- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04569136
Physical Therapy Intervention for Puerperal Mastitis
March 21, 2023 updated by: Kuan-Yin Lin, National Cheng Kung University
Physical Therapy Intervention for Puerperal Mastitis in Breastfeeding Women
Puerperal mastitis is one of the most commonly reported problems during breastfeeding.
Women frequently report breast pain, tenderness, redness, engorgement, fever, malaise, chills, lethargy, sweating, headache, nipple damage and a hot spot on the affected breast.
These highly distressing symptoms may severely impact on a woman's daily activities and quality of life and might lead to the premature cessation of exclusive breastfeeding, which may have significant impact on infant health and survival.
The role of physical therapy in reducing pregnancy/postpartum-related disorders including breast problems is gaining momentum and importance in obstetrics.
However, to date, only low-level evidence has shown positive effects of breast massage, a physical technique, on pain, milk supply and symptom relief in women with breastfeeding problems.
This is encouraging, however further research is needed to explore whether physical therapy is effective to reduce symptoms of puerperal mastitis.
The investigators will conduct a prospective, assessor blinded single-center randomized controlled trial to assess the effectiveness of an individualized physical therapy program with therapeutic ultrasound, education and massage for patients with puerperal mastitis, compared to patients receiving usual obstetric care and sham ultrasound treatment.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
The high incidence of mastitis in breastfeeding women places health professionals working with postpartum women in key positions for managing women for symptoms of mastitis.
This study aims to investigate the effectiveness of a physical therapy program for mastitis.
The data the investigators collect from this study will provide evidence on effective and targeted strategies to achieve the goals of acceptable, effective and low risk physical therapy treatment of mastitis in postpartum women.
Once these perspectives are known, recommendations on mastitis management can be made.
Study Type
Interventional
Enrollment (Anticipated)
75
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Kuan-Yin Lin, PhD
- Phone Number: 6737 +886-6-2353535
- Email: 10802003@gs.ncku.edu.tw
Study Locations
-
-
-
Tainan, Taiwan, 704
- Recruiting
- National Cheng Kung University
-
Contact:
- Kuan Yin Lin
- Phone Number: 5931 +886 62353535
- Email: 10802003@gs.ncku.edu.tw
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
21 years to 35 years (Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
Female
Description
Inclusion Criteria:
- Have given birth at National Cheng Kung University Hospital (NCKUH)
- Are Breastfeeding
- Are aged 21-35
- Are diagnosed with early stage mastitis
- Have sufficient Chinese/Mandarin language skills to participate
Exclusion Criteria:
- History of breast reduction or augmentation
- An abscess
- Severe physical/psychiatric impairments
- Presence of any malignancies
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intervention group
|
The education session including education about mastitis, feeding techniques, lifestyle changes, thermal/cryo therapy and demonstration of breast self-massage will take approximately 20 minutes.
Participants will be treated with 5 minutes of therapeutic ultrasound (pulsed mode) at a frequency of 1 Mega Hertz, a duty cycle of 20%, a pulse intensity of 1.8 Watt/centimetre squared.
The ultrasound probe will be moved at a speed of about 4 centimetre/second.
The intensity and duration will be adjusted if the patient complains of discomfort.
The ultrasound transducer head will massage over the tender point on the breast.
Breast massage includes general and focused massage.
Participants will lie in supine position.
The breast massage will be applied according to the Vodder method to the affected breast.
|
Sham Comparator: Sham group
|
The education session including education about mastitis, feeding techniques, lifestyle changes, thermal/cryo therapy and demonstration of breast self-massage will take approximately 20 minutes.
Breast massage includes general and focused massage.
Participants will lie in supine position.
The breast massage will be applied according to the Vodder method to the affected breast.
Participants will receive 5 minutes of 'sham' ultrasound at 0 Watt/centimetre squared intensity from a physical therapist.
|
Other: Usual care group
Receiving usual obstetric care, which may include verbal advice/printed patient information regarding mastitis and breastfeeding from the medical or nursing staff
|
Usual obstetric care may include verbal advice/printed patient information regarding mastitis and breastfeeding from the medical or nursing staff.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Breast and nipple pain
Time Frame: 3 months
|
Breast and nipple pain in the past 24 hours will be assessed using the numerical rating scale (NRS).
Participants will be asked to rate her breast pain and nipple pain from 0 to 10 (11 point scale), with 0 indicating no pain and 10 indicating the worst possible pain.
|
3 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Severity of breast engorgement
Time Frame: 3 months
|
The degree of breast engorgement of the left and right breasts will be assessed using a six-point engorgement scale developed by Hill and Humenick.
The higher scores indicate more severe breast engorgement (1=soft, no change, 2=slight change, 3=firm, non-tender, 4=firm, beginning tenderness, 5=firm, tender, 6=very firm and very tender).
|
3 months
|
Breast hardness
Time Frame: 3 months
|
The assessor will use a portable durometer to measure the hardness of left and right breasts.
The participant will lie in a supine position and the durometer will be placed at 3 cm from both nipples in the 10 o'clock and 2 o'clock positions.
The spring-loaded presser is pressed downwards until trigger switch on.
Each position will be measured three times and the mean value will be obtained.
|
3 months
|
Body and breast temperature
Time Frame: 3 months
|
Core body and breast temperatures will be measured using a non-contact infrared thermometer on the central part of the forehead and in the area 3 cm from both nipples in the 10 o'clock and 2 o'clock positions, respectively.
The temperature of each position will be measured three times and the mean value will be recorded.
|
3 months
|
Volume of mother's milk
Time Frame: 3 months
|
The volume of mother's milk will be measured by an electric breast pump for 15 minutes.
Milk volumes will be recorded by weighing the collecting bottle on an electronic digital scale to the nearest 0.1 gram before and after each expression.
|
3 months
|
Acceptability of the intervention program
Time Frame: 3 months
|
Acceptability of the intervention program will be assessed immediately post-intervention using a short questionnaire with 5-point Likert scale response to questions of 'how acceptable did you find the physical therapy interventions used in this study?' and 'how would you rate your overall satisfaction with the physical therapy program?' from 1 to 5, with 1 indicating very low acceptability or satisfaction and 5 indicating very high acceptability or satisfaction.
|
3 months
|
Number of participants reporting adverse events
Time Frame: 3 months
|
Adverse events will be recorded and reported as per Institutional Review Board, National Cheng Kung University Hospital guidelines on reporting adverse events and serious adverse events, with the absence of adverse or serious adverse events related to the physical therapy intervention used to indicate safety of the trial protocol.
|
3 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Kuan-Yin Lin, PhD, National Cheng Kung University
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S240-52. doi: 10.1002/acr.20543. No abstract available.
- Diepeveen LC, Fraser E, Croft AJE, Jacques A, McArdle AM, Briffa K, McKenna L. Regional and Facility Differences in Interventions for Mastitis by Australian Physiotherapists. J Hum Lact. 2019 Nov;35(4):695-705. doi: 10.1177/0890334418812041. Epub 2018 Nov 27.
- Kasseroller RG. The Vodder School: the Vodder method. Cancer. 1998 Dec 15;83(12 Suppl American):2840-2. doi: 10.1002/(sici)1097-0142(19981215)83:12b+3.0.co;2-5.
- Lavigne V, Gleberzon BJ. Ultrasound as a treatment of mammary blocked duct among 25 postpartum lactating women: a retrospective case series. J Chiropr Med. 2012 Sep;11(3):170-8. doi: 10.1016/j.jcm.2012.05.011.
- McLachlan Z, Milne EJ, Lumley J, Walker BL. Ultrasound treatment for breast engorgement: A randomised double blind trial. Aust J Physiother. 1991;37(1):23-8. doi: 10.1016/S0004-9514(14)60531-6.
- Witt AM, Bolman M, Kredit S, Vanic A. Therapeutic Breast Massage in Lactation for the Management of Engorgement, Plugged Ducts, and Mastitis. J Hum Lact. 2016 Feb;32(1):123-31. doi: 10.1177/0890334415619439. Epub 2015 Dec 7.
- Wong RA, Schumann B, Townsend R, Phelps CA. A survey of therapeutic ultrasound use by physical therapists who are orthopaedic certified specialists. Phys Ther. 2007 Aug;87(8):986-94. doi: 10.2522/ptj.20050392. Epub 2007 Jun 6. Erratum In: Phys Ther. 2007 Sep;87(9):1258.
- Hill PD, Humenick SS. The occurrence of breast engorgement. J Hum Lact. 1994 Jun;10(2):79-86. doi: 10.1177/089033449401000212.
- Lim AR, Song JA, Hur MH, Lee MK, Lee MS. Cabbage compression early breast care on breast engorgement in primiparous women after cesarean birth: a controlled clinical trial. Int J Clin Exp Med. 2015 Nov 15;8(11):21335-42. eCollection 2015.
- Geissler NJ. An instrument used to measure breast engorgement. Nurs Res. 1967 Spring;16(2):130-6. No abstract available.
- Mori H, Uemura N, Koga H, Okazaki M. Objective assessment of reconstructed breast hardness using a durometer. Breast Cancer. 2018 Jan;25(1):81-85. doi: 10.1007/s12282-017-0791-y. Epub 2017 Jun 23.
- Teran CG, Torrez-Llanos J, Teran-Miranda TE, Balderrama C, Shah NS, Villarroel P. Clinical accuracy of a non-contact infrared skin thermometer in paediatric practice. Child Care Health Dev. 2012 Jul;38(4):471-6. doi: 10.1111/j.1365-2214.2011.01264.x. Epub 2011 Jun 8.
- Jones E, Dimmock PW, Spencer SA. A randomised controlled trial to compare methods of milk expression after preterm delivery. Arch Dis Child Fetal Neonatal Ed. 2001 Sep;85(2):F91-5. doi: 10.1136/fn.85.2.f91.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
December 1, 2020
Primary Completion (Anticipated)
July 1, 2023
Study Completion (Anticipated)
October 31, 2023
Study Registration Dates
First Submitted
September 23, 2020
First Submitted That Met QC Criteria
September 23, 2020
First Posted (Actual)
September 29, 2020
Study Record Updates
Last Update Posted (Actual)
March 22, 2023
Last Update Submitted That Met QC Criteria
March 21, 2023
Last Verified
March 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- MOST 109-2314-B-006-041-MY3
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Study Data/Documents
-
Clinical Study Report
Information identifier: DOI:10.6315/2009.37(4)06
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Mastitis
-
First Affiliated Hospital of Zhejiang UniversityRecruitingIdiopathic Granulomatous Mastitis | Mastitis ChronicChina
-
Medipol UniversityUnknownIdiopathic Granulomatous MastitisTurkey
-
Granulomatous Mastitis Working GroupCompleted
-
Wuhan UniversityRecruitingRefractory Granulomatous Lobular MastitisChina
-
Wuhan UniversityRecruitingRefractory Granulomatous Lobular MastitisChina
-
Baskent UniversityRecruitingIdiopathic Granulomatous MastitisTurkey
-
Samsun Education and Research HospitalCompletedIdiopathic Granulomatous MastitisTurkey
-
Wuhan UniversityEnrolling by invitationBreast Diseases | Psychiatric Disorder | Mastitis GranulomatousChina
-
Shengjing HospitalRecruiting
Clinical Trials on Education
-
Erzincan UniversityCompletedQuality of Life | Nursing Caries | Breastfeeding | Postpartum | Nursing Model | Levine Conservation Model
-
Oregon Health and Science UniversityEnrolling by invitation
-
Mexican National Institute of Public HealthUniversity of North Carolina, Chapel Hill; Danone ResearchCompleted
-
Mclean HospitalCompleted
-
University of South FloridaNational Cancer Institute (NCI)WithdrawnPediatric CancerUnited States
-
University of Social Sciences and Humanities, WarsawNational Science Centre, PolandRecruiting
-
Pamukkale UniversityCompletedBreastfeeding | ImmigrantTurkey
-
University of MostarUnknownPain Score | Apgar Score | Mental Health Issue | Delivery Mode | Breastfeeding RateBosnia and Herzegovina
-
Centro de Endocrinologia Experimental y AplicadaNational Council of Scientific and Technical Research, ArgentinaCompletedType 2 DiabetesArgentina
-
US Department of Veterans AffairsThe American Legion Department of WisconsinCompletedCoronary Artery Disease | Hypertension | Diabetes Mellitus | HyperlipidemiaUnited States