The Influence of adding Breathing Training to Land based Whole body strength training &Aquanatal Exercises on Lumbopelvic Pain, Functional Disability, SFMA Scores, Physiological and gait parameters, and posture during Pregnancy

Determining the effect of adding breathing exercises to land-based whole body training and aquanatal exercises on lumbar-pelvic pain, functional disability, SFMA scores Physiological parameters, gait parameters and posture in pregnant women.

Two arm parallel group randomised trial with blinded interventions and outcome assessment will perform on 60 pregnant women. Randomization conducted using Randomizer.org web site.

Mother land clinic” for land-based whole body strength training group, and “Shahid Chamran “Swimming pool for aqua natal exercises. Pregnant patients will be referred from Bazarganan Hospital &Gynecologist office. Double blinded study, in which the participants, the assessors, and the analyzers will be blinded.

Inclusion criteria: Healthy noly parus women, age 20-35 years old, in the 18-22 weeks of pregnancy with on a history of abortion, normal both pregnancy screening tests, normal blood tests & normal blood pressure, diagnosed with pregnancy related lumbo pelvic pain is approved by a gynecologist, received at least the first dose of Covid -19 vaccine.; Exclusion criteria: Report of lumbopelvic pain current or past, infections, vascular, metabolic, or endocrine problems,any medication or analgesia and treatment to relieve pain,a history of lumbar surgery, vaginal bleeding, and any contraindication to exercise in pregnancy.

1- Whole body strength training & breathing training; will perform focusing on myofascial lines with TRX,,appropriate dumbbells, and training Sticks. 2- Aquanatal exercises & breathing training; the routine will be included of aerobics, strengthening, flexibility, and balance training in the water.

Pain& functional disability primary variables; SFMA, Physiologic & gait parameters, and pasture will be the secondary variables.

Following the baseline assessments, referring to http://www.randomization.com website, participants who meet the inclusion criteria will be randomly assigned into the Land-based whole body strength training & aqua natal exercises groups.Simple randomization will be used.Allocation concealment,the stage of performing the randomization process, the process of performing random allocation in the study, the person who create the random sequence, the person who consider participants in terms of inclusion and exclusion criteria, and the participants assignment‌‌ will be specified.Randomization will be performed from a computer-generated sequence, concealed in sequentially numbered, sealed, opaque envelopes, and will be kept by the hospital and motherland clinic . (1 for the land - based whole body strength training & 2 for the aqua natal training group) created before initiation of data collection by a researcher who is not involved in the recruitment or treatment of the patients.Then, the random numerical sequence is placed in the sealed opaque envelops. Another researcher blind to the baseline assessments will open an envelope and will process with treatment according to the group assignment. An independent assessor who is not aware of the study hypothesis and method, will assess the outcome measures before and after 14 weeks interventions, while is blind to the intervention groups.

In this study the outcome assessors, data analyzer, and participants will be blinded to the process of randomization and devision of the individuals into two experimental and control groups. In the double-blind study, neither party involved in the trial know which group is receiving the actual treatment. Neither the participant nor the assessor, knows who is receiving what treatment. This method is used to prevent orientation in the results. The research set up double-blind with the main experimenter having a colleague. The main assessor is in the process of testing and launching, but their colleague is not in the process of testing. Since participants do not know which group they belong to, their beliefs about treatment do not affect the outcome. The researchers also do not know which groups are actually receiving treatment, they are unable to influence the treatment process by revealing small clues. A Double- blind study helps to reduce the effects of orientation on research. This orientation can include the unwanted influence of the researcher on the way of collecting information or dividing individuals into groups. Researchers sometimes inadvertently interfere in the research process because of their feelings about the research plan or their personal interest in obtaining a specific result.

Demographic and outcomes-related data are the files which will be shared.

After publishing paper(s) extracted from the study.

The data can be displayed and shared at the reasonable request of the Iranian Clinical Trail Registration center, journals, and University individuals/ researchers who are conducting research and scientific activities related to this field.

Data analysis and the use of documentation can only be provided which their results are reported in systematic review articles by academic researchers and authors. Requirements for sharing data and documents include: 1. To Send an email ( preferably with a valid university address) to one of the study researchers/ authors 2. A brief and logical explanation of how to use the data or documentations. 3.Ensuring That the protocol the protocol for systematic review studies, any accessing request to data or documentations will be recorded.

Through asking from authors; Amir Letafatkar, letafatkaramir@yahoo.com NiloufarFarivar, Niloufar_farivar@yahoo.com

The applicant can request details from the researchers within 7-10 days by an official message sent via an email.