Full length article| Volume 265, P18-24, October 2021

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Expert advice about therapeutic exercise in the management of sacroiliac dysfunction in pregnancy: Secondary analysis of a randomized trial

  • Manuela Filipec
    Corresponding author at: Department of Physiotherapy, University North, Varazdin, Croatia.
    Department of Physical Medicine and Rehabilitation, Clinical Hospital ‘Sveti Duh’, Zagreb, Croatia

    Department of Physiotherapy, University North, Varazdin, Croatia
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  • Ratko Matijević
    Department of Obstetrics and Gynaecology, University of Zagreb, Zagreb, Croatia

    School of Medicine, Merkur University Hospital, Zagreb, Croatia
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      • Sacroiliac dysfunction during pregnancy is a primary cause of pain and disability.
      • There is wide heterogeneity in approaches to sacroiliac dysfunction in pregnancy.
      • Expert advice is effective for the reduction of symptoms of sacroiliac dysfunction.



      To assess primiparous and multiparous women, and singleton and multiple pregnancies in a recently published randomized trial.

      Study design

      Secondary analysis of a randomized clinical trial was performed. In total, 500 women with sacroiliac dysfunction diagnosed in pregnancy were randomized into a study group (who received expert advice about therapeutic exercise) and a control group (who continued with their normal lifestyle habits). The outcome measures assessed were: pain intensity [visual analogue scale (VAS)] and degree of functional disability (Quebec scale) at enrolment and after 3 and 6 weeks. Primiparous and multiparous women, and singleton and multiple pregnancies in the study and control groups were analysed separately.


      Sacroiliac dysfunction was more common in primiparous women compared with multiparous women (84.70% vs 77.16%), and in multiple pregnancies compared with singleton pregnancies (86.53% vs 80.07%). For all four subgroups analysed in this secondary analysis, the reduction in pain intensity (p = 0.001) and the degree of functional disability (p = 0.001) were better in the study group compared with the control group. Better results for the two outcome measures were found when comparing primiparous and multiparous women in the study group at follow-up, but the difference in functional disability disappeared 6 weeks after enrolment (p = 0.383). There was no difference in the two outcome measures between singleton and multiple pregnancies 3 and 6 weeks after enrolment (p = 0.061, p = 0.489 and p = 0.741, p = 0.353, respectively).


      Expert advice about therapeutic exercise is effective for the reduction of symptoms of sacroiliac dysfunction in all four subgroups (primiparous and multiparous women, singleton and multiple pregnancies). Earlier reduction of pain intensity and degree of functional disability were obtained in primiparous women compared with multiparous women in the study group.


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