PHYSICAL FITNESS AND THEIR ASSOCIATION WITH LOW BACK PAIN ACROSS GESTATIONAL TRIMESTERS

Abstract

Background: Pregnancy-related low back pain (LBP) is a widespread yet poorly managed condition. While physical activity is recommended, the specific relationship between objectively measured physical fitness and LBP throughout pregnancy remains unclear, hindering the development of effective exercise interventions.Objective: This study aimed to investigate the association between comprehensive physical fitness and the prevalence of LBP in pregnant women during mid- and late-gestation. Methods: In a cross-sectional study at Sir Syed College of Nursing and Allied Health Sciences, Karachi, 180 pregnant women were divided into mid-gestation (14-28 weeks, n=101) and late-gestation (28-37 weeks, n=79) groups. LBP was assessed using the Oswestry Disability Index (ODI). Physical fitness was objectively evaluated using a validated 23-component test system measuring core strength, flexibility, balance, and muscular endurance.Results: A high prevalence of LBP was observed (77.23% in mid-gestation; 72.15% in late-gestation). As pregnancy progressed, significant declines were found in key fitness components: back strength decreased from 32.09 ± 10.22 kg to 28.59 ± 9.07 kg, flexibility worsened from -1.80 ± 7.63 cm to -7.46 ± 9.63 cm, and balance (left blind balance) reduced from 7.30 ± 8.04 seconds to 4.78 ± 4.20 seconds. LBP was negatively correlated with performance in lower limb and gluteal strength exercises, such as standing heel raises and glute kickbacks.Conclusion: The decline in physical fitness, particularly in core strength, flexibility, and balance, is significantly associated with LBP during pregnancy. These findings highlight the critical need for targeted exercise programs that strengthen the core and lower limb muscles to alleviate and potentially prevent pregnancy-related low back pain.

Keywords: Pregnancy-Related Low Back Pain, Physical Fitness, Gestational Trimesters, Core Strength, Exercise Intervention.