AquaMama - Testing the Effect of a Public Water-exercise Program on Low Back Pain and Sick Leave Among Healthy Pregnant Women

Low back pain occurs frequently during pregnancy. Studies show prevalence from 50 to 70% of all pregnant women indicating a general problem. Low back pain increases with gestational age and has been shown to be an important contributing factor to sick leave during pregnancy. Low back pain also has a negative impact on the ability to perform daily chores. It is therefore important to focus on how to prevent or reduce low back pain in pregnant women. Some studies suggest that exercise decreases the pain intensity of low back pain during pregnancy.

However, most women reduce the intensity of exercise and time spent exercising during pregnancy, and many women do not exercise, despite both national and international recommendation advising pregnant women to be physically active at a moderate intensity level for at least 30 minutes per day. The reason for this reduction in physical exercise level can be attributed to the growing body, pregnancy complications or a sense of insecurity while exercising. Exercise such as swimming and exercising in water have been shown to be increasingly used during pregnancy, because pregnant women feel comfortable and safe performing exercises in water. Two randomized intervention studies found that water-exercise during pregnancy can diminish low back pain and reduce the number of days spent on sick leave. In both studies, the intervention was supervised in groups and took place during the day at a scheduled time. These results indicate that supervised water-exercise may have a beneficial effect on healthy pregnant women.

In Denmark, an unsupervised water exercise program for healthy pregnant women, AquaMama, was implemented in public swimming pools in 2011. However, there is no evidence on the effect of unsupervised water exercise programs on the intensity of low back pain and the number of days spent on sick leave. We therefore developed an unsupervised individual water exercise program on the basis of AquaMama supplemented with supportive components to be tested in a randomized controlled trial.

Recruitment Pregnant women are recruited from the Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark. The women are selected on the basis of their due date to time the water exercise intervention from the 20th to 32nd weeks of gestation. The women eligible for participation are invited to participate by a mailed invitation send by post with an enclosed description of the project. After one week the women are contacted by telephone or email and invited to an interview, a physical examination of the pelvic and to fill out a baseline questionnaire.

Intervention