Postpartum women with C-section receiving deep and superficial tissue mobilization would have better improvement on pain, lumbopelvic muscle functions, spinal mobility, and posture compare to the superficial tissue mobilization and control group
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
120
Myofascial abdominal diaphragm release
Direct focused scar release technique
Direct manipulations to visceral structures
National Cheng Kung University
Tainan, Tainan, Taiwan
Scar Characteristic: Extensibility
The extensibility of the scar will be measured using the modified adheremeter in each of 4 directions including superior, inferior, medial and lateral and then the area of mobility will be calculated.
Time frame: 8 weeks
Scar Characteristic: Viscoelasticity
The biomechanical and viscoelastic properties of the scar tissue will be measured using a non-invasive myometer
Time frame: 8 weeks
Scar Characteristic: Irritability
The irritability of the scar will be measured using the digital pressure algometer for two conditions: first, when the pressure turns from discomfort to pain and the participant asks to stop, and then when the maximal pressure or pain the participant can tolerate.
Time frame: 8 weeks
Muscle function measures of lumbopelvic muscles
Ultrasonography image for muscle thickness of lumbopelvic muscles during rest and maximum contraction.
Time frame: 8 weeks
Muscle function measures of pelvic floor muscle control
Ultrasonography image for muscle thickness of pelvic floor muscle control during rest, maximum contraction
Time frame: 8 weeks
Spinal Mobility
Range of motion for cervical, thoracic, and lumbar spine in the sagittal, frontal, and transverse plane as well as pelvic tilt will be assessed using the wireless double inclinometers
Time frame: 8 weeks
Myofascial Flexibility
Straight leg raise test and Thomas test will be used to examine the muscle flexibility of the major lower extremity muscles.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
pelvic anatomy education
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Time frame: 8 weeks
Spinal Alignment and Posture
Radiographic measurement, posture will be assessed using the photographic measurement. Reflective markers will first be placed and attached on the canthus of the eye, tragus of the ear, the spinous processes of C2, C7, T1, T3, T11, T12, L1, L5, S1, S5, and bilateral anterior superior iliac spine and posterior superior iliac spine in standing. The participants will be instructed to maintain their gaze straight ahead at a target adjusted for body height. Two standing photographs will be taken, one in the usual standing posture and the other in the best standing posture. Following the other two photographs will be taken, one in maximal pelvic anterior tilt and the other in the maximal pelvic posterior tilt.
Time frame: 8 weeks
Pain intensity measure of Visual Analogue Scale
Visual Analogue Scale is a self-reported instrument assessing average pain intensity in currently. Possible score range from 0 (no pain) to 10 (worst possible pain).
Time frame: 8 weeks
Pain intensity measure of pelvic girdle questionnaire
pelvic girdle questionnaire is a self-reported instrument assessing pelvic girdle pain intensity in currently. Questionnaire consisting of 20 activity items and 5 symptom items on a 4-point response scale. Possible score range from 0 (no pain) to 100 (worst possible pain).
Time frame: 8 weeks
Pain intensity measure of Oswestry Low Back Pain Disability Questionnaire
Oswestry Low Back Pain Disability Questionnaire is a self-reported instrument assessing patient's permanent functional disability in currently. For each section the total possible score is 5: if the first statement is marked the section score = 0; if the last statement is marked, it = 5. The higher the score, the greater the degree of disability.
Time frame: 8 weeks
Self-perceived Change Health Status: Global Rating of Change Scale (GROC)
The GROC is a single-item instrument that provides a means of measuring self-perceived change in health status. The GROC uses the 15-point Likert scale to rate the perceived "overall change" on a continuum, with -7 (labeled "worse") on the left and +7 (labeled "better") on the right, and 0 in the middle (labeled "no change"), compared with the baseline
Time frame: 8 weeks
Patient and Observer Scar Assessment Scale (POSAS)
The POSAS includes 2 numerical numeric scales: The Patient Scar Assessment Scale and the Observer Scar Assessment Scale. It objectively assesses vascularity, pigmentation, thickness, relief, pliability, and surface area, and incorporates patient subjective symptoms of pain, itching, color, stiffness, thickness, and relief.
Time frame: 8 weeks