The Effect of Pelvic Floor Muscle Training Along with an Exercise Intervention in Non-specific Chronic Low Back Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Introduction: Non-specific chronic Low back pain (NSCLBP) is often linked to trunk muscle dysfunction, affecting abdominopelvic stability.Research emphasizes assessing pelvic floor muscle (PFM) strength in women with NSCLBP, and therefore, PFM training could serve as a valuable component to enhance rehabilitation by improving pain, strength, and functionality.Objective: The present systematic review and meta-analysis aim to synthesize and evaluate the findings from randomized clinical trials (RCTs) that investigate the impact of pelvic floor muscle-strengthening exercises on pain, functional disability, muscle strength, and quality of life.Data sources: Electronic searches were conducted across databases such as Scopus, Web of Science, CINAHL, Cochrane Central, PEDro, PubMed, ProQuest, and MEDLINE to identify relevant RCTs published up to July 2023.Study eligibility criteria: Eligible studies compared PFM training with exercise interventions for individuals with NSCLBP, and potential biases were assessed using the RoB 2 tool.Study appraisal and synthesis method: For the synthesis of results, MedCalc software version 23.0.9 was used, and a random-effects model was applied to address heterogeneity.Results: The review included eight RCTs focused on individuals with NSCLBP.The review findings indicate that PFM training is effective in reducing pain intensity on the Visual Analog Scale (VAS: SMD = -0.644,95% CI = -0.953 to -0.335).The meta-analysis showed neutral to favorable results for function, pelvic floor strength, transversus abdominis strength, and quality of life.Conclusion: Synthesizing data from multiple RCTs, this review highlights the efficacy of pelvic floor muscle-strengthening interventions in reducing NSCLBP.However, the shorter duration of most studies may limit insights into long-term effects, as extended programs are needed for muscle adaptation, improved motor control, and enhanced lumbar-pelvic stabilization.