Table 2: Methodological quality of randomized controlled trials grouped per symptom

Low Back Pain and Pelvic Girdle Pain
Prenatal prevention
Author and date / Sample characteristics / Control group (C) / Experimental group (E) / Intervention period / Results / PEDro
/10 / Power calculation
Kashanian 09 / 30 women
C:15 E:15
Nulliparous
16 week GA / No intervention / Stretching and strength exercises (hamstrings, adductors, paravertebral and abdominal muscles) 30 minutes 3x/week / 8 weeks / - Sign. effect in relieving LBP (E > C) / 5 / No
Garshasbi 05 / 212 women
C:105 E:107
Nulliparous
17-22 week GA / No intervention / Strength exercises (hamstrings, adductors, iliopsoas, paravertebral and abdominal muscles)
60 minutes 3x/week / 12 weeks / - LBP ↑ in C; and sign. ↓ in E (E > C)
- Sign. decreasing of flexibility of spine (E > C)
- No detectable effect on lordosis (E=C) / 7 / No
Suputtitada 02 / 67 women
C:35 E:32
Nulliparous
3rd trimester / No intervention / Sitting pelvic tilt exercises / 8 weeks / - Sign. differences in mean VAS at day 56 E vs C
(E C)
- Sign. differences in mean VAS at day 0 and 56
in E (VASday56 < VASday0)
- No incidence of negative pregnancy outcomes / 5 / Not mentioned
Kihlstrand 99 / 258 women
C:129 E:129
< 19 week GA / No intervention / 30 minutes water gymnastics + 30 minutes relaxation training 1x/week / 12 weeks / - Sign. effect in relieving LBP (E > C)
- Sign. effect on number of women on sick leave
due to LBP / 6 / Yes
Morkved 07 / 311 women
C:153 E:148
Nulliparous
20 weeks GA / Information / PFMT, stretching, relaxation, aerobic and strength exercises 60 minutes 1x/week under supervision and 2 times daily at home / 12 weeks / - Sign. differences in reporting lumbopelvic pain
immediately after treatment (E C); 3 months
postpartum no sign. differences
- No sign. differences in number of days sick
leave (E=C)
- E has sign. higher scores on functional status
(E>C) / 8 / Yes
Stafne 12 / 855 women
C:365 E:396
20 w GA / Standard antenatal care / Aerobic, strength and balance exercises, breathing, relaxation exercises, 60 minutes
1x/week (group) and
2x/week 45 minutes home exercises / 12 weeks / - No sign. differences in lumbopelvic pain at 36
weeks (E=C)
- Sign. less sick leave due to lumbopelvic pain
(E>C) / 7 / Yes
Eggen 12 / 257 women
C:128 E:129
<20W GA / Standard care / Supervised group session (aerobic, PFMT, circulation ex, strength ex, mobilizing low back, relaxation, stretching; 60 min, 1x/week, info, daily 3 home exercises / 16-20W / - No sign. differences in self-reported LBP and
PGP (E=C)
- No sign. differences in pain intensity in
morning/evening, disability, SF8, PCS, MCS
(E=C) / 7 / Yes
Prenatal treatment
Author and date / Sample characteristics / Control group (C) / Experimental group (E) / Intervention period / Results / PEDro
/10 / Power calculation
Kluge 11 / 50 women
C:24 E:26
16-24 weeks GA
With LBP / No intervention / 30-45 minutes strength, stretch and stabilizing exercises (5 supervised classes and at home) / 10 weeks / - Sign. improvement in pain intensity in E
and no sign. improvement of functional
ability at end of study
- No sign. changes in pain intensity and
functional ability at end of study in C / 7 / Yes
Sedaghati 07 / 90 women
C: 50 E: 40
20-22w GA
With LBP / No intervention / 15 min warm up and cool down, 30 min cycling (55-65% max HR), 3x/W / 8 weeks / - LBP intensity was only significantly increased
in the control group / 5 / No
Peterson 12 / 57 women
C: 20 E1:22
E2:15
With LBP
At any point in pregnancy / Mind-body therapy, 1x/M until 28W, 2x/M until 36W, 4-5x/M until delivery / E1: exercises to promote low back stability and flexibility (15 min 5x/W at home)
E2: spinal manipulative therapy.
1x/M until 28W, 2x/M until 36W, 4-5x/M until delivery / Until delivery / - At least 50%of patients in each group
experienced clinically meaningful improvement
at the Roland Morris Disability Questionnaire.
- At least 50% of E1 and E2 also experienced
clinically meaningful improvement for the
Numeric Pain Rating Scale. / 7 / No
Nilsson-Wikmar 05 / 118 women
C:40 E1:41 E2:37
Until 35 weeks
With PGP / Information + belt / E1: + home stabilizing exercises (exercises session are not recorded)
E2: + strength and stabilizing exercises under supervision 2x/week / 16 weeks / - Pain ↓ and activity level ↑, but no sign.
difference (E=C) / 6 / No
Depledge 05 / 90 women
C:30 E1:28 E2:29
Symphysis pubis dysfunction / Advice and strength exercises 3x daily performed / E1: + rigid belt
E2: + non-rigid belt / 1week / - Pain ↓ in all three groups, but no additive effect
of belts (E1 en E2=C) / 6 / Yes
Haugland 06 / 569 women
C:285 E:275
18th-32nd week GA
With PGP / No intervention (free to seek advice or therapy) / Information + exercise + belt
2 hours 1x/week / 4 weeks / - Improving of postpartum PGP, but no sign.
difference E vs C (E=C)
- 60% of C searched treatment elsewhere (bias) / 5 / No
Kordi 13 / 105 women
C:35 E1: 31 E2: 31
With PGP / Information / E1: non rigid lumbopelvic belt plus info
E2:home based PG stabilizing exercises (brisk walking 25 min/d; 3x/W; stretching and strengthening exercises 2x/d,3x/W; plus info / 6 weeks / - The pain intensity of E1 was decreased
significantly at 3 and 6 weeks FU compared to
E2 and C.(E1>E2 en C)
- The mean score of the Oswestry Disability
Index of E1 was improved more than E2 and C
significantly. (E1>E2 en C) / 5 / No
Elden 05 / 386 women
C:130 E1:125 E2:131
With PGP / Information, pelvic belt, exercises / E1: + acupuncture
30 minutes 2x/week
E2: + stabilizing exercises 1 hour 1x/week / 6 weeks / - Sign. differences in morning and evening pain in
favor of E (E > C; E1 > E2) / 8 / Yes
Elden 08 / 386 women
C:130 E1:125 E2:131
With PGP / Follow-up 12 weeks after delivery / - No sign. differences in recovery between the 3
treatment groups (E1=E2=C)
- PGP sign. resolved in 99% of the women 12
weeks postpartum
- 3-quarters of the women were pain free 3 weeks
postpartum / 5 / Yes
Elden 13 / 123 women
C:60 E:63
With PGP / Standard treatment (= elastic pelvic belt + home exercises (strengthen + stretch trunk/hip/ shoulder muscles) / Standard treatment + craniosacral therapy (45 min 1x/W (2W), 45 min 1x/2W (6W)) / 8 weeks / - Morning pain intensity was lower and function
less deteriorated after craniosacral therapy.
(E>C)
- No differences in evening pain and sick-leave
were found between both groups. (E=C)
- Treatment effects were small and further studies
are needed before recommending craniosacral
therapy for PGP. / 8 / Yes
Weight increase
Prenatal prevention
Author and date / Sample characteristics / Control group (C) / Experimental group (E) / Intervention period / Results / PEDro
/10 / Power calculation
Polley 02 / 120 women
C:53 E:57
BMI > 19,8
< 20 weeks GA / Standard prenatal care / Diet + exercise / 20 w GA -> 6 weeks postpartum / - Percentage of normal-weight women who
exceeded the IOM recommendations was sign.
lower in E; but the effect in opposite direction
among overweight women was not significant
- Postpartum weight retention is related to weight
gain during pregnancy / 5 / No
Asbee 09 / 100 women
C:43 E:57
6-16 weeks GA / Standard prenatal care / Diet + exercise 3-5x/week / Not mentioned / - E gained sign. less weight than C (E>C)
- Nulliparous women gained sign. more weight
than parous women
- No sign. differences between groups in GDM,
pre-eclampsia / 5 / Yes
Hui 12 / 190 women
C:88 E:102
< 26 weeks GA / Standard prenatal care / Diet + exercise
30-45 minutes 3-5x/week at mild-moderate level / 16 weeks / - Sign. difference in daily intake of calories, fats
and cholesterol after 2 m in favor of E (E>C)
- E had higher physical activity after 2M than C
(E>C)
- Prevalence of EGWG reduced sign. more in E
than C (E>C) / 6 / Yes
Hui 06 / 52 women
C:21 E:24,
7 drop-out
20 to 30 weeks GA / Information on diet+ exercise / Diet + exercise
30-45 minutes 3-5x/week at / 16 weeks / - No sign. difference in weight gain (E=C) / 5 / No
Cavalcante 09 / 71 women
C:37 E:34
Sedentary
16-20 weeks GA / No exercise / Water aerobics 50 minutes 3x/week at moderate intensity / 20 weeks / - No sign. differences in maternal weight gain,
BMI, percentage body fat during pregnancy
(E=C) / 7 / Yes
Price 12 / 62 women
C:31 E:31 / No exercise / Moderate aerobic exercise 45-60 minutes 4x/week / 24 weeks / - No sign. difference in weight gain (E=C) / 6 / No
Haakstad 11 / 105 women
C:53 E:52
Sedentary
Nulliparous / Standard prenatal care / Supervised exercise program (aerobic dance + strength training) / 12 weeks / - Sign. difference in maternal weight loss during
pregnancy and 6-8 months postpartum (E > C) / 6 / Yes
Barakat 13 / 510 women
C:255 E:255 / Usual care / Moderate aerobic exercise 50 minutes 3x/week / - Sign. difference in weight gain, 12% lower in E
group (E>C) / 6 / Yes
Sedaghati 07 / 90 women
C: 50 E: 40
20-22w GA / No intervention / 15min warm up and cool down, 30 min cycling (55-65% max HR), 3x/W / 8 weeks / - Sign. difference in weight gain in favor of E
(E>C) / 5 / No
Huang 11 / 189 women
C:64 E1:64 E2:61 / Standard prenatal care / E1: 6 sessions of individual counseling (diet + postnatal exercise)
E2: 6 sessions of individual counseling (diet + pre/postnatal exercise) / E1: birth -> 6 months postpartum
E2: pregnancy -> 6 months postpartum / - Sign. differences in gestational weight gain in
favor of E (E2 C en E1)
- Sign. difference in weight retention at 6 months
postpartum (E2 > C en E1) / 5 / Yes
Prenatal treatment
Author and date / Sample characteristics / Control group (C) / Experimental group (E) / Intervention period / Results / PEDro
/10 / Power calculation
Phelan 11 / 401 women
C:200 E:201
13,5 weeks GA
Normal-weight, overweight or obese / Standard prenatal care / Diet + exercise / 13,5 w GA
-> 6 months postpartum / - Sign. reduction of EGWG in normal-weight
women
- Sign. prevention of weight retention in
normal-weight women
- No sign. effect on EGWG in obese/
overweight women / 6 / No
Vinter 11 / 304 women
C:154 E:150
10-14 weeks GA
BMI 30-45 kg/m² / Standard prenatal care / Exercise training (aerobic, resistance, balance) 30-60 minutes daily + 4 sessions of dietary counseling / 10 – 14 weeks GA -> 35 weeks GA / - Sign. less GWG in E than C (E>C)
- The IOM recommendations on GWG were
exceeded in sign. less women in E than C / 5 / Yes
Santos 05 / 72 women
C:35 E:37
Overweight
< 20 weeks GA / Relaxation + group discussions / Aerobic training 60 minutes 3x/week under supervision / 12 weeks / - Sign. differences in oxygen uptake at
anaerobic threshold (18% increased in E,
16% decreased in C)
- E is 5 times more likely than C to have
regular/good cardiorespiratory capacity / 7 / Yes
Nascimento 11 / 82 women
C:42 E:40
14-24 weeks GA
Overweight or obese (BMI≥30 kg/m²) / Standard prenatal care / Supervised light-moderate exercise program (40 minutes weekly) + home exercises (5x/week) / 22 weeks / - No sign. difference in gestational weight
gain E vs C (E=C)
- Only overweight, not obese pregnant women
gained sign. less weight during pregnancy
and after study entry than C (E>C) / 5 / Yes
Oostdam 12 / 121 women
C:59 E:6 2
16 weeks GA / Standard care / aerobic and strength exercise 60 minutes 2x/week / 24 weeks / - No sign. difference in gestational weight
gain.(E=C) / 7 / Yes
Gestational Diabetes Mellitus
Prenatal prevention
Author and date / Sample characteristics / Control group (C) / Experimental group (E) / Intervention period / Results / PEDro
/10 / Power calculation
Stafne 12 / 855 women
C:381 E:381
18-22 week GA
Normal BMI / Standard prenatal care / Moderate – high intensity exercise training 45-60 minutes 3x/week / 12 weeks / - No sign. differences in prevalence of GDM
between groups.(E=C)
- No differences in insulin resistance between
groups
- Similar pregnancy outcomes in E and C / 7 / Yes
Barakat 13 / 510 women
C:255 E:255
10-12 week GA / Usual care / Moderate aerobic exercise 50 minutes 3x/week / From 10-12 week GA till 38-39 w / - No sign. difference in developing GDM
(E=C) / 6 / Yes
Hui 06 / 52 women
C:21 E:24,
7 drop-out
26 weeks GA / Information on diet+ exercise / Diet + exercise
30-45 minutes 3-5x/week at / 20 w -> 36 w GA / - No sign. difference in prevalence of GDM
(E=C) / 5 / No
Price 12 / 62 women
C:31 E:31
12-14 weeks GA / No exercise / Moderate aerobic exercise 45-60 minutes 4x/week / 12-14 w -> 36 w GA / - No sign. difference in prevalence of GDM
(E=C) / 6 / No
Oostdam 12 / 121 women
C:59 E:6 2
16weeks GA / Standard care / aerobic and strength exercise 60 minutes 2x/week / 24 weeks / - No sign. difference in prevalence of GDM
(E=C) / 7 / Yes
Prenatal treatment
Author and date / Sample characteristics / Control group (C) / Experimental group (E) / Intervention period / Results / PEDro
/10 / Power calculation
Avery 97 / 29 women
C:14 E:15