{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T03:37:25Z","timestamp":1793504245211,"version":"4.5.0"},"update-to":[{"DOI":"10.12688\/f1000research.168854.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000}}],"reference-count":22,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"na"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Background Low back pain (LBP) is a common complaint experienced by pregnant women, especially in the third trimester, which can interfere with daily activities, sleep quality, and readiness for labor. Nonpharmacological approaches such as music therapy and hypnobirthing are developing as alternatives that are considered safe, inexpensive, and minimal in side effects, but the effectiveness of the combination of the two methods has not been widely studied in the context of pregnancy in Indonesia Methods This quasi-experimental study aimed to examine the effectiveness of hypnobirthing, music therapy, and their combination in alleviating LBP among third-trimester pregnant women. A total of 200 participants were divided into four groups: hypnobirthing (n=50), music therapy (n=50), a combination group (n=50), and a control group receiving standard antenatal care (n=50). The study was conducted at four Community Health Centers (Puskesmas) in Palembang City, South Sumatra Province, Indonesia. Pain levels were assessed before and after the intervention using the Visual Analog Scale (VAS). The statistical analyses used included the Paired Sample t-test, One-Way ANOVA, and Post hoc comparisons using Tukey HSD test for mean pain scores between the groups. Results The study showed a statistically significant reduction in LBP intensity in all the intervention groups compared to that in the control group (p &lt; 0.001), with the combined intervention group demonstrating the greatest improvement. These findings suggest that both hypnobirthing and music therapy are effective in managing pregnancy-related LBP, and their combination may offer enhanced benefits for managing pregnancy-related LBP. Conclusions Music therapy and hypnobirthing have been proven effective in reducing lower back pain intensity in pregnant women in their third trimester, with the combination of both therapies providing the most significant effect. This study supports the inclusion of non-pharmacological approaches in routine antenatal care to improve maternal comfort and well-being.<\/ns3:p>","DOI":"10.12688\/f1000research.168854.2","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T09:09:05Z","timestamp":1779872945000},"page":"868","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Effectiveness of Hypnobirthing, Music therapy and Combined Intervention in Reducing Low Back Pain Among Third-Trimester Pregnant Women: A Quasi-Experimental Study"],"prefix":"10.12688","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1681-9614","authenticated-orcid":false,"given":"Murbiah","family":".","sequence":"first","affiliation":[{"name":"Lincoln university Collage Petaling Jaya Selangor Lincoln University College Faculty of Medicine"},{"name":"Palembang Sumatera Selatan Universitas Muhammadiyah Ahmad Dahlan Palembang"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santhna Letchmi","family":"Panduragan","sequence":"additional","affiliation":[{"name":"Lincoln university Collage Petaling Jaya Selangor Lincoln University College Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasmahwati","family":"Pardi","sequence":"additional","affiliation":[{"name":"Lincoln university Collage Petaling Jaya Selangor Lincoln University College Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafizah","family":"Che hassan","sequence":"additional","affiliation":[{"name":"Lincoln university Collage Petaling Jaya Selangor Lincoln University College Faculty of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Husin","family":".","sequence":"additional","affiliation":[{"name":"Sekolah tinggi ilmu kesehatan Bina Husada Palembang Sumatera selatan sekolah tinggi llmu kesehatan Bina Husada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e1389","DOI":"10.1002\/hsr2.1389","article-title":"Low back pain in a sample of Syrian pregnant women: A cross-sectional study.","volume":"6","author":"A Amayri","year":"2023","journal-title":"Health Sci. 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Sharma, Jyoti Sharma, Sumbul Zehra, Bio musicology or Music Therapy, Km. Mayawati Government Girls P.G. College, Badalpur, Uttar Pradesh, 16 Sep 2025, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/14-868\/v1#referee-response-412881","order":0,"name":"referee-response-412881","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Murbiah murbiah<\/b>; \n<i>Posted: 19 Oct 2025<\/i>; We would like to sincerely thank the reviewer for the thoughtful and constructive feedback provided on our manuscript entitled \n<i>\u201cEffectiveness of Hypnobirthing, Music Therapy, and Combined Intervention in Reducing Low Back Pain Among Third-Trimester Pregnant Women: A Quasi-Experimental Study.\u201d<\/i> We appreciate the reviewer\u2019s positive assessment of our study\u2019s clinical relevance, methodological design, and cultural contribution. Below we provide a detailed response to each point raised:  \n<b>1. Clarification of Randomization Method<\/b> Thank you for your very constructive feedback. We have clarified the randomization procedure in the Research Methods section. The allocation process was conducted using a computer-based random number generator via the Research Randomizer application. The randomization results were placed in sealed envelopes in sequential order to maintain the confidentiality of the allocation. (see the sample size section).  \n<b>2.&nbsp;Intervention Fidelity and Standardization<\/b> We agree with this comment. In the Intervention Procedures section, we have added the following information: &nbsp;Hypnobirthing interventions are conducted according to standard procedures that include guided breathing techniques, visualization, and deep relaxation performed by certified practitioners. Each Hypnobirthing session lasts 30 minutes, twice a week for four weeks Music therapy sessions use music &nbsp;Music therapy interventions are carried out in accordance with standard procedures, namely listening to soothing instrumental music for 30 minutes every day for four weeks, with a slow tempo of 50\u201370 beats per minute, moderate music volume, and a quiet environment. This aims to maintain the consistency of participants' sensory experiences. (Saad &amp; Jariyah, 2022), the music used is the traditional composition \u201cGending Sriwijaya\u201d. This work, created by Nungcik AR in 1943 and accompanied by Palembang-style gamelan music arranged by A. Dahlan Rachim and R.C. Hardjosubroto, is a symbol of South Sumatran culture. The traditional Gending Sriwijaya music used in this study is part of the traditional cultural heritage of the Palembang community in South Sumatra, Indonesia.  \n<b>3.&nbsp;Control Group and Attention Control<\/b> Thank you for your valuable suggestion. We have added a note that the leaflet was given once at the beginning of the intervention (week 1) and briefly discussed by the staff as a form of educational control to control group. The control group received 30-minute light education sessions conducted by health workers, so that the duration and attention received were comparable to the intervention group. The educational material consisted of information in the form of leaflets about hypnobirthing and music therapy.&nbsp;  \n<b>4.&nbsp;Statistical Reporting and Confidence Intervals<\/b> We have revised the Results section by adding a 95% confidence interval (CI) and effect size to Table 5.  \n<b>5.&nbsp;Study Limitations and Future Directions<\/b> We have followed up on this input by adding a new paragraph in the Discussion section. We highlight the limitations of this study include the quasi-experimental design, which did not fully control for selection bias, and limitations in the subjective measurement of pain using the VAS. Further research is recommended in the form of a multi-center randomized controlled trial (RCT) and a cost-effectiveness analysis to assess the economic benefits of this intervention in routine antenatal care.  We are deeply grateful for the reviewer\u2019s constructive feedback, which has substantially improved the rigor and clarity of our manuscript. We have revised the paper accordingly and believe these changes address all concerns raised.  Thank you for your valuable time and insightful review.  warm regard murbiah and team","URL":"https:\/\/f1000research.com\/articles\/14-868\/v2#referee-comment-14816","order":1,"name":"referee-comment-14816","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.194657.r450031, Abu R. Srinivasan, Sri Balaji Vidyapeeth (Deemed to be University), Pillayarkuppam, Puducherry, 23 Jan 2026, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/14-868\/v2#referee-response-450031","order":2,"name":"referee-response-450031","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.194657.r450032, Bayu Anggileo Pramesona, Department of Public Health, Faculty of Medicine, Lampung University (Universitas Lampung), Bandar Lampung, 06 Feb 2026, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/14-868\/v2#referee-response-450032","order":3,"name":"referee-response-450032","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This research was supported and financed by Muhammadiyah Ahmad Dahlan University Palembang through campus grants based on work agreement letter number 0280\/II\/3\/AU\/F\/2022. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}