Effectiveness Of Early Bed Mobility Exercises And Ambulation In Post Operative Cesarean Section Pain Reduction

Lady Reading Hospital, Pakistan56 enrolled

Overview

This study aims to evaluate the effectiveness of early bed mobility exercises and ambulation in reducing post-operative pain among women who undergo elective cesarean section. A randomized controlled trial will be conducted with 56 participants divided into intervention and control groups. The intervention group will receive physiotherapy exercises such as pelvic rolling, breathing exercises, and ambulation, while the control group will receive routine nursing care. Pain intensity will be assessed using the Visual Analog Scale (VAS) and Numerical Pain Rating Scale (NPRS). The study is expected to show that early mobilization reduces pain, improves recovery, and enhances overall well-being.

This study is a single-blind randomized controlled trial designed to investigate the effectiveness of early bed mobility exercises and ambulation in reducing post-operative pain among women undergoing elective cesarean section. The study will be conducted at the Department of Gynecology and Obstetrics, Lady Reading Hospital (MTI), Peshawar, over a period of six months. A total of 56 participants aged 18-40 years who meet the inclusion criteria will be recruited and randomly assigned into two groups using consecutive blocked randomization. The intervention group will receive a structured physiotherapy program including pelvic rolling, leg sliding, deep breathing, chest expansion exercises, ankle pumping, and ambulation starting 5 hours post-surgery. The control group will receive routine nursing care. Pain intensity will be assessed using the Visual Analog Scale (VAS) and Numerical Pain Rating Scale (NPRS) before and after the intervention. Data will be analyzed using Statistical Package for the Social Sciences (SPSS) version 25, applying paired and independent t-tests to compare within and between group differences. The study aims to demonstrate that early mobilization significantly reduces post-operative pain, decreases the need for analgesics, shortens hospital stay, and improves functional recovery and overall well-being in post-cesarean women.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

Interventions

Early Bed Mobility Exercises and AmbulationPROCEDURE

A structured physiotherapy program initiated 5 hours after cesarean section, including mobility and breathing exercises along with early ambulation, administered multiple times daily until discharge to improve recovery and reduce post-operative pain.

Routine Nursing CareOTHER

Standard postoperative care provided according to hospital protocol without any additional structured physiotherapy or mobilization program.

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 40 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Women undergoing elective cesarean section * Age between 18-40 years * Medically stable patients * Patients admitted and staying in hospital for at least 24 hours post-surgery * Willing to participate and provide informed consent Exclusion Criteria: * History of previous abdominal surgeries (e.g., hernia, cholecystectomy) * Presence of comorbidities such as diabetes, rheumatoid arthritis, or long-term steroid use * Patients with severe postpartum complications (e.g., hemorrhage, deep vein thrombosis, pulmonary embolism) * Patients experiencing severe nausea, dizziness, or vomiting * Patients unable to follow instructions * Patients unwilling to participate

Outcomes

Primary Outcomes

Change in Postoperative Pain Intensity

Pain intensity will be measured using the Visual Analog Scale (VAS), a continuous scale ranging from 0 (no pain) to 10 (worst imaginable pain), where higher scores indicate worse pain intensity.

Time frame: Baseline (within 5 hours post-surgery) and at discharge (3-5 days post-surgery)

Time to First Ambulation

Time to first ambulation will be defined as the time (in hours) from the end of surgery to the participant's ability to walk independently without assistance. Shorter time indicates better recovery.

Time frame: Within 24-48 hours post-surgery

Secondary Outcomes

Change in Functional Recovery Status

Functional recovery will be assessed using the Barthel Index of Activities of Daily Living (ADL), which measures independence in activities such as sitting, standing, and walking. The scale ranges from 0 (total dependence) to 100 (complete independence), with higher scores indicating better functional recovery.

Time frame: Baseline (post-surgery) and at discharge (3-5 days)