Postpartum Lumbopelvic Pain
Conditions
Keywords
pregnancy, pelvic floor muscles, Lumbo-pelvic pain, Stabilization exercises, abdominal muscles thickness, Multifidus muscles thickness, Multifidus muscles cross section area
Brief summary
The purpose of this study was to evaluate the effects of stabilization exercises on pain, disability and pelvic floor muscles function in patients with lumbopelvic pain.
Detailed description
Pregnancy is a specific experience that leads to several physical changes in women's body and influence most aspects of their lives. Pregnancy and delivery can cause serious complications such as urinary incontinence, pelvic organ prolapse, fecal incontinence, and low back pain (LBP) that have negative effects on women's sexual, physical, social and psychological health. Based on Wu et al. systematic review, prevalence of pregnancy related low back pain (PLBP) during pregnancy and postpartum is 45% and 25% respectively. LBP is one of the most current causes of disability and sick leave after delivery.Abnormal load transfer in the lumbopelvic region has been considered as one possible explanation to lumbopelvic pain.The local stabilizing muscles, i.e. the transversely oriented abdominal, diaphragm, the lumbar MF and the PFM Play an important role in load transfer in the lumbopelvic region.so, we considered that an exercise program that addresses muscular dysfunction, such as lumbar stabilization exercise can improve motor pattern of local stabilizing muscles and can use in management of postpartum lumbopelvic pain.
Interventions
18 sessions during 6 consecutive weeks, three times per week, 30 or 40 minutes per session including: Twenty minutes for receiving hot pack and TENS and 10 or 20 minutes for training the exercises in 7 level : 1.Train the specific contraction of the deep abdominal muscles, multifidus and pelvic floor muscles(PFM). 2.Train the specific contraction of deep abdominal muscles with coactivation of multifidus and PFM in supine, prone, sitting, standing and quadruped position. 3. Segmental control exercises in close kinematic chain. 4. Segmental control exercises in open kinematic chain with limb loading, emphasis on abdominal muscles. 5. Segmental control exercises in open kinematic chain with limb loading, emphasis on back extensor muscles. 6. Progress exercises to functional task. 7. Coactivation of abdominal and multifidus muscles with limb loading in aerobic tasks.
OTHERControl group
8 sessions during 6 consecutive weeks, three times per week, per session including: Twenty minutes for receiving hot pack and TENS
Sponsors
Zahedan University of Medical Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
* age more than 18 years old * pain located between costal margin to gluteal fold with or without radiation to lower limbs * onset of pain during pregnancy or after delivery * history of delivery at least 3 months ago.
Exclusion criteria
* known chronic rheumatologic or Orthopedic disorders * systemic locomotor disease * history of fracture, neoplasm,intervertebral disk pathology or radiculopathy, spondylolysis or spondylolysthesis * contraindication of exercises, heart disease, diabetes, thrombophlebitis, uncontrolled epilepsy * ongoing pregnancy * treatment with specific stabilisation exercise during previous 3 months.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Multifidus muscle thickness and crass section area(S1 level) | 6 weeks | Ultrasound imaging |
| pain | 6 weeks | Visual Analog Scale(VAS) questionnaire |
| Disability | 6 weeks | Oswestry Disability Index(ODI) questionnaire |
| Pelvic Floor Muscle activity | 6 weeks | Transabdominal approach of Ultrasound imaging |
| Abdominal muscles(Transverse Abdominis,Internal Oblique,External Oblique) thickness | 6 weeks | Ultrasound imaging |
Other
| Measure | Time frame | Description |
|---|---|---|
| weight | 6 weeks | with questionnaire |
| height | 6 weeks | with questionnaire |
| Body Mass Index(BMI) | 6 weeks | with questionnaire |
| age | 6 weeks | with questionnaire |
Countries
Iran
Outcome results
None listed