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Vol. 23. Issue 2.
Pages 181-186 (01 March 2019)
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Vol. 23. Issue 2.
Pages 181-186 (01 March 2019)
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DOI: 10.1016/j.bjpt.2018.11.006
Evidence of stabilizing exercises for low back- and pelvic girdle pain – a critical review
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Britt Stuge
Corresponding author
britt.stuge@medisin.uio.no

Correspondence address: Division of Orthopaedic Surgery, Oslo University Hospital, Bygg 72, 2. etg, Pb. 4956 Nydalen, 0424 Oslo, Norway.
Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
Highlights

  • The evidence of core stabilization exercises is controversial.

  • Exercises need to be understood in the bio-psycho-social context.

  • Individually tailor the exercises to the patient's needs and capability.

  • Adherence might increase when the patients understand the aim of the exercises.

  • Exercises need to guided and supervised to secure performance and quality.

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Abstract
Background

Pregnancy-related low back pain (LBP) and pelvic girdle pain (PGP) have been associated with an alteration in the strategy for lumbopelvic stabilization. Different core stabilization approaches exist, the evidence is however controversial.

Methods

This paper discusses how to improve the evidence of exercises for women suffering from LBP and PGP during and after pregnancy. Exercises should be understood in a context, where the bio-psycho-social perspective directs the prescription of exercises, targeting both psychological and physical factors. The type of exercise probably should be individually tailored to the needs and capability of the individual and it is not only about the most appropriate exercise, it is about dosage and delivery of the exercises, and it is about performance. To promote adherence the use of patient preferences, with self-defined movement goals, may be a motivational basis for behavior change. Communication skills may facilitate positive beliefs and provide a motivational foundation for empowerment, self-efficacy and for self-management. To learn by discovery where the patient learns through their own experiences, might motivate the patients to active engagement and to behavioral change. Adherence probably will increase when the patients understand the aim and the rationale behind the exercises they are prescribed. However, with high adherence to exercises that maintains an inappropriate motor pattern, LBP and PGP possibly could proceed into chronicity.

Conclusion

Exercises need to be meaningful to the patient, relevant for daily activities, individualized according to patient preferences, guided and supervised to secure performance and quality.

Keywords:
Low back pain
Pelvic girdle pain
Exercises
Individualization
Physical therapy
Rehabilitation

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