Postpartum lumbopelvic pain.
Conditions
Interventions
Intervention 1: Intervention group: This group includes postpartum women with lumbopelvic pain who receive motor control exercises along with respiratory resistance training for 8 weeks and 3 times a
Sponsors
Iran University of Medical Sciences
Eligibility
Sex/Gender
Female
Age
20 Years to 40 Years
Inclusion criteria
Inclusion criteria: Women with CNLBP: back pain without specific pathology that occurs between the last rib and the end of the gluteal fold. Women with pelvic pain: Positive active straight leg raise (ASLR) test, and having a positive result on at least three of six sacroiliac provocation tests (including distraction, compression, posterior shear test (thigh-thrust test), Gaenslen provocation test (right), Gaenslen provocation test (left) and sacral thrust test). Women who have back and pelvic pain together. The onset of lumbar, pelvic or lumbopelvic pain is during pregnancy or postpartum. At least 3 months and at most 1 year after postpartum. Age over 20 years The pain intensity of the patients, at the time of the test or during the last two weeks, should be between 3 and 7 on the visual analog scale. Reading and writing literacy (at least cycle level education) Vaginal delivery Body mass index below 30
Exclusion criteria
Exclusion criteria: Spinal deformity or pathological condition (canal stenosis, scoliosis, spondylolisthesis, fractures, spinal or pelvic tumors…) History of neurological, cardiovascular, respiratory, renal diseases, or rheumatoid arthritis. Postpartum urinary dysfunctions History of surgical intervention in the lumbopelvic region. Urogenital prolapse above grade 3 History of cesarean section or more than two vaginal deliveries Refusal to participate in the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Excursion of the diaphragm muscle: The diaphragm muscle is the main respiratory muscle and is responsible for 75% of the air flow to the lungs. It plays a role in spinal stability, and its inappropriate function causes lumbopelvic pain. During the activity of the diaphragm muscle, the position of this muscle changes, and in people with back pain, this position change or displacement is less than in people without lumbopelvic pain. Timepoint: Excursion of the diaphragm muscle is measured at the beginning of the study (before the exercise therapy) and 8 weeks later (after the final session of the exercise therapy). Method of measurement: The excursion of the right hemidiaphragm will be recorded during deep respiration and ASLR by ultrasound imaging. | — |
Secondary
| Measure | Time frame |
|---|---|
| Pelvic floor muscle activity: the contraction of the pelvic floor muscles causes upward and inward forces in the pelvic floor and closes the urinary tract; which can play a role in creating stability in the lumbopelvic region. Timepoint: Pelvic floor muscle activity will be measured at the beginning of the study (before exercise therapy) and 8 weeks later (after the final session of exercise therapy). Method of measurement: Ultrasound imaging will be used to assess pelvic floor muscle activity. The vertical distance of bladder base displacement, defined as the difference between the maximum displacement of the bladder base during deep expiration/ following a 10-second hold of the ASLR and the initial position of the bladder base at rest, will be regarded as an indicator of PFMs activity.;Abdominal muscle activity: Abdominal muscles play a role in stabilizing the spine, pelvic bone, and sacroiliac joint. These muscles create a brace around the abdomen. Timepoint: Abdominal muscle activity will be measured at the beginning of the study (before exercise therapy) and 8 weeks later (after the final session of exercise therapy). Method of measurement: Using ultrasound imaging, the thickness of abdominal muscles will be measured at rest and then compared with the measurements obtained at the end of deep respiration and after a 10-second hold of the ASLR.;Pain intensity: Pain intensity is a type of diagnostic information that, in order to check the patient's pain level, will be measured by the visual pain criterion. Timepoint: Pain intensity will be measured at the beginning of the study (before therapeutic exercise) and 8 weeks later (after the final session of therapeutic exercise). Method of measurement: Pain intensity will be measured using the visual analog scale.;Disability: Disability refers to any condition in the body and mind that creates limitations for individuals to perform a series of activities. Timepoint: Disability will be measured at the beginning of the s | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactShabnam Shahali
Iran University of Medical Sciences
Outcome results
None listed