Effectiveness Of Early Bed Mobility Exercises And Ambulation In Post Operative Cesarean Section Pain Reduction

Effectiveness Of Early Bed Mobility Exercises And Ambulation In Post Operative Cesarean Section Pain Reduction: A Randomized Controlled Trial

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.

Study Overview

• Status: Completed
• Conditions: Cesarean Section; Early Ambulation; Exercise Therapy
• Intervention / Treatment: Procedure: Early Bed Mobility Exercises and Ambulation; Other: Routine Nursing Care

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.

• Study Type: Interventional
• Enrollment (Actual): 56
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • KPK
    • Peshawar, KPK, Pakistan, 25000
      • Lady Reading Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

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

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: Early Bed Mobility Exercises and Ambulation; Participants in this group will receive a structured physiotherapy program starting 5 hours after cesarean section. The intervention includes pelvic rolling, leg sliding, deep breathing exercises, pursed-lip breathing, chest expansion exercises, huffing and coughing techniques, ankle pumping, abdominal wall setting, and early ambulation. Exercises will be performed 3 times daily with 10-12 repetitions per session from the day of surgery until discharge.	Procedure: Early 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.
Active Comparator: Routine Postoperative Nursing Care; Participants in this group will receive routine post-operative nursing care as per hospital protocol without any structured physiotherapy exercise program.	Other: Routine Nursing Care; Standard postoperative care provided according to hospital protocol without any additional structured physiotherapy or mobilization program.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Postoperative Pain Intensity	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.	Baseline (within 5 hours post-surgery) and at discharge (3-5 days post-surgery)
Time to First Ambulation	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.	Within 24-48 hours post-surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Functional Recovery Status	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.	Baseline (post-surgery) and at discharge (3-5 days)

Collaborators and Investigators

• Sponsor: Lady Reading Hospital, Pakistan
• Investigators: Principal Investigator: Dr Syeda Wajeeha, MS, Lady Reading Hospital Peshawar

Publications and helpful links

General Publications

• Citak Karakaya I, Yuksel I, Akbayrak T, Demirturk F, Karakaya MG, Ozyuncu O, Beksac S. Effects of physiotherapy on pain and functional activities after cesarean delivery. Arch Gynecol Obstet. 2012 Mar;285(3):621-7. doi: 10.1007/s00404-011-2037-0. Epub 2011 Aug 10.
• Weerasinghe K, Rishard M, Brabaharan S, Mohamed A. Effectiveness of face-to-face physiotherapy training and education for women who are undergoing elective caesarean section: a randomized controlled trial. Arch Physiother. 2022 Feb 3;12(1):4. doi: 10.1186/s40945-021-00128-9.
• Weerasinghe K, Rishard M, Brabaharan S, Walpita Y. Physiotherapy training and education prior to elective Caesarean section and its impact on post-natal quality of life: a secondary analysis of a randomized controlled trial. BMC Res Notes. 2023 Oct 13;16(1):270. doi: 10.1186/s13104-023-06550-5.

Study record dates

Study Major Dates

• Study Start (Actual): March 25, 2025
• Primary Completion (Actual): December 11, 2025
• Study Completion (Actual): March 22, 2026

Study Registration Dates

• First Submitted: March 17, 2026
• First Submitted That Met QC Criteria: March 26, 2026
• First Posted (Actual): March 30, 2026

Study Record Updates

• Last Update Posted (Actual): April 7, 2026
• Last Update Submitted That Met QC Criteria: April 4, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Postoperative Pain; Physiotherapy; Early Mobilization; Pain Reduction; Postnatal Exercises
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain, Postoperative; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena; Exercise; Locomotion; Walking
• Other Study ID Numbers: 82/LRH/MTI

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data (IPD) collected during the study, including pain scores (VAS, NPRS), demographic data, and outcome measures, will be shared with other researchers upon reasonable request for academic and research purposes. All personal identifiers will be removed to ensure participant confidentiality.
• IPD Sharing Time Frame: Data will be made available within 6 months after publication of the study results and will remain available for up to 5 years.
• IPD Sharing Access Criteria: Access to the data will be granted to qualified researchers upon reasonable request. Requests must include a research proposal and will be reviewed by the principal investigator. Data will be shared after approval and signing of a data-sharing agreement to ensure ethical use and confidentiality.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE; CSR

Drug and device information, study documents

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