Cesarean Section, Exercise Therapy, Early Ambulation
Conditions
Keywords
Pain Reduction, Postnatal Exercises, Postoperative Pain, Early Mobilization, Physiotherapy
Brief summary
This study aims to evaluate the effectiveness of early bed mobility exercises and ambulation in reducing post-operative pain among women who undergo elective cesarean section. A randomized controlled trial will be conducted with 56 participants divided into intervention and control groups. The intervention group will receive physiotherapy exercises such as pelvic rolling, breathing exercises, and ambulation, while the control group will receive routine nursing care. Pain intensity will be assessed using the Visual Analog Scale (VAS) and Numerical Pain Rating Scale (NPRS). The study is expected to show that early mobilization reduces pain, improves recovery, and enhances overall well-being.
Detailed description
This study is a single-blind randomized controlled trial designed to investigate the effectiveness of early bed mobility exercises and ambulation in reducing post-operative pain among women undergoing elective cesarean section. The study will be conducted at the Department of Gynecology and Obstetrics, Lady Reading Hospital (MTI), Peshawar, over a period of six months. A total of 56 participants aged 18-40 years who meet the inclusion criteria will be recruited and randomly assigned into two groups using consecutive blocked randomization. The intervention group will receive a structured physiotherapy program including pelvic rolling, leg sliding, deep breathing, chest expansion exercises, ankle pumping, and ambulation starting 5 hours post-surgery. The control group will receive routine nursing care. Pain intensity will be assessed using the Visual Analog Scale (VAS) and Numerical Pain Rating Scale (NPRS) before and after the intervention. Data will be analyzed using Statistical Package for the Social Sciences (SPSS) version 25, applying paired and independent t-tests to compare within and between group differences. The study aims to demonstrate that early mobilization significantly reduces post-operative pain, decreases the need for analgesics, shortens hospital stay, and improves functional recovery and overall well-being in post-cesarean women.
Interventions
PROCEDUREEarly Bed Mobility Exercises and Ambulation
A structured physiotherapy program initiated 5 hours after cesarean section, including mobility and breathing exercises along with early ambulation, administered multiple times daily until discharge to improve recovery and reduce post-operative pain.
OTHERRoutine Nursing Care
Standard postoperative care provided according to hospital protocol without any additional structured physiotherapy or mobilization program.
Sponsors
Lady Reading Hospital, Pakistan
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
This study will follow a single-blind design in which the outcome assessor will be blinded to group allocation. Participants and care providers will be aware of the assigned interventions, but the assessor responsible for measuring outcomes (VAS and NPRS) will remain unaware to reduce bias.
Intervention model description
Participants will be randomly assigned into two groups, an intervention group receiving physiotherapy exercises (early bed mobility and ambulation) and a control group receiving routine nursing care. Both groups will be followed simultaneously and outcomes will be compared between them.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Women undergoing elective cesarean section * Age between 18-40 years * Medically stable patients * Patients admitted and staying in hospital for at least 24 hours post-surgery * Willing to participate and provide informed consent
Exclusion criteria
* History of previous abdominal surgeries (e.g., hernia, cholecystectomy) * Presence of comorbidities such as diabetes, rheumatoid arthritis, or long-term steroid use * Patients with severe postpartum complications (e.g., hemorrhage, deep vein thrombosis, pulmonary embolism) * Patients experiencing severe nausea, dizziness, or vomiting * Patients unable to follow instructions * Patients unwilling to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Postoperative Pain Intensity | Baseline (within 5 hours post-surgery) and at discharge (3-5 days post-surgery) | Pain intensity will be measured using the Visual Analog Scale (VAS), a continuous scale ranging from 0 (no pain) to 10 (worst imaginable pain), where higher scores indicate worse pain intensity. |
| Time to First Ambulation | Within 24-48 hours post-surgery | Time to first ambulation will be defined as the time (in hours) from the end of surgery to the participant's ability to walk independently without assistance. Shorter time indicates better recovery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Functional Recovery Status | Baseline (post-surgery) and at discharge (3-5 days) | Functional recovery will be assessed using the Barthel Index of Activities of Daily Living (ADL), which measures independence in activities such as sitting, standing, and walking. The scale ranges from 0 (total dependence) to 100 (complete independence), with higher scores indicating better functional recovery. |
Countries
Pakistan
Contacts
PRINCIPAL_INVESTIGATORDr Syeda Wajeeha, MS
Lady Reading Hospital Peshawar
Outcome results
None listed