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Motor control of the spine in pregnancy-related lumbopelvic pain: A systematic review

  • Amélie Desgagnés
    Affiliations
    Rehabilitation Department, Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Cirris), Laval University, 525 boulevard Wilfrid-Hamel (G1M 2S8), Quebec City, QC, Canada
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  • Philippe Patricio
    Affiliations
    Rehabilitation Department, Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Cirris), Laval University, 525 boulevard Wilfrid-Hamel (G1M 2S8), Quebec City, QC, Canada
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  • Noémie Bérubé
    Affiliations
    Rehabilitation Department, Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Cirris), Laval University, 525 boulevard Wilfrid-Hamel (G1M 2S8), Quebec City, QC, Canada
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  • Stéphanie Bernard
    Affiliations
    Rehabilitation Department, Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Cirris), Laval University, 525 boulevard Wilfrid-Hamel (G1M 2S8), Quebec City, QC, Canada

    Rehabilitation Department, Laval University, 2325 rue de l'Université (G1V 0A6), Quebec City, QC, Canada
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  • Mélanie Lamothe
    Affiliations
    Clinique PhysioInteractive, 3520 rue de l'Hêtrière (G3A 0B4), Saint-Augustin-de-Desmaures, Quebec City, Canada
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  • Hugo Massé-Alarie
    Correspondence
    Corresponding author at: 525 boulevard Wilfrid-Hamel, Office H-1408, Quebec City, QC G1M 2S8, Canada
    Affiliations
    Rehabilitation Department, Centre interdisciplinaire de recherche en réadaptation et intégration sociale (Cirris), Laval University, 525 boulevard Wilfrid-Hamel (G1M 2S8), Quebec City, QC, Canada
    Search for articles by this author

      Highlights

      • Women with and without pregnancy-related lombopelvic pain were compared.
      • Kinematics differences during walking were present but differ between studies.
      • Transversus abdominis activation during leg movement was larger in lumbopelvic pain.
      • Differences in pelvic floor muscle function were inconsistent.
      • Stereotyped motor control alterations of the lumbopelvic spine were not observed.

      Abstract

      Background

      Some studies observed differences in motor control of the spine between women with pregnancy-related lumbopelvic pain and matched controls. Understanding alterations in spine motor control may help optimizing treatment in this population. The objective is to determine if there are differences in motor control of the spine in pregnant and post-partum women with and without pregnancy-related lumbopelvic pain.

      Methods

      Five databases were searched: MEDLINE, Embase, CINAHL, Web of Science and Evidence-Based Medicine Reviews (last search: February 4th 2021). Observational studies that compared motor control of the lumbopelvic spine (in terms of muscle activation [e.g. using EMG or ultrasound imaging] or kinematics) between women with pregnancy-related lumbopelvic pain and matched controls were included. Risk of bias was assessed with a modified version of STROBE statement for cross-sectional studies. No meta-analysis was performed.

      Finding

      Fifteen studies were included. Compared to matched controls, pregnant women with pregnancy-related lumbopelvic pain showed differences in lumbar spine kinematic during walking and lifting, although not consistent between studies. The only consistent results were higher transversus abdominis muscle activation during leg movements in post-partum pregnancy-related lumbopelvic pain. Differences in pelvic floor muscle function was inconsistent.

      Interpretation

      This systematic review identified multiple differences in motor control in pregnancy-related lumbopelvic pain population, predominantly in dynamic tasks. However, consistent differences in lumbopelvic spine motor control were rare. More studies are necessary to determine if motor control is different in pregnancy-related lumbopelvic pain to better understand alteration in motor control and to optimize the efficacy of rehabilitation treatments.

      Keywords

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