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Impact of Post-Cesarean Abdomino-Pelvic Training on Diastasis Recti and Sexual Function (APPT-S)

2 maja 2026 zaktualizowane przez: Mehmet Incebıyik, Harran University

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

This study aims to investigate the effects of a specific exercise program on physical recovery and sexual health in women who have had a cesarean section. Pregnancy and abdominal surgery can lead to a separation of the abdominal muscles, known as Diastasis Recti Abdominis (DRA), and may affect pelvic health and sexual function. Participants will be randomly assigned to either an intervention group or a control group. The intervention group will participate in a 6-week "Structured Abdomino-Pelvic Power-Training" program starting at the 6th week after surgery. This program includes specific exercises to strengthen the core and pelvic floor muscles. The control group will follow the standard routine postpartum care. The researchers will use ultrasound and Doppler imaging to measure the distance between the abdominal muscles and the blood flow in the pelvic area at the beginning of the study and after 6 weeks of training. Participants will also complete a validated questionnaire (FSFI) to evaluate their sexual function. The goal of the research is to determine if this structured exercise program helps close the abdominal gap more effectively and improves pelvic blood flow and sexual well-being compared to standard care.

Przegląd badań

Szczegółowy opis

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.

Typ studiów

Interwencyjne

Zapisy (Szacowany)

120

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

Kopia zapasowa kontaktu do badania

Lokalizacje studiów

    • HALİLİYE
      • Sanliurfa, HALİLİYE, Turcja (Türkiye), 63300
      • Şanliurfa, HALİLİYE, Turcja (Türkiye), 63300
        • Harran University Research and Application Hospital
        • Kontakt:

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

  • Dorosły

Akceptuje zdrowych ochotników

Tak

Opis

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.

-

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 studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Pojedynczy

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: 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.
Aktywny komparator: 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.
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.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Change in Inter-recti Distance (IRD)
Ramy czasowe: From baseline (6th week postpartum) to the completion of the exercise program (3rd month postpartum).
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).
From baseline (6th week postpartum) to the completion of the exercise program (3rd month postpartum).

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Szacowany)

1 maja 2026

Zakończenie podstawowe (Szacowany)

1 listopada 2026

Ukończenie studiów (Szacowany)

1 grudnia 2026

Daty rejestracji na studia

Pierwszy przesłany

2 maja 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

2 maja 2026

Pierwszy wysłany (Rzeczywisty)

8 maja 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

8 maja 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

2 maja 2026

Ostatnia weryfikacja

1 maja 2026

Więcej informacji

Terminy związane z tym badaniem

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIE

Opis planu IPD

To protect the privacy of the participants and ensure data confidentiality in accordance with the institutional ethical guidelines, individual participant data (IPD) will not be made publicly available. The study involves sensitive clinical measurements and personal health information that were collected under the condition of strict anonymity. Results will be disseminated through aggregated data in peer-reviewed publications.

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

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Badania kliniczne na Abdomino-Pelvic Power-Training Program

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