Randomized Study on the Evaluation of the Regular Practice of Standardized Postures Stretching Postural® in Secondary Prevention of Low Back Pains During Pregnancy.

NCT03765853 | Completed

• 2 other identifiers: 2018-502018-A01759-46
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Lower back pain (LBP) during pregnancy is a frequent syndrome: it concerns two thirds of pregnant women. This complaint isn't routinely searched for and therefore underdiagnosed. Furthermore, few solutions are given to these women in order to reduce their pain, and indirectly to improve everyday life. What's more, LBP is the cause of many work interruptions. Physical exercise during pregnancy is recommended by the National College of Gynaecologists and Obstetricians for low risk pregnancies. Several techniques have proven to be efficient. The main objective of our study is to assess the benefit of regular practice of standardised Stretching Postural® postures in patients presenting "de novo" lower back pain during pregnancy. The Stretching Postural® technique comprises of static postures involving muscular contractions and stretches. This allows the strengthening of the postural muscles, including the paravertebral muscles. After a short learning period, postures can be done autonomously by the patients. The postures are adaptable to each and everyone's morphology and physical limitations. Our study is an open, prospective, randomised monocentric superiority trial in parallel branches involving major patients during low risk pregnancies. These women suffer from "de novo" lower back pain during the second and third trimesters of their pregnancies. Each patient will be randomly assigned to one of the following 2 groups:

• Stretching Postural® group (group A): usual prevention methods (ergonomic education) and Stretching Postural® postures.
• "Control" group (group B): usual prevention methods only. Patients presenting "de novo" LBP are included in the study after a routine consult then randomly separated into two groups. During the initial consult, the physician assesses inclusion and judgement criteria, collects informed consent from the patients and teaches them the usual prevention methods as well as, concerning group A, Stretching Postural® postures. Computerized support agendas are given in order to improve observance. Patients are evaluated at day 0 (initial evaluation), after 4 weeks (intermediate) and after 8 weeks (final), according to the main judgment criterion, as well as on secondary pain criteria by the Concise Pain Questionnaire, on their quality of life, the rate of work interruptions and their satisfaction rate. Neonatal outcome is collected at birth. Intermediate phone interviews will allow psychological support and improve observance. Inclusion is scheduled to last 22 months; each subject will be followed during a period of 2 months. The total duration of the study is 2 years. Expected results are a decrease in back pain and an improvement of the quality of life in group A. Decrease in pain scale, equivalent to overall pain during the last week between the two groups will be our main judgment criterion. In order to detect a difference of 1.5 pain scale points (on a scale from 1 to 10) with an alpha risk of 5%, 80% magnitude and a standard deviation of 2, 56 subjects are necessary; 28 in each group. Perspectives: This study will allow for a better diagnosis of lower back pain during pregnancy, and, consequently, for the implementation of routine means of care such as collective or private lessons in Stretching Postural® and the supply of personalised prevention documents.

Conditions

Lower Back Pain

Outcome Measures

Primary Outcomes (1)

• Change in Lower Back Pain

  Evaluated on the Numeric Pain Rating Scale (0 = No pain to 10 = Worst possible pain). This scale, validated, is a self-assessment of the average pain felt during the last week collecting by an evaluation questionnaire. It's part of Concise Pain Questionnaire's questions.

  2 months

Secondary Outcomes (1)

• Assessment of the analgesic efficacity on the Numeric Pain Rating Scale representing the average pain on the last week at 4 weeks.

  week 4

Study Arms (2)

Stretching Postural®

OTHER

Other: Physiotherapy

Control

NO INTERVENTION

Interventions

Physiotherapy OTHER

Usual prevention methods (ergonomic education) and Stretching Postural® postures.

Stretching Postural®

Eligibility Criteria

• Age: 18 Years+
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Pregnant patients between 15 and 32 amenorrhea at the beginning of the study
• Absence of pre existing major lower back pain
• Back or lumbar pain and/or sacroiliac
• Good understanding of French
• BMI before pregnancy \<35
• singletons
• Low risk pregnancy : no maternal and foetal major pathology (absence of professional risk, no antecedent of obstetric pathology, major gynecological pathology, exposure to toxic, important medical risk factors, infectious disease)
• Possibility to listen a computer audio
• Patient having accepted to participate to the study and having signed informed consent.

You may not qualify if:

• Physical handicap not allowing the change of positions in autonomy
• Severe cardiac, lung,hepatic, rheumatological pathology
• Sciatic without LPB (Low Back Pain), motor deficit or slipped disc
• High risk pregnancy
• maternal plan : antecedent of late miscarriage, cervix cerclage, disease having an impact on pregnancy, unbalanced diabetes insulin.
• foetal plan : multiple pregnancy, severe intrauterine growth retardation, severe foetal pathology.

Sponsors & Collaborators

• Assistance Publique Hopitaux De Marseille: lead

Study Sites (1)

Service de Gynécologie Obstétrique - Hôpital Nord

Marseille, Marseille Cedex, 13915, France

Location

Related Publications (1)

• Barbier M, Blanc J, Faust C, Baumstarck K, Ranque-Garnier S, Bretelle F. Standardized Stretching Postural postures to treat low-back pain in pregnancy: the GEMALODO randomized clinical trial. Am J Obstet Gynecol MFM. 2023 Oct;5(10):101087. doi: 10.1016/j.ajogmf.2023.101087. Epub 2023 Jul 11.

  PMID: 37437692 RESULT

MeSH Terms

Conditions

Low Back Pain

Interventions

Physical Therapy Modalities

Condition Hierarchy (Ancestors)

Back Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Therapeutics; Rehabilitation

Study Officials

• Jean Olivier Arnaud, Director

  Assistance Publique Hôpitaux de Marseille

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: December 4, 2018
• First Posted: December 5, 2018
• Study Start: November 1, 2018
• Primary Completion: September 22, 2020
• Study Completion: September 22, 2020
• Last Updated: May 8, 2026

Record last verified: 2022-08

Locations

FR (1)