Effects of Pelvic Floor Muscle Training and a Modified Lumbopelvic Belt on Pain, Kinesiophobia, and Functional Status in Pregnant Women With Symphysis Pubis Pain (Pubic Pain)

October 30, 2026 updated by: Asiya Uzun, Kahramanmaras Sutcu Imam University

The aim of this study is to investigate the effects of pelvic floor muscle training and a modified lumbopelvic belt on pain, kinesiophobia, and functional status in pregnant women with symphysis pubis pain.Although the power analysis yielded a relatively small minimum sample size, the target sample size was increased to account for potential loss to follow-up and missing data, as may occur in clinical research. Accordingly, the study was planned to include at least 30 pregnant women in the final analysis, and 40 pregnant women will be recruited to allow for potential attrition and withdrawal.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

The reported prevalence of symphysis pubis dysfunction (SPD) during pregnancy varies across the literature. Data from the general population indicate that SPD affects approximately 3-8% of pregnant women. The incidence of symphysis pubis diastasis, a more severe clinical condition, has been reported across a wide range, from 1 in 300 to 1 in 30,000 pregnancies. However, recent studies report that the prevalence of SPD may exceed 30% among pregnant women with pelvic pain. This variability may be attributed to differences in diagnostic criteria, assessment methods, and sample characteristics.

Study Type

Interventional

Enrollment (Estimated)

15

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

Study Locations

  • Turkey (Türkiye)
      • Kahramanmaraş, Turkey (Türkiye)
        • Recruiting
        • Kahramanmaraş Sütçü İmam Üniversitesi hastanesi
        • Contact:

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 40 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Description

Inclusion criteria

Participants must:

  • Be pregnant and aged 18-40 years.
  • Have experienced pubic symphysis pain for at least 2 weeks, with pain more severe than any accompanying posterior pelvic pain.
  • Have positive findings on at least two of the following tests: pubic symphysis palpation, modified Trendelenburg test, and active straight leg raise test.
  • Provide written informed consent.

Exclusion criteria

Participants will be excluded for:

  • High-risk pregnancy or a medical contraindication to pelvic support belt use.
  • Serious systemic bone disease or a history of serious lumbar or pelvic trauma.
  • Current systemic corticosteroid use or active pelvic treatment/orthosis.
  • Neurological or cognitive conditions that prevent clinical testing or participation in the exercise program.

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: Symphysis Pubis Dysfunction group

The first group will be designated as the intervention group and will receive comprehensive physiotherapy education in conjunction with the use of a modified lumbopelvic belt. As part of a structured education program, participants will receive pelvic floor muscle training and diaphragmatic breathing training, as well as guidance on protective and symptom-relieving modifications to activities of daily living and relevant ergonomic and behavioral recommendations.
Other: modified lumbopelvic belt

intervention group and will receive comprehensive physiotherapy education in conjunction with the use of a modified lumbopelvic belt.As part of a structured education program, participants will receive pelvic floor muscle training and diaphragmatic breathing training, as well as guidance on protective and symptom-relieving modifications to activities of daily living and relevant ergonomic and behavioral recommendations.
Active Comparator: control group

The second group will be designated as the comparison group and will receive an educational program that includes pelvic floor muscle training, diaphragmatic breathing training, modifications to activities of daily living, and protective strategies. No belt will be used in this group.
Other: educational program

educational program that includes pelvic floor muscle training, diaphragmatic breathing training, modifications to activities of daily living, and protective strategies

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
VAS pain assesment
Time Frame: From enrollment to the end of treatment at 4 weeks

Pain intensity will be assessed using a 10-cm visual analog scale (VAS), ranging from 0 to 10. A score of 0 indicates no pain, whereas a score of 10 indicates unbearable pain. The VAS is widely used to assess pain intensity. Pain intensity will be classified as mild (1-4), moderate (5-7), or severe (8-10). Pain in the lower back, back, and pelvic girdle will be assessed separately during activity, at rest, and during sleep at night.
From enrollment to the end of treatment at 4 weeks
Pain threshold measurement (algometer)
Time Frame: From enrollment to the end of treatment at 4 weeks

An algometer has long been used to measure soft-tissue pain associated with trigger points (11). An algometer will be used to assess the pressure pain threshold. The device has a blunt, non-sharp probe with a contact surface area of 1 cm². Pressure will be applied perpendicular to the midpoint of the muscle. Before the procedure, participants will be informed about the assessment and instructed to report when they first feel pain as the pressure is gradually increased. Measurements will be taken with the participant in a supine position. The pressure value at which the participant first experiences pain will be recorded as the pain threshold. Three measurements will be taken at 1-minute intervals, and the mean will be calculated (12). The assessment will be performed by applying pressure over the pubic symphysis.
From enrollment to the end of treatment at 4 weeks
Pelvic Girdle Questionnaire (PGQ)
Time Frame: From enrollment to the end of treatment at 4 weeks

The PGQ was developed by Stuge et al. (13). It is a condition-specific measure for assessing activity limitations and symptoms in individuals with pelvic girdle pain. It was developed for use in pregnant and postpartum individuals with pelvic girdle pain and can be used in both research and clinical practice. Its Turkish validity and reliability were established by Yelvar et al.
From enrollment to the end of treatment at 4 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Oswestry Disability Index (ODI)
Time Frame: From enrollment to the end of treatment at 4 weeks

The ODI is a questionnaire developed specifically for individuals with low back pain to assess the degree of functional limitation in daily life. Its Turkish version has been tested for validity and reliability. It consists of 10 items addressing pain, personal care, lifting, standing, walking, sitting, traveling, sexual activity, and social life. Each item is scored from 0 to 5, with 0 representing the best level of function and 5 the worst
From enrollment to the end of treatment at 4 weeks
Tampa Scale for Kinesiophobia (TSK)
Time Frame: From enrollment to the end of treatment at 4 weeks

The Tampa Scale for Kinesiophobia was used to assess the severity of kinesiophobia in pregnant women. The TSK is a 17-item scale developed to measure fear of movement or reinjury. The original scale was developed by Miller, Kori, and Todd in 1991.The scale uses a four-point Likert response format: strongly disagree = 1, disagree = 2, agree = 3, and strongly agree = 4. To calculate the total score, items 4, 8, 12, and 16 are reverse-scored, and all item scores are summed. The total score ranges from 17 to 68, with higher scores indicating greater kinesiophobia.
From enrollment to the end of treatment at 4 weeks
World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-BREF)
Time Frame: From enrollment to the end of treatment at 4 weeks

The WHOQOL-BREF is a multidimensional self-report measure developed by the World Health Organization (WHO) to assess quality of life from a biopsychosocial perspective. A shorter version of the original WHOQOL-100, it was published in 1998. The WHOQOL-BREF consists of 26 items covering four domains of quality of life: physical health, psychological health, social relationships, and environment. Each item uses a five-point Likert scale to assess the respondent's perception of their quality of life over the previous two weeks. Scores are calculated separately for each domain and converted to a scale ranging from 0 to 100; higher scores indicate better quality of life. The WHOQOL-BREF enables comprehensive assessment of quality of life in both the general population and specific patient groups. It is widely used as a valid and reliable measure in health, psychology, rehabilitation, and public health research.
From enrollment to the end of treatment at 4 weeks

Collaborators and Investigators

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

Sponsor

Kahramanmaras Sutcu Imam University

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)

April 1, 2026

Primary Completion (Estimated)

February 20, 2027

Study Completion (Estimated)

May 15, 2027

Study Registration Dates

First Submitted

October 30, 2026

First Submitted That Met QC Criteria

October 30, 2026

First Posted (Actual)

November 5, 2026

Study Record Updates

Last Update Posted (Actual)

November 5, 2026

Last Update Submitted That Met QC Criteria

October 30, 2026

Last Verified

October 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2026/047

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

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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