Abstract
OBJECTIVES: To review and synthesize existing evidence on exercise interventions of varying intensity for pregnancy-related back pain and to identify directions for future research. METHODS: A systematic review of nine studies involving 1,438 participants was conducted. Interventions focused predominantly on low-to moderate-intensity exercise, and no study employed high-intensity interval training (HIIT). Exercise types included aerobic and resistance training as well as aquatic and stability exercises. RESULTS: Most studies demonstrated significant reductions in back pain, but methodological heterogeneity and limited sample sizes prevented meta-analytical synthesis. Randomized controlled trials showed moderate risk of bias due to challenges in blinding and randomization, while non-randomized trials had substantial limitations, including inadequate measurement validation and increased risk of bias. CONCLUSION: Existing evidence supports the potential benefits of low-to moderate-intensity exercise for pregnancy-related back pain but remains methodologically weak. High-quality studies are needed to evaluate HIIT and other innovative strategies for managing pain and improving maternal health and wellbeing. TRIAL REGISTRATION: identifier CRD42024578089.