Predicting pregnancy-related low back pain: a prospective cohort protocol integrating motor control and functional movement tests with pressure pain thresholds

Abstract

Background: Pregnancy-related low back pain (PLBP) is a highly prevalent musculoskeletal disorder, affecting 50–70% of pregnant women, yet effective predictive tools are lacking. While functional movement tests, motor control assessments, and pressure pain threshold (PPT) measurements show promise for evaluating musculoskeletal health, their combined predictive value for PLBP incidence remains unexplored. Objective: This study will aim to evaluate the screening value of a comprehensive battery of motor control tests, functional movement tests, and PPT measurements for predicting the incidence of PLBP. Methods: A prospective longitudinal cohort study will be conducted with 100 low-risk pregnant women at 10–12 weeks of gestation. At baseline, participants will undergo a 20-item motor control and functional test battery and PPT measurements at 27 lumbar points and three remote sites. The incidence of PLBP will be monitored monthly for up to 28 weeks via diaries, the Visual Analog Scale (VAS > 30mm), and the Roland-Morris Disability Questionnaire (RMDQ ≥ 3). Logistic regression and Receiver Operating Characteristic (ROC) curve analyses will be used to determine associations and predictive performance of the composite scores for PLBP incidence. Results: Results are pending completion of the longitudinal follow-up. Conclusion: This study is the first to comprehensively investigate the combined predictive power of motor control, functional movement, and pain sensitivity for PLBP. The findings are expected to identify key early risk factors and contribute to the development of a validated predictive score, ultimately informing targeted prevention strategies to reduce the burden of PLBP and improve maternal health outcomes.