Maternity garment treatment for the relief of low back pain

Abstract

Background Low back pain (LBP) is the most common musculoskeletal problem during pregnancy. Pregnant women traditionally wear maternity support belts for back discomfort and have experienced pain relief. However, the designs of these maternity support garments lack scientific research and their clinical efficacy remains elusive. Limited evidence is available to substantiate its putative beneficial effects. Aims This study aims to investigate the garment needs of pregnant women in terms of physical and psychological comfort, based on which to establish design criteria, to develop a maternity support garment, and to evaluate the effect in the maternity garment treatment for the relief of LBP. Methods This study was conducted in three phases: a) an exploratory phase, b) a developmental phase, and c) an evaluative phase. In the exploratory phase, a longitudinal study of 29 pregnant women was undertaken to investigate which biomechanical measures should be used to specify the functional requirements of the maternity support garment. In-depth interviews and wear trials were completed to elicit responses of pregnant women (10 in personal interviews and 14 in wear trials) on 8 maternity support garments. Fabric objective measurements of the same 8 tested garments and 16 alternative samples were conducted before material selection for the first garment prototype. In the developmental phase, the functional garment design criteria were determined and several prototypes were made based on DeJonge's design framework. In the evaluative phase, the garment prototype was assessed in a pilot clinical study on 9 patients with LBP between gestational weeks 29-36. Pain intensity, functional status, biomechanical measures, and pregnancy outcomes were also investigated. Results The interviews generated five main themes of garment needs including supportive function, comfort, ease to put on and take off, aesthetics and safety. The wear trials showed that the most preferred garment consisted of a thin cotton fabric with soft and smooth handfeel which was invisible in fitting, allowed easy movements and convenience for toileting. The material tests identified the characteristics of the most favorable sample. The longitudinal study found that the centre of pressure and sagittal lumbar curvature can be used to determine the biomechanical effect. Based on these findings, four garment prototypes were developed to satisfy the design criteria developed under five main themes. The pilot clinical study suggested that the maternity support vest is feasible and comfortable to wear as an adjunct therapy to exercises and has promising effects on pregnancy-related low back pain. Conclusions The research deliverables not only improve the garment treatment for LBP in pregnant women, but also provide a new scientific basis for therapeutic garment design. The methodologies and the results in the interviews, wear trials, biomechanical study, prototyping and clinical trials contribute to future research on the effect of garment therapy.