Exercise-Based Sensorimotor Physiotherapy for Postpartum Pelvic Health and Functional Recovery
Effects of a 12-Week Exercise-Based Sensorimotor Physiotherapy Program on Postpartum Pelvic Health and Functional Recovery: A Stratified Randomized Controlled Trial
This study evaluated whether a 12-week exercise-based sensorimotor physiotherapy program could improve pelvic health and functional recovery in postpartum women. Participants were women aged 18-40 years who were between 6 weeks and 6 months after a singleton delivery. They were randomly assigned to either a sensorimotor physiotherapy group or a control group. The physiotherapy group received supervised exercises targeting pelvic floor activation, lumbopelvic motor control, sensory re-education, proprioceptive training, functional stabilization, and biofeedback-assisted training. The control group received standard postpartum education and home advice.
The main outcomes were pelvic motor control and perineal sensory function. Other outcomes included pelvic floor muscle strength, urinary symptoms, pelvic distress, core endurance, postural stability, pain intensity, and health-related quality of life. Outcomes were assessed at baseline, week 6, week 12, and week 24. The study aimed to determine whether structured sensorimotor physiotherapy provides greater benefits than standard postpartum advice and whether recovery patterns differ according to vaginal or cesarean delivery.
Visão geral do estudo
Status
Condições
Descrição detalhada
This was a prospective, single-center, assessor-blinded, stratified, parallel-group randomized controlled trial conducted in postpartum women. The study was designed to evaluate the effects of a structured 12-week exercise-based sensorimotor physiotherapy program on postpartum pelvic health, lumbopelvic motor control, sensory function, and functional recovery.
Eligible postpartum women were stratified according to delivery mode, vaginal delivery or cesarean delivery, and then randomly allocated to either the Sensorimotor Physiotherapy Group or the Control Group. The intervention group received supervised individual physiotherapy sessions twice weekly for 12 weeks, together with a structured home exercise program. The intervention included pelvic floor activation, lumbopelvic motor control training, proprioceptive exercises, sensory re-education, functional stabilization, and surface electromyography-assisted biofeedback. The control group received standard postpartum education and general home advice.
Outcome assessments were performed at baseline, week 6, week 12, and week 24 by blinded assessors. The primary focus was to determine whether the sensorimotor physiotherapy program improved pelvic motor control and perineal sensory function compared with standard postpartum advice. Secondary outcomes were used to evaluate broader functional and patient-reported recovery, including pelvic floor strength, urinary symptoms, pelvic distress, core endurance, postural stability, pain intensity, and health-related quality of life. Delivery mode was examined as an exploratory factor that could influence recovery patterns.
Tipo de estudo
Inscrição (Real)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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Kayseri
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Kayseri, Kayseri, Turquia (Türkiye), 38130
- Kayseri University
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
Aceita Voluntários Saudáveis
Descrição
Inclusion Criteria:
- Women aged 18-40 years.
- Postpartum women between 6 weeks and 6 months after delivery.
- Singleton delivery.
- Vaginal delivery or cesarean delivery.
- Ability to understand and perform the required assessment procedures.
- Ability to participate in the exercise-based intervention procedures.
- Provision of written informed consent before enrollment.
Exclusion Criteria:
- Third- or fourth-degree perineal tears.
- Pelvic organ prolapse stage II or higher according to the POP-Q classification.
- Active urinary tract infection or genital infection.
- Previous pelvic or abdominal surgery unrelated to cesarean delivery.
- Neurological conditions affecting lumbopelvic motor control.
- Musculoskeletal conditions affecting lumbopelvic motor control.
- Chronic pelvic pain syndromes.
- Psychiatric disorders limiting participation.
- Participation in structured physiotherapy or pelvic rehabilitation within the preceding 6 months.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Solteiro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
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Experimental: Exercise-Based Sensorimotor Physiotherapy Program
A 12-week physiotherapist-led exercise-based sensorimotor physiotherapy program delivered individually twice weekly for approximately 45 minutes per session.
The program included pelvic floor activation, diaphragmatic breathing, lumbopelvic motor control training, abdominal-pelvic floor synergy exercises, proprioceptive stimulation, tactile discrimination tasks, sensory re-education, functional stabilization, task-specific training, and surface electromyography-assisted biofeedback.
Participants also completed a structured home exercise program for 15-20 minutes per day, five days per week.
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A 12-week physiotherapist-led exercise-based sensorimotor physiotherapy program delivered individually twice weekly for approximately 45 minutes per session.
The program included pelvic floor activation, diaphragmatic breathing, lumbopelvic motor control training, abdominal-pelvic floor synergy exercises, proprioceptive training, tactile discrimination tasks, sensory re-education, functional stabilization, task-specific training, and surface electromyography-assisted biofeedback.
Participants also completed a structured home exercise program for 15-20 minutes per day, five days per week.
Outros nomes:
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Outro: Standard Postpartum Education and Home Advice
A standard postpartum education and home advice program including information on postpartum anatomy, posture correction, bladder care, and general pelvic floor exercises.
Participants received a printed home exercise leaflet and two telephone contacts at weeks 4 and 8 to encourage continuation of general advice.
No supervised physiotherapy, individualized exercise progression, biofeedback, or structured sensorimotor training was provided.
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A standard postpartum education and home advice program including information on postpartum anatomy, posture correction, bladder care, and general pelvic floor exercises.
Participants received a printed home exercise leaflet and two telephone contacts at weeks 4 and 8 to encourage continuation of general advice.
No supervised physiotherapy, individualized exercise progression, biofeedback, or structured sensorimotor training was provided.
Outros nomes:
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
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Change in Pelvic Motor Control Composite Score
Prazo: Baseline, week 6, week 12, and week 24
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Pelvic motor control was assessed using the Pelvic Motor Control Composite Score, an experimental composite index derived from surface electromyography-based parameters including normalized root mean square amplitude, onset latency, relaxation time, and contraction intermittency.
Higher scores indicate better lumbopelvic motor control.
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Baseline, week 6, week 12, and week 24
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Change in Perineal Sensory Function
Prazo: Baseline, week 6, week 12, and week 24
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Perineal sensory function was assessed using pressure detection threshold measured with a calibrated handheld algometer and two-point discrimination measured with a precision caliper.
Lower values indicate better sensory responsiveness and tactile discrimination.
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Baseline, week 6, week 12, and week 24
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Change in Pelvic Floor Muscle Strength
Prazo: Baseline, week 6, week 12, and week 24
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Pelvic floor muscle strength was assessed using the Modified Oxford Scale and the PERFECT scheme.
Higher scores indicate greater pelvic floor muscle strength and function.
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Baseline, week 6, week 12, and week 24
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Change in Urinary Incontinence Severity
Prazo: Baseline, week 6, week 12, and week 24
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Urinary incontinence severity was assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form.
Higher scores indicate greater urinary incontinence severity.
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Baseline, week 6, week 12, and week 24
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Change in Pelvic Floor Distress
Prazo: Baseline, week 6, week 12, and week 24
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Pelvic floor-related distress was assessed using the Pelvic Floor Distress Inventory-20.
Higher scores indicate greater pelvic floor symptom-related distress.
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Baseline, week 6, week 12, and week 24
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Change in Pelvic Floor Impact on Daily Function
Prazo: Baseline, week 6, week 12, and week 24
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The functional impact of pelvic floor symptoms was assessed using the Pelvic Floor Impact Questionnaire-7.
Higher scores indicate greater negative impact of pelvic floor symptoms on daily activities and quality of life.
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Baseline, week 6, week 12, and week 24
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Change in Core Endurance
Prazo: Baseline, week 6, week 12, and week 24
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Core endurance was assessed using prone plank and side plank duration.
Longer duration indicates better core endurance.
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Baseline, week 6, week 12, and week 24
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Change in Postural Stability
Prazo: Baseline, week 6, week 12, and week 24
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Postural stability was assessed using center-of-pressure displacement during stabilometry.
Lower center-of-pressure displacement or sway area indicates better postural stability.
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Baseline, week 6, week 12, and week 24
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Change in Pain Intensity
Prazo: Baseline, week 6, week 12, and week 24
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Pain intensity was assessed using a 0-10 visual analogue scale.
Higher scores indicate greater pain intensity.
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Baseline, week 6, week 12, and week 24
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Change in Health-Related Quality of Life
Prazo: Baseline, week 6, week 12, and week 24
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Health-related quality of life was assessed using the 12-item Short Form Health Survey version 2. Higher scores indicate better perceived health-related quality of life.
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Baseline, week 6, week 12, and week 24
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Cadeira de estudo: Özge Çopuroğlu, Kayseri University
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- KayseriUniversity111
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