Low Back Pain Intensity and Core Muscle Strength After Different Delivery Modes

September 28, 2025 updated by: Mohamed Gamal Abouelyazeed Ali, South Valley University

Testing the Association Between Low Back Pain Intensity and Core Muscle Strength in Women Who Underwent Cesarean or Vaginal Deliveries

Cesarean delivery (CD) may trigger an increase in low back pain (LBP) intensity and induce core muscle weakness. This study will assess the correlation between low back pain intensity and core muscle strength of transverse abdominis and Lumbar multifidus among women who underwent CD and compare it with those who experienced vaginal delivery.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Cesarean delivery (CD) is one of the most common surgical procedures in obstetrics, and it is also one of the oldest medical procedures. The rise in the rate of cesarean sections is one of the most striking hallmarks of modern obstetrics.

In Egypt, the prevalence of CD has increased dramatically over the last decade, with the most recent Egypt Demographic and Health Survey (EDHS) reporting a rate of 52 percent, implying that cesarean sections may be overused or utilized for improper reasons.

The two deep local core muscles are the transversus abdominis and the lumbar multifidus muscles. The definition of Core muscle strength is the active ability of these muscles to not only produce but also, maintain stresses to provide stability for the spine through management of the intra-abdominal pressure.

LBP prevalence in mothers undergoing cesarean delivery was higher compared to its counterpart in mothers undergoing vaginal delivery. The related mechanisms for LBP during the postpartum period following cesarean or vaginal deliveries may be overweight and obesity, postural adaptations, and stressful positions that mothers assume during either delivery or lactation.

Study Type

Observational

Enrollment (Actual)

36

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Egypt
    • Qena Governorate
      • Qina, Qena Governorate, Egypt, 83523
        • Faculty of physical therapy, South Valley University

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

18 years to 35 years (Adult)

Accepts Healthy Volunteers

No

Sampling Method

Probability Sample

Study Population

36 participants participated in our study, and were classified into 2 groups; (group A) represents 18 mothers undergoing cesarean birth, and (group B) represents 18 mothers undergoing normal vaginal birth.

Description

Inclusion Criteria:

  1. All women are either primiparous or multiparous.
  2. Their ages ranged from 18 to 35 years.
  3. All participants had a body mass index (BMI) of not more than 29.5, and a waist-to-hip ratio of not more than 1.
  4. Participants were assessed between the 6th week to the 12th week postnatal.
  5. All participants were able to continue all assessment procedures.
  6. They were medically stable.

Exclusion Criteria:

  1. Women who were below 18 years old or above 35 years old.
  2. Women who had a (BMI) above 29.5 or a waist-to-hip ratio above 1.
  3. Women who did not continue all assessment procedures.
  4. Women who had a past history of specific LBP as those who were diagnosed with spondylolisthesis, lumbar disc prolapse, or structural scoliosis.

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

  • Observational Models: Cohort
  • Time Perspectives: Retrospective

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Group A
18 participants have been exposed to cesarean delivery
Other: Visual analogue scale (VAS)
VAS is a reliable and valid method for assessing the intensity of low back pain (LBP)
Device: Pressure Biofeedback Unit (PBU)
PBU is a valid and reliable instrument for measuring the maximal voluntary isometric contraction of both lumbar multifidus and transversus abdominis muscles (core muscle strength)
Group B
18 participants have been exposed to vaginal delivery
Other: Visual analogue scale (VAS)
VAS is a reliable and valid method for assessing the intensity of low back pain (LBP)
Device: Pressure Biofeedback Unit (PBU)
PBU is a valid and reliable instrument for measuring the maximal voluntary isometric contraction of both lumbar multifidus and transversus abdominis muscles (core muscle strength)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The intensity of LBP
Time Frame: Assessment will be done 6-12 weeks after Cesarean OR Vaginal deliveries
The intensity of low back pain is a standardized method to quantify the severity of low back pain
Assessment will be done 6-12 weeks after Cesarean OR Vaginal deliveries
The maximal voluntary isometric contraction of the transversus abdominis muscle
Time Frame: Assessment will be done 6-12 weeks after Cesarean or Vaginal Deliveries
The maximum voluntary isometric contraction (MVIC) is an objective standardized method with high reliability used to evaluate and quantify muscle strength
Assessment will be done 6-12 weeks after Cesarean or Vaginal Deliveries
The maximal voluntary isometric contraction of the lumbar multifidus muscle
Time Frame: Assessment will be done 6-12 weeks after Cesarean or Vaginal Deliveries
The maximum voluntary isometric contraction (MVIC) is an objective standardized method with high reliability used to evaluate and quantify muscle strength
Assessment will be done 6-12 weeks after Cesarean or Vaginal Deliveries
The correlation coefficient between low back pain intensity and core muscle strength
Time Frame: Assessment will be done 6-12 weeks after Cesarean or Vaginal Deliveries
The correlation coefficient between two variables of outcome is a valid statistical method to the association between them
Assessment will be done 6-12 weeks after Cesarean or Vaginal Deliveries

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

South Valley 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

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)

June 28, 2021

Primary Completion (Actual)

January 29, 2022

Study Completion (Actual)

August 5, 2023

Study Registration Dates

First Submitted

August 6, 2022

First Submitted That Met QC Criteria

August 6, 2022

First Posted (Actual)

August 9, 2022

Study Record Updates

Last Update Posted (Estimated)

October 2, 2025

Last Update Submitted That Met QC Criteria

September 28, 2025

Last Verified

September 1, 2024

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Core muscle strength

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

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.

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