Investigation the Effects of Stabilization Exercises on Pain, Disability and Activity of Pelvic Floor Muscles in Patients With Postpartum Lumbopelvic Pain

Zahra Teymuri, Zahedan University of Medical Sciences

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.

Study Overview

• Status: Completed
• Conditions: Postpartum Lumbopelvic Pain
• Intervention / Treatment: Other: Stabilization exercise; Other: Control group

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.

• Study Type: Interventional
• Enrollment (Actual): 36
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Iran, Islamic Republic of
  • Sistan and Bluchestan, Iran, Islamic Republic of
    • Zahra Teymuri

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 50 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Female

Description

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.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: stabilization exercises; stabilization exercises for 6 weeks, 3 sessions per week and each session was 40 minutes for the training group.	Other: Stabilization exercise; 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.
Experimental: control group; electrotherapy include of 20 minutes TENS conventional and Ultrasound pulse for 10 minutes without any exercises for the control group.	Other: Control group; 8 sessions during 6 consecutive weeks, three times per week, per session including: Twenty minutes for receiving hot pack and TENS

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
pain	Visual Analog Scale(VAS) questionnaire	6 weeks
Disability	Oswestry Disability Index(ODI) questionnaire	6 weeks
Pelvic Floor Muscle activity	Transabdominal approach of Ultrasound imaging	6 weeks
Abdominal muscles(Transverse Abdominis,Internal Oblique,External Oblique) thickness	Ultrasound imaging	6 weeks
Multifidus muscle thickness and crass section area(S1 level)	Ultrasound imaging	6 weeks

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
age	with questionnaire	6 weeks
weight	with questionnaire	6 weeks
height	with questionnaire	6 weeks
Body Mass Index(BMI)	with questionnaire	6 weeks

Collaborators and Investigators

• Sponsor: Zahedan University of Medical Sciences

Publications and helpful links

General Publications

• Teymuri Z, Hosseinifar M, Sirousi M. The Effect of Stabilization Exercises on Pain, Disability, and Pelvic Floor Muscle Function in Postpartum Lumbopelvic Pain: A Randomized Controlled Trial. Am J Phys Med Rehabil. 2018 Dec;97(12):885-891. doi: 10.1097/PHM.0000000000000993.

Study record dates

Study Major Dates

• Study Start: September 1, 2015
• Primary Completion (Actual): March 1, 2016
• Study Completion (Actual): April 1, 2016

Study Registration Dates

• First Submitted: January 15, 2017
• First Submitted That Met QC Criteria: January 20, 2017
• First Posted (Estimate): January 25, 2017

Study Record Updates

• Last Update Posted (Estimate): January 25, 2017
• Last Update Submitted That Met QC Criteria: January 20, 2017
• Last Verified: January 1, 2017

More Information

Terms related to this study

• Keywords: pregnancy; pelvic floor muscles; Stabilization exercises; Lumbo-pelvic pain; abdominal muscles thickness; Multifidus muscles thickness; Multifidus muscles cross section area
• Other Study ID Numbers: ZAUMS

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO