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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)

30. oktober 2026 oppdatert av: 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.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

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.

Studietype

Intervensjonell

Registrering (Antatt)

15

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

  • Navn: Asiya Uzun, Asisstant Proffesor
  • Telefonnummer: +90(344) 300-2621
  • E-post: asiyauzun@ksu.edu.tr

Studiesteder

      • Kahramanmaraş, Tyrkia (Türkiye)
        • Rekruttering
        • Kahramanmaraş Sütçü İmam Üniversitesi hastanesi
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 40 år (Voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Hunn

Beskrivelse

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.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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.

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.

Aktiv komparator: 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.

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

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
VAS pain assesment
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Oswestry Disability Index (ODI)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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

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Sponsor

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. april 2026

Primær fullføring (Antatt)

20. februar 2027

Studiet fullført (Antatt)

15. mai 2027

Datoer for studieregistrering

Først innsendt

30. oktober 2026

Først innsendt som oppfylte QC-kriteriene

30. oktober 2026

Først lagt ut (Faktiske)

5. november 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

5. november 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

30. oktober 2026

Sist bekreftet

1. oktober 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • 2026/047

Plan for individuelle deltakerdata (IPD)

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NEI

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