by Mojzisova. We measured the inclination of the pelvis (using non-invasive anthropometric measuring) and observed the presence of pain in the selected area: clinically via the Patrick-Faber test and posterior pelvic pain provocation test and subjectively with the aid of a standardized LBP related survey. The statistical methods used were the t-test, the median and Wilcoxon-White test and the Spearman factor of serial correlations. RESULTS: We observed a statistically significant difference between the pelvic inclination of physically active and inactive women (using a t-test for non-pair values with a significance level of p = 0.01). Another significant difference was evident between the subjective pain sensation of regularly exercising and non-exercising women, which was proven by both the median and the Wilcoxon-White tests (p = 0.01). A significant relationship between pelvic inclination and the sensation of pain classified in a survey by means of a 1-10 scale was proven by the Spearman factor of serial correlations (p = 0.01). CONCLUSIONS: Using mathematical statistical methods, our study has proven the important role of physical activity during pregnancy - its relationship to pain sensation and to the degree of pelvic inclinati