Effect of Physical Activity Education on Reducing Low Back Pain and Improving Exercise Attitude Among Pregnant Women

Yuni Astuti(1*), Adelia Priska Amanda(2)


(1) Universitas Muhammadiyah Yogyakarta
(2) Universitas Muhammadiyah Yogyakarta
(*) Corresponding Author

Abstract


Low back pain (LBP) is a prevalent musculoskeletal complaint during pregnancy, associated with physiological and biomechanical changes that limit daily activity. Structured physical activity and educational interventions have shown benefits in reducing pain and improving maternal attitudes toward exercise. The aim of this study was to evaluate the effect of physical activity education using a booklet on the incidence of LBP and attitudes towards physical activity among pregnant women. This quasi-experimental study employed a one-group pretest-post-test design without a control group. Participants included 33 pregnant women in the second and third trimesters attending a primary health centre in Bantul, Yogyakarta, Indonesia. A pretested questionnaire was used to collect data on the sociodemographic characteristics, the occurrence of low back pain, and the attitude towards physical activity during pregnancy. The intervention consisted of structured physical activity education using a handbook containing recommended prenatal exercises, ergonomic guidance, and safe practice tips, delivered over three weeks. Data were analysed using the Wilcoxon signed-rank test with significance level α=0.05. A total of 29 respondents were included in the study. The median LBP score decreased from 5 to 2 post-intervention (Z = -4.737, p < 0.001). The proportion of participants with a positive attitude towards physical activity increased from 37.9% to 89.7% (Z = -3.638, p < 0.001). Physical activity education using a booklet effectively reduced the intensity of LBP and improved the physical activity attitudes of pregnant women. Integration of structured exercise education into antenatal care services is recommended to promote maternal comfort

Keywords


Physical activity; low back pain; attitude; pregnant women

Full Text:

PDF

References


Saxena AK, Chilkoti GT, Singh A, Yadav G. Pregnancy-induced Low Back Pain in Indian Women: Prevalence, Risk Factors, and Correlation with Serum Calcium Levels. Anesth Essays Res. 2019;13(2):395–402. doi:10.4103/aer.AER_196_18 PubMed PMID: 31198266; PubMed Central PMCID: PMC6545952.

Salari N, Mohammadi A, Hemmati M, Hasheminezhad R, Kani S, Shohaimi S, et al. The global prevalence of low back pain in pregnancy: a comprehensive systematic review and meta-analysis. BMC Pregnancy and Childbirth. 2023 Dec 2;23(1):830. doi:10.1186/s12884-023-06151-x

Yoseph ET, Taiwo R, Kiapour A, Touponse G, Massaad E, Theologitis M, et al. Pregnancy-Related Spinal Biomechanics: A Review of Low Back Pain and Degenerative Spine Disease. Bioengineering. 2025 Aug;12(8):858. doi:10.3390/bioengineering12080858

Manyozo SD, Nesto T, Bonongwe P, Muula AS. Low back pain during pregnancy: Prevalence, risk factors and association with daily activities among pregnant women in urban Blantyre, Malawi. Malawi Med J. 2019 Mar;31(1):71–6. doi:10.4314/mmj.v31i1.12 PubMed PMID: 31143400; PubMed Central PMCID: PMC6526334.

Vignato J, Perkhounkova Y, Saeidzadeh S, Patsais M, Inman M, Marie McCarthy A, et al. Pathways from pain to physical and mental health-related quality of life during the third trimester of pregnancy: an exploratory mediation analysis. J Clin Nurs. 2021;30(9–10):1372–82. doi:10.1111/jocn.15686

Berber MA, Satılmış İG. Characteristics of Low Back Pain in Pregnancy, Risk Factors, and Its Effects on Quality of Life. Pain Management Nursing. 2020 Dec 1;21(6):579–86. doi:10.1016/j.pmn.2020.05.001 PubMed PMID: 32571670.

Horibe K, Isa T, Matsuda N, Murata S, Tsuboi Y, Okumura M, et al. Association between sleep disturbance and low back and pelvic pain in 4-month postpartum women: A cross-sectional study. Eur Spine J. 2021;30(10):2983–8. doi:10.1007/s00586-021-06847-8

Koukoulithras I, Stamouli A, Kolokotsios S, Plexousakis M, Mavrogiannopoulou C. The Effectiveness of Non-Pharmaceutical Interventions Upon Pregnancy-Related Low Back Pain: A Systematic Review and Meta-Analysis. Cureus. 13(1):e13011. doi:10.7759/cureus.13011 PubMed PMID: 33728108; PubMed Central PMCID: PMC7934802.

Physical Activity and Exercise During Pregnancy and the Postpartum Period [Internet]. [cited 2025 Oct 24]. Available from: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/04/physical-activity-and-exercise-during-pregnancy-and-the-postpartum-period

Koukoulithras I, Stamouli A, Kolokotsios S, Plexousakis M, Mavrogiannopoulou C. The Effectiveness of Non-Pharmaceutical Interventions Upon Pregnancy-Related Low Back Pain: A Systematic Review and Meta-Analysis. Cureus. 13(1):e13011. doi:10.7759/cureus.13011 PubMed PMID: 33728108; PubMed Central PMCID: PMC7934802.

Santos FF, Lourenço BM, Souza MB, Maia LB, Oliveira VC, Oliveira MX. Prevention of low back and pelvic girdle pain during pregnancy: a systematic review and meta-analysis of randomised controlled trials with GRADE recommendations. Physiotherapy. 2023 Mar 1;118:1–11. doi:10.1016/j.physio.2022.09.004

Adem RS, Motuma A, Ayele BH. Prevalence of physical activity among pregnant women attending antenatal care services in public facilities Harari region Eastern Ethiopia. Sci Rep. 2025 Aug 29;15(1):31826. doi:10.1038/s41598-025-17673-z

Santos FF, Lourenço BM, Souza MB, Maia LB, Oliveira VC, Oliveira MX. Prevention of low back and pelvic girdle pain during pregnancy: a systematic review and meta-analysis of randomised controlled trials with GRADE recommendations. Physiotherapy. 2023 Mar 1;118:1–11. doi:10.1016/j.physio.2022.09.004 PubMed PMID: 36288631.

Diez-Buil H, Hernandez-Lucas P, Leirós-Rodríguez R, Echeverría-García O. Effects of the combination of exercise and education in the treatment of low back and/or pelvic pain in pregnant women: Systematic review and meta-analysis. International Journal of Gynecology & Obstetrics. 2024;164(3):811–22. doi:10.1002/ijgo.15000

Adha FR, Komalasari DR. Validity and Reliability of The Numeric Rating Scale in Non-Myogenic Low Back Pain Patients. Academic Physiotherapy Conference Proceeding. 2024 Jul 25;414–22.

Physiopedia [Internet]. [cited 2025 Oct 26]. Numeric Pain Rating Scale. Available from: https://www.physio-pedia.com/Numeric_Pain_Rating_Scale

Yuliasari. Hubungan pengetahuan dan sikap dengan pelaksanaan senam hamil (studi pada ibu hamil trimester II dan III) di Puskesmas Ciputat Tangerang Selatane [Internet]. 2011 May 5 [cited 2025 Oct 26]. Available from: https://repository.uinjkt.ac.id/dspace/handle/123456789/2397

Pisoh DW, Karelle NTJ, Nchufor RN, Ako TW, Mforteh AAA, Boten M, et al. Low back pain during pregnancy: prevalence, risk factors and clinical profile in the Bamenda Regional Hospital. BMC Pregnancy Childbirth. 2025 Apr 8;25:406. doi:10.1186/s12884-025-07506-2 PubMed PMID: 40200208; PubMed Central PMCID: PMC11980220.

Wang SM, Dezinno P, Maranets I, Berman MR, Caldwell-Andrews AA, Kain ZN. Low Back Pain During Pregnancy: Prevalence, Risk Factors, and Outcomes. Obstetrics & Gynecology. 2004 Jul;104(1):65–70. doi:10.1097/01.AOG.0000129403.54061.0e

Popajewski M, Zawadka M, Wójcik-Załuska A, Milart P. Maternal Parity Effect on Spine Posture Changes and Back Pain During Pregnancy. Healthcare. 2024 Jan;12(22):2202. doi:10.3390/healthcare12222202

Yazir AN, Rahmadhani R, Setiawati D, Sari JI. The Relationship Between Gestational Age, Parity, Nutritional Status with the Incidence of LBP in Pregnant Women. Media Publikasi Promosi Kesehatan Indonesia (MPPKI). 2024 Nov 11;7(11):2649–56. doi:10.56338/mppki.v7i11.6069

The influence of gestational trimester, physical activity practice and weight gain on the low back and pelvic pain intensity in low risk pregnant women [Internet]. [cited 2025 Oct 27]. Available from: https://journals.sagepub.com/doi/epdf/10.3233/BMR-171006?src=getftr&utm_source=scopus&getft_integrator=scopus doi:10.3233/BMR-171006

Akmeşe ZB, Oran NT. Effects of Progressive Muscle Relaxation Exercises Accompanied by Music on Low Back Pain and Quality of Life During Pregnancy. J Midwife Womens Health. 2014 Sep;59(5):503–9. doi:10.1111/jmwh.12176

Omoke NI, Amaraegbulam PI, Joannes Umeora OU, Okafor LC. Prevalence and risk factors for low back pain during pregnancy among women in Abakaliki Nigerian. Pan Afr Med J. 2021;39. doi:10.11604/pamj.2021.39.70.24367

Diez-Buil H, Hernandez-Lucas P, Leirós-Rodríguez R, Echeverría-García O. Effects of the combination of exercise and education in the treatment of low back and/or pelvic pain in pregnant women: Systematic review and meta-analysis. Int J Gynaecol Obstet. 2024 Mar;164(3):811–22. doi:10.1002/ijgo.15000 PubMed PMID: 37475695.

Sánchez-Polán M, Nagpal TS, Zhang D, Silva-Jose C, Montejo R, Barakat R. The Influence of Physical Activity during Pregnancy on Maternal Pain and Discomfort: A Meta-Analysis. J Pers Med. 2023 Dec 28;14(1):44. doi:10.3390/jpm14010044 PubMed PMID: 38248744; PubMed Central PMCID: PMC10817295.

Bayisa D, Waltengus F, Lake S, Wakuma B, Bayisa L, Chala M, et al. Pregnant women’s knowledge, attitudes, and associated factors toward physical exercise during pregnancy among those attending antenatal care at Bahir Dar city, Northwest Ethiopia. SAGE Open Med. 2022 Aug 13;10:20503121221115252. doi:10.1177/20503121221115252 PubMed PMID: 35983082; PubMed Central PMCID: PMC9379271.

Arthur Charpentier. Back Pain with Daily Living Abilities of Pregnant Women in Canada. 2020.

Diez‐Buil H, Hernandez‐Lucas P, Leirós‐Rodríguez R, Echeverría‐García O. Effects of the combination of exercise and education in the treatment of low back and/or pelvic pain in pregnant women: Systematic review and meta‐analysis. Intl J Gynecology & Obste. 2024 Mar;164(3):811–22. doi:10.1002/ijgo.15000

Knudsen SDP, Roland CB, Alomairah SA, Jessen AD, Maindal HT, Bendix JM, et al. The effect of exercise training and motivational counselling on physical activity behaviour and psychosocial factors in pregnant women: secondary analyses of the FitMum randomised controlled trial investigating prenatal physical activity. BMC Public Health. 2024 Jan 4;24(1):92. doi:10.1186/s12889-023-17525-3

Benyian FF. Evaluation of pregnant women’s knowledge and attitude toward physical exercise during pregnancy at maternity hospitals. Journal of Education and Health Promotion. 2024 Feb;13(1):79. doi:10.4103/jehp.jehp_982_23

Elmeida IF, Nurlaila, Nurchairina, Berliana E. Education and the Role of Midwife and Family Support in the Use of KIA Handbooks: A Comprehensive Approach. jppipa, pendidikan ipa, fisika, biologi, kimia. 2025 Oct 1;11(9):545–52. doi:10.29303/jppipa.v11i9.12964


Article Metrics

Abstract view : 35 times
PDF - 7 times

DOI: https://doi.org/10.26714/mki.9.1.2026.20-28

Refbacks

  • There are currently no refbacks.


Copyright (c) 2026 Yuni Astuti, Adelia Priska Amanda

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This journal is indexed by:

              

 

View My Stats 

Universitas Muhammadiyah Semarang and PPNI Jawa Tengah

Kedungmundu Raya No. 18 Semarang NRC Building Universitas Muhammadiyah Semarang

Phone: 02476740287
Fax: 02476740287
Email: mki@unimus.ac.id