Cesarean Section Complications, Low Back Pain
Conditions
Keywords
Osteopathic Manipulation, Low Back Pain, Post Cesarean Section Adhesions, Visual Analogue Scale, Oswestry Low Back Disability Questionnaire, Modified Schober Test
Brief summary
Chronic low back pain post cesarean section adhesions represents a restricting dysfunction, mainly influences abdominal fascia that leads to major welfare and economic restrictions. Osteopathic manipulation is a drug-free non-invasive is the therapeutic application of manually guided forces to improve physiologic function and support homeostasis. The purpose of the current study is to determine the effect of osteopathic manipulations of post cesarean section adhesions on low back pain
Detailed description
Chronic low back pain is a common musculoskeletal disorder affects adults with 84% prevalence. It influences lower back, and lasts at least 12 weeks. Where increased annual cesarean section rates up to 19.1% associated with scar, pelvic, abdominal and low back pain disorders. From the fascial point of view, abdominal muscles are in continuity with the thoracolumbar fascia and the pelvic floor. It has been demonstrated that they work with great synergy and guaranteed by fascial continuity . Osteopathic manipulative technique consists of a range of direct, indirect, combined, fluid and reflex-based manual techniques that are applied specifically to a joint or non-specifically to a body area. Direct techniques apply thrust, impulse, muscle contraction, fascial loading or passive range of motion .The purpose of the current study is to determine the effect of osteopathic manipulations of post cesarean section adhesions on low back pain. Up on that 30 post cesarean women suffering from low back pain at least for 6 months from the Outpatient Clinic of Mitghamer Hospital, El-Daqahlia. Their age range 20-35 years old, BMI range≤ 25 kg /m2. They will be allocated into control group will receive analgesics. Study group will receive four weeks of analgesics, plus osteopathic manipulations once per week.
Interventions
OTHEROsteopathic Manipulations
Osteopathic Manipulations (a. Myofascial release technique: Direct scar release+ Indirect scar release 'Fascial unwinding'; b. Grand Maneuver; Visceral manipulations of uterus
OTHERControl Group
Paracetamol tablets
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Masking description
The whole participants, care provider, investigator and the outcome assessor will not be aware of each participant allocation within the current study groups; Based on a third person will be assigned for randomization.
Intervention model description
Randomized, Pre/Posttreatment, Controlled Trial.
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 35 Years
Healthy volunteers
No
Inclusion criteria
* They suffered from low back pain and undergoes cesarean section at least 6 months before entry into study. * Their body mass index (BMI) will be ≤ 25 kg /m2. * Their age will range from 20 to 35 years. * They would not use any other analgesic drugs during the study period.
Exclusion criteria
* Pregnancy or suspected pregnancy. * Recent abdominal surgery * Patients with severe spinal pathology (cauda equine syndrome, spinal canal stenosis, fracture of spine, discitis, infectious disease of spine). * Cancer. * Abdominal and pelvic infection, open wound, burn and skin irritation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual analogue scale | Pre-treatment, and Post-treatment of the the study treatment program afetr 4-weeks). | a self-reported pain measurement a widely utilized scale in rehabilitation. It has been shown to be valid and reliable, and its ratio scale properties make VAS the optional tool for describing pain intensity |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Oswestry Low Back Disability Questionnaire | Pre-treatment, and Post-treatment of the the study treatment program after 4-weeks). | An extremely important tool that researchers and disability evaluators use to measure a patient's permanent functional disability. The test is considered the 'gold standard' of low back functional outcome tools. It consists of 10 patient-completed questions in which the response options are presented as 6-point Likert scales. Scores range from 0% (no disability) to 100% (most severe disability). Each question is scored from 0-5 (minimum to maximum).The point total from each section is summed and the then divided by the total number of questions answered and multiplied by 100 to create a percentage disability. The scores range from 0-100% with lower scores meaning less disability. |
| Modified Schober Test | Pre-treatment, and Post-treatment of the the study treatment program after4-weeks). | The Modified Schober test is designed to measure the range of lumbar flexion in patients. The positive Schober test result is when the distance between the two lines does not increase by at least 5cm when the person bends forward. The normative values were found to be 6.85 ±1.18 cm for flexion, and 2.42±0.74 cm for extension. |
Countries
Egypt
Contacts
STUDY_CHAIRKhadija S Abdulaziz, PHD
Professor of Physical Therapy for Woman's Health
STUDY_DIRECTORMohamed A Abo Elainin, PHD
Consultant of Obstetrics and Gynecology
Outcome results
None listed