Effect of physioball selected exercise on low back pain, lumbar lordosis, strength and flexibility in pregnant women

Document Type : Original Article


1 M.Sc. student of Physical Education and Sport Sciences, Mashhad Imam Reza University, Mashhad, Iran.

2 Associate professor, Department of Physical Education and Sport Sciences, School of Physical Education and Sport Sciences, Ferdowsi University of Mashhad, Mashhad, Iran

3 Associate professor, Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


Introduction: Back pain during pregnancy is a common condition which is often considered as an unavoidable problem. Exercise is one of the methods to reduce it and increase physical strength and flexibility. Physiobal is also one of the exercises; therefore, this study was performed with aim to evaluate the effect of one course of physioball selected exercise on low back pain, lordosis and performance (power and flexible) of lumbar-sacral region in pregnant women.
Methods:This quasi-experimental study and applicable in terms of goal was performed on 18 healthy pregnant women (in 5-8 months of pregnancy) with age range of 20-35 years and certain degree of back pain referred to the gynecology clinic of Mashhad Omol-Banin (sa) hospital in 2015. Variables were back pain, lordosis, lumbar muscle strength and flexibility. Physioball exercise lasted for 21 sessions, 3 days a week, 60 minutes each session which included 5 to 10 minutes of warm-up and then one ball was allocated to each participant and physioball exercise was performed. The severity of exercises increased based on the principle of overload and individual abilities of pregnant women. Data were analyzed using SPSS software (version 19) and Kolmogorov-Smirnov, Levan, repeated measure analysis of variance and covariance analysis test. pResults: According to the findings of this study, physioball exercises reduced back pain in pregnant women (p=0.020), also strength significantly increased (p=0.000), but had no effect on the amount of lordosis (p=0.072) and lateral flexibility (p=0.11).
Conclusion: The physioball selected exercises during pregnancy can be an effective method to increase the strength of lumbar-sacral muscles and reduce back pain in pregnant women. But it cannot affect the amount of lordosis because as pregnancy progresses, it leads to more weight gain and weight gain seems to be the main cause of lordosis. Also, physioball exercise has no flexible significant effect on lateral flexibility of lumbar-sacral muscles.


  1. Rahmanynia F, Mohebi H, Sam F. Compare the result of pregnancy and healthy baby at birth in mothers athlete and non-athlete. J move 2006; 16:39-56. (Persian).
  2. Abbasi S. The relationship between physical activity levels of cortisol and anxiety levels of pregnant women during childbirth. [Master's Thesis]. Mashhad, Iran: Ferdowsi University of Mashhad; 2006. (Persian).
  3. Borg-Stein J, Dugan SA, Gruber J. Musculoskeletal aspects of pregnancy. Am J Phys Med Rehabil 2005; 84(3):180-92.
  4. Fong SS, Tam YT, Macfarlane DJ, Ng SS, Bae YH, Chan EW, et al. Core muscle activity during TRX suspension exercises with and without kinesiology taping in adults with chronic low back pain: implications for rehabilitation. Evid Based Complement Alternat Med 2015; 2015(6):16-23.
  5. Garshasbi A, Faghih Zadeh S. The effect of exercise on the intensity of low back pain in pregnant women. Int J Gynaecol Obstet 2005; 88(3):271-5.
  6. Alamzadeh M, Farahpour N, Mohammadi M. The role of special exercises to reduce back pain during pregnancy in women with no history of sports. J move 2006; 25:53-62. (Persian).
  7. Naimi S. The relationship between trunk proprioceptive acuity and back pain in pregnancy women. J Shahid Beheshti Univ Med Sci 2005; 11(49):10-5. (Persian).
  8. Zand S, Rafiei M, Zamani A. The impact of simple exercises and correct posture variables affecting everyday tasks on low back pain during pregnancy. J Mashhad Univ Med Sci 2011; 62:48-53. (Persian).
  9. Saeedi S. Assessing the impact of changes in lumbar lordosis and low back pain during pregnancy and 8 weeks postpartum women corrective exercises on lordosis and low back pain. [Master's Thesis]. Shahrekord, Iran: University of Shahrekord; 2011. (Persian).
  10. Richardson CA, Snijders CJ, Hides JA. The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain. Spine 2002; 27(4):399–405.
  11. Farahpour N. Effects of a special training program to reduce back pain in pregnant women. [Master's Thesis]. Tehran, Iran: Tarbiat Modarres University; 2001. (Persian).
  12. Yan CF, Hung YC, Gau ML, Lin KC. Effects of a stability ball exercise programme on low back pain and daily life interference during pregnancy. Midwifery 2014; 30(4):412-9.
  13. Daneshmandi H, Alizadeh MH, Gharakhanlou R. Corrective Exercises and Therapy. 1st ed. Tehran: Samt Publication; 2004. (Persian).
  14. Tharaco-lumber spine backward bending (Extenion). Goniometry. Available at: URL: http://www.scranton.edu/faculty/kosmahl/courses/gonio/spine/pages/thor-back.shtml; 2015.
  15. Rajabi R, Samadi H. Laboratory manual of corrective exercises for post graduate students. Tehran, Iran: University of Tehran Press; 2009. (Persian).
  16. Spalding A, Kelly LE. Fitness on the ball: a core program for brain and body. New York: Human Kinetics, Pap/Cdr; 2010.
  17. Mirzakhani K, Hejazinia Z, Golmakani N, Sardar MA, Shakeri MT. The effect of birth ball exercises during pregnancy on mode of delivery in primiparous women. J Midwifery Reprod Health. 2015; 3(1):269-75.
  18. Rouhi M. The effect of a special training program on muscular fitness and disability from back pain in pregnant women. [Master's Thesis]. Isfahan, Iran: Isfahan of University of Medical Science; 2013. (Persian).
  19. Kihlstrand M, Stenman B, Nilsson S, Axelsson O. Water-gymnastics reduced the intensity of back/low back pain in pregnant women. Acta Obstet Gynecol Scand 1999; 78(3):180-5.
  20. Wedenberg K, Moen B, Norling A. A prospective randomized study comparing acupuncture with physiothepy for low-back and pelvic pain in pregnancy. Acta Obstet Gynecol Scand 2000; 79(5):331-5.
  21. Martins RF, Pinto e Silva JL. An exercise method for the treatment of lumbar and posterior pelvic pain in pregnancy. Rev Brasil Ginecol Obstet 2005; 27(5):275-82.
  22. Morkved S, Salvesen KA, Schei B, Lydersen S, Bø K. Does group training during pregnancy prevent lumbopelvic pain? A randomized clinical trial. Acta Obstet Gynecol Scand 2007; 86(3):276-82.
  23. Miri T. Comparison exercises and protocols Williams researcher on the mechanical chronic low back pain middle-aged women. [Master's Thesis]. Mashhad, Iran: Ferdowsi University of Mashhad; 2014. (Persian).
  24. Dumas GA, Reid JG, Wolfe LA, Griffin MP, McGrath MJ. Exercise, posture and back pain during pregnancy. Clin Biomech1995; 10(2):98-103.
  25. Nilsson-Wikmar L, Holm K, Öijerstedt R, Harms-Ringdahl K. Effect of three different physical therapy treatments of pain and activity in pregnant women with pelvic girdle pain: a randomized clinical trial with 3, 6 and 12 months follow-up postpartum. Spine 2005; 30(8):850-6.
  26. Haugland KS, Rasmussen S, Daltveit AK. Group intervention for women with pelvic girdle pain in pregnancy. A randomized controlled trial. Acta Obstet Gynecol Scand 2006; 85(11):1320-6.
  27. Silva G. Prevention and treatment of low back pain. 1th ed. New York: Elsevier; 2008. (Persian).
  28. Letafatkar A, Daneshmandi H, Hdadnezhad M, Abdul Wahabi Z. Developed corrective action (theory and practice). Isfahan: Avaye Zohoor; 2011. (Persian).
  29. Ajang M. Comparison of current corrective exercises and exercises to improve Kyphosis Physioball rear and vital capacity of female students. [Master's Thesis]. Isfahan, Iran: Physical Education and Sports Sciences University of Isfahan; 2013. (Persian).
  30. Akbari Gandomani Z. Compared to traditional training methods and training Physioball in kyphosis correction and female students 12 to 14 regional Lordosis wheat. [Master's Thesis]. Tehran, Iran: Tehran University of Medical Sciences; 2013. (Persian).
  31. Adelghahreman M. Comparison of dynamic balance and anthropometric changes before and after birth. [Master's Thesis]. Mashhad, Iran: Ferdowsi University of Mashhad; 2010. (Persian).
  32. Mostahfezian M. Exercise and pregnancy. Najaf Abad, Iran: Publisher Islamic Azad University Najaf Abad; 2006. (Persian).
  33. Kofotolis N, Kellis E. Effects of two 4-week proprioceptive neuromuscular facilitation programs on muscle endurance, flexibility, and functional performance in women with chronic low back pain. Phys Ther 2006; 86(7):1001-12.
  34. Swiss RS. Exercise ball: fun, safe, and effective workouts with your Swiss ball. New York: Parragon Inc; 2008.
  35. Mannion AF, Taimela S, Müntener M, Dvorak J. Active therapy for chronic low back pain: part 1. effects on back muscle activation, fatigability, and strength. Spine 2001; 26(8):897–908.