運動對於懷孕相關下背與骨盆疼痛之成效

Effects of Exercise on Pregnancy-Related Lumbopelvic Pain: A Systematic Review

懷孕時期的下背與骨盆疼痛盛行率高，部分延續至產後仍有疼痛情形，且會干擾婦女睡眠、日常生活與工作，降低生活品質，甚至影響母嬰關係，且近年來越來越多的研究指出運動對於懷孕時的下背與骨盆疼痛有部分助益，需要系統性文獻回顧彙整與評析。本研究目的乃針對運動性介入措施對孕期下背與骨盆疼痛治療的相關研究進行系統性文獻探討，藉由綜述其研究設計與方法、介入措施、結果與研究的品質，提供臨床專業人員參考與提出未來研究展望。本研究參考Kingdon、Baker 與Lavender（2006）使用的方式進行文獻篩選，運用Cochrane Library、MEDLINE、CINAHL、PsycInfo、CEPS 思博網、與國家圖書館之中文期刊篇目索引系統六個資料庫，關鍵字設MeSH 字串為「pregnancy」與「pain」，尋找 1997至2010 年發表之措施研究。經篩選後共有八篇研究納入分析，這些研究均採用隨機控制試驗的研究設計，多以疼痛強度、功能狀態與生活品質作為評價措施效果的指標，發現核心穩定運動、水中有氧運動與骨盆底運動為主要的措施，其成效指標的水準在實驗組與控制組的疼痛強度、功能狀態與生活品質，均有顯著差異。核心穩定運動、水中有氧運動與骨盆底運動可能有助於改善懷孕相關下背與骨盆疼痛。

Pregnancy-related lumbopelvic pain (PR-LP) is prevalent worldwide and may persistent after delivery. PR-LP also affected women’s sleep, daily life, work, quality of life, and even mother-infant attachment. Recently, more and more studies indicated that exercise might be effective in reducing PR-LP. This study aims (1) to systematically review intervention studies involving exercise in reducing PR-LP, including the methods, outcome variables, instruments, and results, and (2) to analyze the strength, weakness, and future directions. According to the systematic review manual developed by Kingdon, Baker, and Lavender (2006), this study searched intervention studies in the Cochrane Library, MEDLINE, CINAHL, PsycInfo, CEPS, and Index to Taiwan Periodical Literature System of the National Central Library, with setting key words “pregnancy” and “pain” from year 1997 to 2010. Eight studies were included and analyzed after screening by inclusion and exclusion criteria. We found that these studies all adopted randomized control trial design. Most of these studies used pain intensity, functional status, and quality of life as outcome indicators. Stabilizing exercise, water aerobics, and pelvic tilt exercise could improve PR-LP effectively.