Detailed Search Results
| Author/Association: | Delgado A, Amorim MM, Oliveira AdAP, Souza Amorim KC, Selva MW, Silva YE, Lemos A, Katz L |
| Title: | Active pelvic movements on a Swiss ball reduced labour duration, pain, fatigue and anxiety in parturient women: a randomised trial [with consumer summary] |
| Source: | Journal of Physiotherapy 2024 Jan;70(1):25-32 |
| Method: | clinical trial |
| Method Score: | 8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
| Consumer Summary: | WHAT WAS ALREADY KNOWN ON THIS SUBJECT: There is moderate certainty evidence that use of the Swiss ball during labour reduces the intensity of pain; however, it has an uncertain effect on the duration of labour. None of those previous studies used a Swiss ball exercise protocol based on obstetric evaluation and the exercises were not targeted at pelvic biomechanics. WHAT THIS STUDY ADDS: Performing Swiss ball exercises targeted at pelvic biomechanics for specific stages of labour reduced: the duration of labour; the intensity of maternal pain, fatigue and anxiety; and the risk of vulvar swelling. The exercises also increased the likelihood of vaginal delivery rather than caesarean section. |
| Abstract: | QUESTION: How much do active pelvic movements on a Swiss ball during labour affect maternal and neonatal outcomes? METHOD: A randomised trial with concealed allocation, blinded assessors and intention-to-treat analysis. PARTICIPANTS: Two-hundred parturient women. INTERVENTION: The experimental group performed pelvic anteversion and retroversion, lateral pelvic tilts and circular hip movements according to individual obstetric evaluation (foetal station and position, cervical dilatation and the presence of early pushing urge) on a Swiss ball. The control group received usual care. Both groups were permitted to walk and shower. OUTCOME MEASURES: The primary outcome was the duration of the first stage of labour. The secondary outcomes were the duration of the second stage of labour, pain intensity, delivery mode, medication use, local swelling, fatigue, anxiety, satisfaction and neonatal outcomes. RESULTS: The experimental intervention reduced the duration of labour by 179 minutes (95% CI 146 to 213) in stage one and 19 minutes (95% CI 13 to 25) in stage two. It decreased pain by approximately 2 points (95% CI 2 to 2) on a 0-to-10 scale at 30, 60 and 90 minutes. It reduced the risk of a caesarean section (ARR 0.14, 95% CI 0.03 to 0.25; NNT 7, 95% CI 4 to 32) and vulvar swelling (ARR 0.11, 95% CI 0.03 to 0.19; NNT 9, 95% CI 5 to 31). It reduced fatigue by 18 points (95% CI 16 to 21) on a 15-to-75-point scale and anxiety by 9 points (95% CI 8 to 11) on an 18-to-72-point scale. Other effects were negligible or unclear. CONCLUSION: Active pelvic movements on a Swiss ball during labour reduced the duration of labour, pain intensity, and maternal fatigue and anxiety; they also lowered the risk of caesarean section and vulvar swelling. Several effects exceeded the smallest worthwhile effect. REGISTRATION: NCT04124835. Full text (sometimes free) may be available at these link(s):  help |
