Effects of Pelvic Floor Exercises and Pelvic Support Belt in Symphysis Pubis Dysfunction

Effects of Pelvic Floor Exercises With and Without Pelvic Support Belt on Pain, Functions and Disability Among Post-partum Females With Symphysis Pubis Dysfunction

Symphysis Pubis Dysfunction (SPD) is a medical condition that affects the pelvic region, particularly the joint that joins the two pubic bones at the front of the pelvis, the pubic symphysis. Although normally this joint is quite stable, the ligaments surrounding the pelvis loosen in preparation for childbirth due to hormonal changes during pregnancy, particularly an increase in a hormone called relaxin. This may result in pelvic joint instability, which can cause pain and discomfort, usually in the pelvic region, lower abdomen, or groin. Symptoms, physical examination, and medical history are frequently used to diagnose SPD. Medical professionals may also test for pelvic instability and assess for tenderness near the pubic symphysis. Imaging (such as an X-ray or ultrasound) may be performed to rule out other disorders in certain situations, but it is not always required.

The study will be a randomized clinical trial and will be conducted in Fatima Medical Complex, Hameeda Bashir Hospital, Sadaf Yahya Hospital and Tehsil Head Quarter (THQ) Daska. This study will be completed in time duration of 10 months after the approval of synopsis. Non-probability convenience sampling technique will be used and 48 participants will be recruited in study after randomization. The subjects will be divided into two groups. Group A will receive Phonophoresis for 10 minutes as baseline treatment and pelvic floor exercises (Kegel Exercises, Bridging, Pelvic Tilt, Squats, Dead Bug) with pelvic support belt whereas Group B will receive only pelvic floor exercises and Phonophoresis as baseline treatment. The tools that will be used are Oswestry Disability Index, Pelvic Floor Impact Questionnaire (PFIQ-7) and Visual Analog Scale (VAS) for assessing Pain, Disability and functioning. After data collection, data will be analyzed by using SPSS version 25.

Keywords: pelvic floor, exercises, post-partum, symphysis pubis dysfunction, pain, function, disability

Study Overview

• Status: Recruiting
• Conditions: Pubic Symphysis Diastasis
• Intervention / Treatment: Other: pelvic floor excercises; Other: pelvic support belt

• Study Type: Interventional
• Enrollment (Estimated): 48
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Imran Amjad, PhD; Phone Number: 03324390125; Email: Imran.amjad@riphah.edu.pk

Study Locations

• Pakistan
  • Daska Kalan, Pakistan
    • Recruiting
    • Sadaf Yahya Hospital
    • Contact: mehar un nisa shafique, MS; Phone Number: 03344563221; Email: meharun.nisa@riphah.edu.pk
    • Principal Investigator: wajeeha siddiqui, MSPT-WH

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Multigravida females
• Women diagnosed with pubic symphysis dysfunction
• Females willing to provide informed consent to participate in the study.
• Functional Status: Able to engage in physical activity without significant contraindications.
• Symptom Severity: Experience pain and disability due to symphysis pubis dysfunction
• Previous Treatment: May not have undergone pelvic floor therapy.

Exclusion Criteria:

• • Participants below 8 years and above 12 years.

  • Any Psychological issue
  • Primigravida Females
  • Significant neurological disorders, pelvic pain syndromes, or conditions affecting pelvic floor function.
  • Pelvic Floor Disorders: Presence of other pelvic floor disorders (e.g., Fecal Incontinence, Urinary Incontinence)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: pelvic floor excercises; Group A patients will be given 10 minutes session of Phonophoresis as baseline treatment and pelvic floor exercises with 10 repetitions maximun including Kegel Exercises, Dead Bug, Bridging, Pelvic tilt and Squats with 2 sets each for up to 3-5 times a week with pelvic support belt.	Other: pelvic floor excercises; Group A patients will be given 10 minutes session of Phonophoresis as baseline treatment and pelvic floor exercises with 10 repetitions maximun including Kegel Exercises, Dead Bug, Bridging, Pelvic tilt and Squats with 2 sets each for up to 3-5 times a week with pelvic support belt; Other: pelvic support belt; Group B patients will be given 10 minutes session of Phonophoresis as baseline treatment and pelvic floor exercises with 10 repetitions maximum including Kegel Exercises, Dead Bug, Bridging, Pelvic tilt and Squats with 2 sets each for up to 3-5 times a week without pelvic support belt
Experimental: pelvic support belt; Group B patients will be given 10 minutes session of Phonophoresis as baseline treatment and pelvic floor exercises with 10 repetitions maximum including Kegel Exercises, Dead Bug, Bridging, Pelvic tilt and Squats with 2 sets each for up to 3-5 times a week without pelvic support belt	Other: pelvic support belt; Group B patients will be given 10 minutes session of Phonophoresis as baseline treatment and pelvic floor exercises with 10 repetitions maximum including Kegel Exercises, Dead Bug, Bridging, Pelvic tilt and Squats with 2 sets each for up to 3-5 times a week without pelvic support belt

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Analog Scale (VAS):	Visual Analogue Scale (VAS) is frequently used to gauge the severity of pain in a variety of healthcare settings across the globe. For determining how much pain a patient is suffering, it is an easy, rapid, and efficient tool.(13) VAS exhibits great repeatability and test-retest reliability.(14) VAS features a continuous scale made up of both horizontal and vertical lines, which are referred to as the vertical VAS and horizontal visual analogue scale. The vertical and horizontal VAS have a strong association. However, the horizontal VAS score is slightly lower than the vertical VAS score	6th week
Oswestry Disability Index (ODI)	The original Oswestry Disability Index (ODI) was developed in a specialist referral clinic for patients with chronic low back pain. (17) The Oswestry (version 2.1a) 21 is a 10-item, self report questionnaire that consists of items regarding the physical effects of pain and asks participants to rate their pain level (Section 1) and their ability to perform 9 tasks (Sections 2 through 10). Responses are graded on 6-point scales (0-5) for each item, with higher scores indicative of higher levels of perceived disability. The ODI refers to the ratio of the total score to the maximum score and is expressed as a percentage	6th week
Pelvic Floor Impact Questionnaire (PFIQ-7):	PFIQ covers the impact of POP on daily life.(19) The PFIQ consists of 21 items that measures the impact of bladder, bowel, and vaginal symptoms on daily activity, social/relationships, and emotional health. Response options range from 0 ("not at all") to 3PFIQ covers the impact of POP on daily life.(19) The PFIQ consists of 21 items that measures the impact of bladder, bowel, and vaginal symptoms on daily activity, social/relationships, and emotional health. Response options range from 0 ("not at all") to 3 ("quite a bit"). In each scale, the mean score of answered items is multiplied by 33.3 to obtain the scale score (range 0-100). Summary scores are calculated by adding up the scale scores (range 0-300). Higher scores indicate more impact on daily activity	6th week

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: mehar un nisa shafique, MS, Riphah International University

Publications and helpful links

General Publications

• Mamipour H, Farazmehr S, Negahban H, Nazary-Moghadam S, Dehghan-Manshadi F, Navi Nezhad M, Jafari S, Sharifzadeh M. Effect of Core Stabilization Exercises on Pain, Functional Disability, and Quality of Life in Pregnant Women With Lumbar and Pelvic Girdle Pain: A Randomized Controlled Trial. J Manipulative Physiol Ther. 2023 Jan;46(1):27-36. doi: 10.1016/j.jmpt.2023.05.005. Epub 2023 Jul 7.
• Patil VR, Sharma RK, editors. POST PREGNANCY-SYMPHYSIS PUBIS DYSFUNCTION AND PAIN MANAGEMENT USING MODIFIED PELVIC BELTS: A REVIEW. Obstetrics and Gynaecology Forum; 2024.
• Borscheva A, Pertseva G, Alekseeva N. Dysfunction of the symphysis as one of the actual problems of modern obstetrics. Medical Herald of the South of Russia. 2021;12(3):44-9.
• ALIAA EH, MAGDA SM, MOHAMED FA. Effect of Phonophoresis and Pelvic Brace on Symphysis Pubis Pain after Delivery. The Medical Journal of Cairo University. 2024;92(03):31-7.
• Morimoto K, Harrington A, Nelson C, Loveless B. Osteopathic approach to sacroiliac joint pain in pregnant patients. J Osteopath Med. 2022 Feb 18;122(5):235-242. doi: 10.1515/jom-2021-0231.

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2025
• Primary Completion (Estimated): March 1, 2026
• Study Completion (Estimated): March 1, 2026

Study Registration Dates

• First Submitted: February 23, 2026
• First Submitted That Met QC Criteria: February 23, 2026
• First Posted (Actual): February 27, 2026

Study Record Updates

• Last Update Posted (Actual): February 27, 2026
• Last Update Submitted That Met QC Criteria: February 23, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: pain; function; disability; pelvic floor; exercises; post-partum; symphysis pubis dysfunction
• Additional Relevant MeSH Terms: Diastasis, Bone; Urogenital Diseases; Neurologic Manifestations; Musculoskeletal Diseases; Wounds and Injuries; Female Urogenital Diseases and Pregnancy Complications; Joint Diseases; Pregnancy Complications; Musculoskeletal Pain; Pelvic Pain; Puerperal Disorders; Joint Dislocations; Pathological Conditions, Signs and Symptoms; Behavior; Signs and Symptoms; Pain; Pelvic Girdle Pain; Motor Activity; Pubic Symphysis Diastasis
• Other Study ID Numbers: REC/RCR&AHS/24/0539

Plan for Individual participant data (IPD)

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

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No