Exploring exercise prescription parameters for pregnancy-related pelvic girdle pain: A systematic review and meta-analysis of effects on pain and function.
TL;DR
In conclusion, structured, supervised abdominopelvic core training is effective for pregnancy-related PGP, and limited subgroup data indicated that supervised abdominopelvic core exercise was associated with more pronounced effects; however, these findings were based on limited data with substantial heterogeneity and certainty ranging from very low to moderate.
Abstract
Exercise is recommended for pregnancy-related pelvic girdle pain (PGP), while consensus on specific prescription parameters remains uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to investigate the effects of exercise interventions and to explore the influence of different prescription parameters on pain and functional improvement in pregnancy-related PGP. Seven databases (the Cochrane Library, Web of Science, Embase, PubMed, CINAHL, Ovid, and PEDro) were searched from inception to December 2025 for randomized controlled trials (RCTs) assessing exercise therapy in PGP, with pain and disability as outcomes. Using the Cochrane ROB 2 tool for risk of bias assessment, we included 11 RCTs (n = 810). Exercise interventions significantly reduced pain (SMD: -0.81; 95% confidence interval [CI]: -1.06, -0.55; I² = 63.9%) and improved function (SMD: -0.69; 95% CI: -1.01, -0.37; I² = 66.2%), with moderate certainty. Evidence was assessed using the GRADE approach. Limited subgroup data indicated that supervised abdominopelvic core exercise (3 sessions/week, 30-60 min/session, 6-10 weeks in duration) was associated with more pronounced effects; however, these findings were based on limited data with substantial heterogeneity and certainty ranging from very low to moderate. In conclusion, structured, supervised abdominopelvic core training is effective for pregnancy-related PGP. Collectively, these subgroup findings provide a preliminary, hypothesis-generating framework to inform future trial design, pending validation in adequately powered studies. This protocol was registered at PROSPERO (CRD420251106116). Perspective: By delineating key exercise prescription parameters for future investigation, this review offers preliminary guidance to inform clinicians in optimizing exercise regimens, underscoring the need for further high-quality research.