Core stability in women with and without chronic pelvic pain

PM R. 2026 Mar 13. doi: 10.1002/pmrj.70103. Online ahead of print.

ABSTRACT

BACKGROUND: Physical activity (PA) and core stability levels are unknown for women with musculoskeletal chronic pelvic pain (CPP) compared to healthy women. At this time, there is no validated treatment method aimed specifically at CPP.

OBJECTIVE: To elucidate the PA habits and core stability of women with and without CPP. We hypothesized that aerobic and resistance PA (aPA, rPA) and core stability would differ significantly.

DESIGN: Prospective, cross-sectional study. Wilcoxon rank sum tests, simple and multiple linear regressions, and Pearson chi-square test were used for analysis.

SETTING: Primary and specialty care outpatient physical medicine and rehabilitation, female pelvic medicine and reconstructive surgery, and gynecology clinics associated with a large tertiary center.

PATIENTS: We recruited 91 women aged 18-70 years with and without CPP (defined by American College of Obstetricians and Gynecologists).

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Physical activity, core stability scores.

RESULTS: Women with CPP demonstrated lower overall core stability (p = .04). Having CPP predicted a 2-point decrease in overall core score (p < .01). Women with CPP demonstrated significantly worse scores for the supine bridge (p < .01) and prone bridge (p = .03). There were no significant differences in aPA or rPA between women with and without CPP. Pelvic floor muscle strength did not have a significant effect on core scores in women with CPP before or after adjusting for age, parity, and body mass index.

CONCLUSIONS: This study reports a novel finding that women with CPP had significantly reduced core scores (suggestive of weaker core stability) but similar levels of physical activity (aPA and rPA) compared to women without CPP. Future directions will include larger, multicenter, randomized controlled trials to investigate the association between pelvic floor muscles and core stability as well as therapeutic interventions to include specific exercises targeted at improving overall core stability in women with CPP.

PMID:41823339 | DOI:10.1002/pmrj.70103