Postsurgical Adhesion
Conditions
Brief summary
Postpartum women with C-section receiving deep and superficial tissue mobilization would have better improvement on pain, lumbopelvic muscle functions, spinal mobility, and posture compare to the superficial tissue mobilization and control group
Interventions
OTHERMyofascial abdominal diaphragm release
Myofascial abdominal diaphragm release
OTHERDirect focused scar release technique
Direct focused scar release technique
OTHERDirect manipulations to visceral structures
Direct manipulations to visceral structures
pelvic anatomy education
OTHERsham
sham
Sponsors
YI-JU TSAI
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
vaginal delivery Inclusion Criteria: * Natural birth without C-section scar * Postpartum more than 6 months * Without any pain in the lumbopelvic region C-section Inclusion Criteria: * Healed C-section scar \> six months * Scar with or without pain Both mode of delivery
Exclusion criteria
* Active infection or infectious disease in the pelvis or abdomen * Pain medications on days of measurements * Skin irritation and inflammation at the site of the scar * Currently pregnant or actively trying to get pregnant * History of radiation to the area * Any fracture around spine and pelvis * Any previous gynecologic and obstetric surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Scar Characteristic: Extensibility | 8 weeks | The extensibility of the scar will be measured using the modified adheremeter in each of 4 directions including superior, inferior, medial and lateral and then the area of mobility will be calculated. |
| Scar Characteristic: Viscoelasticity | 8 weeks | The biomechanical and viscoelastic properties of the scar tissue will be measured using a non-invasive myometer |
| Scar Characteristic: Irritability | 8 weeks | The irritability of the scar will be measured using the digital pressure algometer for two conditions: first, when the pressure turns from discomfort to pain and the participant asks to stop, and then when the maximal pressure or pain the participant can tolerate. |
| Muscle function measures of lumbopelvic muscles | 8 weeks | Ultrasonography image for muscle thickness of lumbopelvic muscles during rest and maximum contraction. |
| Muscle function measures of pelvic floor muscle control | 8 weeks | Ultrasonography image for muscle thickness of pelvic floor muscle control during rest, maximum contraction |
| Spinal Mobility | 8 weeks | Range of motion for cervical, thoracic, and lumbar spine in the sagittal, frontal, and transverse plane as well as pelvic tilt will be assessed using the wireless double inclinometers |
| Myofascial Flexibility | 8 weeks | Straight leg raise test and Thomas test will be used to examine the muscle flexibility of the major lower extremity muscles. |
| Spinal Alignment and Posture | 8 weeks | Radiographic measurement, posture will be assessed using the photographic measurement. Reflective markers will first be placed and attached on the canthus of the eye, tragus of the ear, the spinous processes of C2, C7, T1, T3, T11, T12, L1, L5, S1, S5, and bilateral anterior superior iliac spine and posterior superior iliac spine in standing. The participants will be instructed to maintain their gaze straight ahead at a target adjusted for body height. Two standing photographs will be taken, one in the usual standing posture and the other in the best standing posture. Following the other two photographs will be taken, one in maximal pelvic anterior tilt and the other in the maximal pelvic posterior tilt. |
| Pain intensity measure of Visual Analogue Scale | 8 weeks | Visual Analogue Scale is a self-reported instrument assessing average pain intensity in currently. Possible score range from 0 (no pain) to 10 (worst possible pain). |
| Pain intensity measure of pelvic girdle questionnaire | 8 weeks | pelvic girdle questionnaire is a self-reported instrument assessing pelvic girdle pain intensity in currently. Questionnaire consisting of 20 activity items and 5 symptom items on a 4-point response scale. Possible score range from 0 (no pain) to 100 (worst possible pain). |
| Pain intensity measure of Oswestry Low Back Pain Disability Questionnaire | 8 weeks | Oswestry Low Back Pain Disability Questionnaire is a self-reported instrument assessing patient's permanent functional disability in currently. For each section the total possible score is 5: if the first statement is marked the section score = 0; if the last statement is marked, it = 5. The higher the score, the greater the degree of disability. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Self-perceived Change Health Status: Global Rating of Change Scale (GROC) | 8 weeks | The GROC is a single-item instrument that provides a means of measuring self-perceived change in health status. The GROC uses the 15-point Likert scale to rate the perceived "overall change" on a continuum, with -7 (labeled "worse") on the left and +7 (labeled "better") on the right, and 0 in the middle (labeled "no change"), compared with the baseline |
| Patient and Observer Scar Assessment Scale (POSAS) | 8 weeks | The POSAS includes 2 numerical numeric scales: The Patient Scar Assessment Scale and the Observer Scar Assessment Scale. It objectively assesses vascularity, pigmentation, thickness, relief, pliability, and surface area, and incorporates patient subjective symptoms of pain, itching, color, stiffness, thickness, and relief. |
Countries
Taiwan
Outcome results
None listed