- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT07575490
Impact of Post-Cesarean Abdomino-Pelvic Training on Diastasis Recti and Sexual Function (APPT-S)
The Impact of Structured Postoperative Abdomino-Pelvic Power-Training on Diastasis Recti Abdominis, Pelvic Hemodynamics, and Sexual Function Following Cesarean Section: A Prospective, Randomized Controlled, Doppler Morphometric Analysis Study
Descripción general del estudio
Estado
Intervención / Tratamiento
Descripción detallada
Background and Rationale:
Cesarean section (C-section) is a major surgical procedure that alters the integrity of the abdominal wall. Even if it avoids direct pelvic floor trauma associated with vaginal delivery, the combination of pregnancy-related mechanical stress and surgical incision often leads to Diastasis Recti Abdominis (DRA) and pelvic floor dysfunction. These conditions are frequently associated with reduced sexual function and lower quality of life in the postpartum period. While pelvic floor muscle training (PFMT) is well-studied, there is a lack of objective evidence regarding the impact of structured "Abdomino-Pelvic Power-Training" on tissue-level recovery and vascular perfusion. Study Objectives:
The primary objective of this prospective, randomized controlled study is to evaluate the efficacy of a 6-week structured rehabilitation program on inter-recti distance (IRD), pelvic hemodynamics, and sexual function in primiparous women following elective C-section. Methodology and Intervention:
A total of 160 participants will be recruited at their 6th-week postpartum visit at Harran University Hospital. Eligible participants will be randomized into two groups: Intervention Group: Participants will receive a 6-week structured abdomino-pelvic power-training protocol (including PFMT and core stabilization exercises). The program consists of weekly clinical visits and a prescribed home exercise regimen. Control Group: Participants will receive standard routine postpartum follow-up care without specific exercise training. Outcome Measures and Evaluation:
Assessments will be performed at baseline (6th week postpartum) and at the end of the intervention (3rd month postpartum). Morphometric Analysis: Inter-recti distance (IRD) will be measured using linear probe ultrasonography. Hemodynamic Assessment: Pelvic blood flow will be evaluated via Doppler ultrasonography, measuring Pulsatility Index (PI) and Resistance Index (RI) of the Uterine Artery and Vaginal Artery, as well as perfusion of the surgical scar tissue. Functional Assessment: Sexual function will be measured using the validated Female Sexual Function Index (FSFI) questionnaire. Statistical Analysis:
Data will be analyzed using SPSS software. Continuous variables will be compared using Independent Samples t-test or Mann-Whitney U test between groups, and Paired Samples t-test or Wilcoxon Signed-Rank test for within-group changes over time. Correlation between objective Doppler parameters and subjective FSFI scores will be evaluated.
Tipo de estudio
Inscripción (Estimado)
Fase
- No aplica
Contactos y Ubicaciones
Estudio Contacto
- Nombre: MEHMET İNCEBIYIK, MD, Asst. Prof.
- Número de teléfono: +905353374889
- Correo electrónico: drmehmetincebiyik@gmail.com
Copia de seguridad de contactos de estudio
- Nombre: ismail palalı, PhD, Asst. Prof.
- Correo electrónico: ismail.palali01@gmail.com
Ubicaciones de estudio
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HALİLİYE
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Sanliurfa, HALİLİYE, Turquía (Türkiye), 63300
- Harran University Research and Application Hospital
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Contacto:
- MEHMET İNCEBIYIK, Assistant Professor, MD
- Número de teléfono: 05353374889
- Correo electrónico: drmehmetincebiyik@gmail.com
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Contacto:
- İsmail Palalı, PT, PhD
- Correo electrónico: ismail.palali01@gmail.com
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Şanliurfa, HALİLİYE, Turquía (Türkiye), 63300
- Harran University Research and Application Hospital
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Contacto:
- MEHMET İNCEBIYIK
- Número de teléfono: 05353374889
- Correo electrónico: drmehmetincebiyik@gmail.com
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
- Adulto
Acepta Voluntarios Saludables
Descripción
Inclusion Criteria:Primiparous women (first-time mothers).
Women who have undergone an elective cesarean section.
Participants who are at their 6th week postpartum at the start of the study.
Aged between 18 and 45 years.
Volunteering to participate and capable of signing the informed consent form.
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Exclusion Criteria:
- Multiparous women (those with more than one delivery).
Women with a history of previous abdominal or pelvic surgery (other than the current C-section).
Presence of chronic diseases (e.g., uncontrolled diabetes, hypertension, or connective tissue disorders).
Any musculoskeletal or neurological condition that prevents participation in an exercise program.
History of pelvic organ prolapse or severe urinary incontinence prior to pregnancy.
Active pelvic or abdominal infection.
Participants who have already started a structured postpartum exercise program elsewhere.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
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Experimental: Intervention Group: Abdomino-Pelvic Power-Training
Participants in this arm will participate in a 6-week "Structured Abdomino-Pelvic Power-Training" program, starting at the 6th week postpartum. The intervention consists of: Clinical Sessions: Once-a-week supervised training sessions conducted at the hospital to ensure correct technique. Home Exercise Program: Prescribed daily exercises to be performed by the participant at home for the remaining 6 days of the week. Core Stabilization: Specific exercises targeting the rectus abdominis, obliques, and transversus abdominis muscles to reduce inter-recti distance (IRD). Pelvic Floor Muscle Training (PFMT): Structured contractions aimed at improving pelvic floor strength and hemodynamics. Monitoring: Progress will be monitored during weekly clinical visits, and the intensity will be adjusted based on participant tolerance. |
A 6-week structured exercise program including one weekly supervised clinical session and daily home exercises.
It focuses on core stabilization (rectus abdominis, obliques, transversus abdominis) to reduce inter-recti distance and Pelvic Floor Muscle Training (PFMT) to improve strength and hemodynamics.
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Comparador activo: Control Group: Standard Postpartum Care
Participants in this arm will follow the standard routine postpartum care and follow-up protocol provided by the clinic.
They will not participate in the structured abdomino-pelvic or pelvic floor exercise program during the 6-week study period.
All clinical assessments, including ultrasound measurements for inter-recti distance, pelvic Doppler imaging, and the Female Sexual Function Index (FSFI) questionnaires, will be performed at the same time intervals as the intervention group (at the 6th week and 3rd month postpartum) to provide a comparative baseline for the study.
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Participants will follow the routine clinical postpartum follow-up protocol.
This includes standard medical advice and assessments at the 6th week and 3rd month postpartum, without participation in the structured exercise program.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Change in Inter-recti Distance (IRD)
Periodo de tiempo: From baseline (6th week postpartum) to the completion of the exercise program (3rd month postpartum).
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The distance between the medial borders of the two rectus abdominis muscles, measured in centimeters (cm) using linear probe ultrasonography to evaluate the severity of Diastasis Recti Abdominis (DRA).
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From baseline (6th week postpartum) to the completion of the exercise program (3rd month postpartum).
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Colaboradores e Investigadores
Patrocinador
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Estimado)
Finalización primaria (Estimado)
Finalización del estudio (Estimado)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Otros números de identificación del estudio
- HRÜ/26.04.16
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
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Ensayos clínicos sobre Abdomino-Pelvic Power-Training Program
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Riphah International UniversityActivo, no reclutandoIncontinencia urinaria | Incontinencia Urinaria, Urgencia | Incontinencia Urinaria, Estrés | Síntomas posmenopáusicosPakistán