Assessment of the Impact of Soft Tissue Mobilization on the Scar in Patients After Cesarean Section

Vancouver Scar Scale (VSS)

The Vancouver Scar Scale (VSS) rating the scars according to four parameters: vascularity, pigmentation, pliability, and height. Each parameter contains ranked subscales that may be summed to obtain a total score ranging from 0 (representing normal skin) to 13 (representing worst scar imaginable)

Time frame: 1. Before first intervention (baseline); 2. Before the second intervention (two weeks after the first intervention); 3. Two weeks after the second intervention (follow-up)

Scar assessment according to the Mustoe classification

6-stage scar classification taking into account its shape, size, color, as well as symptoms such as pain and itching.

Time frame: 1. Before first intervention (baseline); 2. Before the second intervention (two weeks after the first intervention); 3. Two weeks after the second intervention (follow-up)

Satisfaction With Life Scale (SWLS)

The Satisfaction with Life Scale (SWLS) is used to measure the feeling of satisfaction with life. This tool consists of five statements that the respondent evaluates on a seven-point scale. The respondent assesses the extent to which each statement applies to his or her life so far. The result obtained is the overall degree of satisfaction with life. The results range from 5 to 35 points. The higher the score, the higher the sense of life satisfaction.

Time frame: 1. Before first intervention (baseline); 2. Before the second intervention (two weeks after the first intervention); 3. Two weeks after the second intervention (follow-up)

Assessment of the sequence of abdominal muscle contraction during activation of the pelvic floor muscles - ultrasound examination

Sonoscape E2 device

Time frame: 1. Before first intervention (baseline); 2. After first intervention; 3. Before the second intervention (two weeks after the first intervention); 4. After the second intervention; 5. Two weeks after the second intervention (follow-up)

Quantitative assessment of soft tissue tension - Stiffness (S)

Objective parameter \[N/m\] quantifying the state of soft tissue tension using the MyotonPro device. Determines the force generated by the myometer's measuring tip needed to deform the tissue being examined to a specified depth. During the planned examination, the area of the cesarean section scar and the erector spinae muscle in the lumbar section will be assessed.

Time frame: 1. Before first intervention (baseline); 2. After first intervention; 3. Before the second intervention (two weeks after the first intervention); 4. After the second intervention; 5. Two weeks after the second intervention (follow-up)

Quantitative assessment of soft tissue tension - Decrement (D)

An objective parameter that quantifies the state of soft tissue tension using the MyotonPro device. It determines a property of tissue called elasticity. It is the ability of muscle tissue to return to its original shape after the deforming force ceases. During the planned examination, the area of the cesarean section scar and the erector spinae muscle in the lumbar section will be assessed.

Time frame: 1. Before first intervention (baseline); 2. After first intervention; 3. Before the second intervention (two weeks after the first intervention); 4. After the second intervention; 5. Two weeks after the second intervention (follow-up)

Transversus Abdominis activation-ratio (TrA-AR)

Ultrasound examination (Sonoscape E2 device): TrA activation ratio is created by dividing the thickness of the transverse abdominis muscle during contraction \[mm\] by the thickness of the transverse abdominis muscle during resting \[mm\]

Time frame: 1. Before first intervention (baseline); 2 Before the second intervention (two weeks after the first intervention); 3. Two weeks after the second intervention (follow-up)