The Comparison of Scar Mobilization Techniques with and without Core Stability Exercises on Scar Tissue Mobility and Lumbopelvic Pain
Abstract
Abstract Views: 0
Abdominal adhesions and lumbopelvic pain can occur after a caesarean section. Many treatment approaches, such as injections, massage, surgical release, soft tissue release, strengthening, stretching and core stability exercises are available for abdominal scars. Physiotherapy treatments are considered safer and more convenient. The study aims to compare the effects of scar mobilization techniques with and without core stability exercises on scar tissue mobility and lumbopelvic pain. The study was a randomized clinical trial conducted at the Rafiqa Hospital and Fatima Hospital, Sargodha, Pakistan. A sample of 30 participants was allocated in Group A and B. Group A received scar mobilization and core stability exercises, while Group B received only scar mobilization, with both groups undergoing 3 sessions per week for total three weeks. The groups were assessed at baseline after the 5th and 9th sessions, using Oswestry Low Back Pain Disability Questionnaire (ODI), Numeric Pain Rating Scale (NPRS), Manual Scar Mobility Testing (MSMT), and Vancouver Scar Scale (VSS). Moreover, the data were analyzed using SPSS 25. The mean age of participants was 27.22 ± 4.21, and their body mass index was 27.10 ± 3.53. Both groups showed significant differences within the subject’s scores of disability, pain and scar mobility (p<0.05). Between-group comparison of both groups at post-treatment II showed considerable improvement in pain scores (NPRS score, p<0.05). Whereas non-significant results were in other outcome measures (disability and scar mobility p>0.05) in post-treatment II. Scar mobilization techniques with core stability exercises were more effective than scar mobilization techniques alone in the conservative treatment of females with lumbopelvic and scar pain after caesarean section.
Downloads
References
Verma V, Vishwakarma RK, Nath DC, Khan HT, Prakash R, Abid O. Prevalence and determinants of caesarean section in South and South-East Asian women. PloS One. 2020;15(3):e0229906. https://doi.org/10.1371%2Fjournal.pone.0229906
Khan NI, Mahmud T, Islam MN, Mustafina SN. Prediction of cesarean childbirth using ensemble machine learning methods. Paper presented at: The 22nd International Conference on Information Integration and Web-based Applications & Services; November 30–December 2, 2020; Chiang Mai, Thailand. https://doi.org/10.1145/3428757.3429138
Fan C, Guidolin D, Ragazzo S, et al. Effects of cesarean section and vaginal delivery on abdominal muscles and fasciae. Medicina. 2020;56(6):e260. https://doi.org/10.3390/medicina56060260
ElDeeb AM, Abd-Ghafar KS, Ayad WA, Sabbour AA. Effect of segmental stabilizing exercises augmented by pelvic floor muscles training on women with postpartum pelvic girdle pain: a randomized controlled trial. J Back Musculoskelet Rehabil. 2019;32(5):693–700. https://doi.org/10.3233/bmr-181258
Eisenberg V, Kafri R. Should every woman after labor be offered pelvic floor physiotherapy? Harefuah. 2018;157(1):34–37.
Banaei M, Azizi M, Moridi A, Dashti S, Yabandeh AP, Roozbeh N. Sexual dysfunction and related factors in pregnancy and postpartum: a systematic review and meta-analysis protocol. Syst Rev. 2019;8(1):1–5. https://doi.org/10.1186/s13643-019-1079-4
Rosa F, Perugin G, Schettini D, Romano N, Romeo S, Podestà R, et al. Imaging findings of cesarean delivery complications: cesarean scar disease and much more. Insights Imag. 2019;10(1):1–14. https://doi.org/10.1186/s13244-019-0780-0
Lavand’homme P. Long-term problems and chronic pain after Caesarean section. In: Capogna G, ed. Anesthesia for Cesarean Section. Springer; 2017:169–182. https://doi.org/10.1007/978-3-319-42053-0_12
Hyldig N, Vinter C, Kruse M, et al. Prophylactic incisional negative pressure wound therapy reduces the risk of surgical site infection after caesarean section in obese women: a pragmatic randomized clinical trial. BJOG: Int J Obstet Gynaecol. 2019;126(5):628–635. https://doi.org/10.1111/1471-0528.15413
Hesselman S, Högberg U, Råssjö EB, Schytt E, Löfgren M, Jonsson M. Abdominal adhesions in gynaecologic surgery after caesarean section: a longitudinal population‐based register study. BJOG: An Int J Obstet Gynaecol. 2018;125(5):597–603. https://doi.org/10.1111/1471-0528.14708
Nuamah MA, Browne JL, Öry AV, Damale N, Klipstein-Grobusch K, Rijken MJ. Prevalence of adhesions and associated post-operative complications after cesarean section in Ghana: a prospective cohort study. Reproduct Health. 2017;14(1):1–9. https://doi.org/10.1186/s12978-017-0388-0
Jabeen K, Karuppaswamy J. Non-surgical management of caesarean scar ectopic pregnancy–a five-year experience. J Obstet Gynaecol. 2018;38(8):1121–1127. https://doi.org/10.1080/01443615.2018.1451986
Wasserman JB, Abraham K, Massery M, Chu J, Farrow A, Marcoux BC. Soft tissue mobilization techniques are effective in treating chronic pain following cesarean section: a multicenter randomized clinical trial. J Women’s Health Phys Ther. 2018;42(3):111–119. https://doi.org/10.1097/JWH.0000000000000103
Wasserman JB, Copeland M, Upp M, Abraham K. Effect of soft tissue mobilization techniques on adhesion-related pain and function in the abdomen: a systematic review. J Bodywork Mov Therap. 2019;23(2):262–269. https://doi.org/10.1016/j.jbmt.2018.06.004
Ismail NIAA, Elgzar WTI. The effect of progressive muscle relaxation on post cesarean section pain, quality of sleep and physical activities limitation. Int J Studies Nurs. 2018;3(3):14–29. https://doi.org/10.20849/ijsn.v3i3.461
Comesaña AC, Vicente MPS, Ferreira TD, Varela MP-LFM, Quintáns MMP, Pilat A. Effect of myofascial induction therapy on post-c-section scars, more than one and a half years old. Pilot study. J Bodywork Mov Therap. 2017;21(1):197–204. https://doi.org/10.1016/j.jbmt.2016.07.003
Arab AM. Evaluation of resulting disability from back pain after childbirth: A comparison between vaginal delivery and cesarean section. 2020. https://doi.org/10.21203/rs.3.rs-27913/v1
Kazdal H, Kanat A, Batcik OE, et al. Central sagittal angle of the sacrum as a new risk factor for patients with persistent low back pain after caesarean section. Asian Spine J. 2017;11(5): 726–732. https://doi.org/10.4184%2Fasj.2017.11.5.726
Ehsani F, Sahebi N, Shanbehzadeh S, Arab AM, ShahAli S. Stabilization exercise affects function of transverse abdominis and pelvic floor muscles in women with postpartum lumbo-pelvic pain: a double-blinded randomized clinical trial study. Int Urogynecol J. 2020;31(1):197–204. https://doi.org/10.1007/s00192-019-03877-1
Liedler M, Woisetschläger G. Influence of post-operative adhesions after caesarean section on chronic lower back pain–A pilot study of osteopathic manipulative treatment. Eur J Osteopath Res. 2019;1(1):38–46. https://doi.org/10.35740/EJOR.2019.1.1.5
Teymuri Z, Hosseinifar M, Sirousi M. The effect of stabilization exercises on pain, disability, and pelvic floor muscle function in postpartum lumbopelvic pain: a randomized controlled trial. Am J Phys Med Rehabil. 2018;97(12):885–891. https://doi.org/10.1097/PHM.0000000000000993
Yalfani A, Bigdeli N, Gandomi F. Effect of isometric–isotonic exercises of core stability in women with postpartum diastasis recti and its secondary disorders (randomized controlled clinical trial). J Health Care. 2020;22:123–137. https://doi.org/10.52547/jhc.22.2.123
Ghavipanje V, Rahimi NM, Akhlaghi F. Six weeks effects of dynamic neuromuscular stabilization (DNS) training in obese postpartum women with low back pain: a randomized controlled trial. Biol Res Nurs. 2022;24(1):106–114. https://doi.org/10.1177/10998004211044828
Cheng H-Y, Shieh C, Wu B-Y, Cheng Y-F. Effect of acupressure on postpartum low back pain, salivary cortisol, physical limitations, and depression: a randomized controlled pilot study. J Trad Chin Med. 2020;40(1):128–136.
Nayyab I, Ghous M, Rehman SS, Yaqoob I. The effects of an exercise program for core muscle strengthening in patients with low back pain after cesarean-section: a single blind randomized controlled trial. J Pak Med Assoc. 2021;71(5):1–15. https://doi.org/10.47391/JPMA.596
Saleh MSM, Botla AMM, Elbehary NAM. Effect of core stability exercises on postpartum lumbopelvic pain: a randomized controlled trial. J Back Musculoskelet Rehabil. 2019;32(2):205–213. https://doi.org/10.3233/BMR-181259
Hui T. Effective physical therapy treatment of post-cesarean section low back pain–case report. J Adv Med Med Res. 2017;22:1–5. https://doi.org/10.9734/JAMMR/2017/34897
Gilbert I, Gaudreault N, Gaboury I. Exploring the effects of standardized soft tissue mobilization on the viscoelastic properties, pressure pain thresholds, and tactile pressure thresholds of the cesarean section scar. J Integ Complement Med. 2022;28(4):355–362. https://doi.org/10.1089%2Fjicm.2021.0178
Daniszewska-Jarząb I. Manual scar therapy on the example of a caesarean section scar. Aesth Cosmetol Med. 2021;10(4):201–204. https://doi.org/10.52336/acm.2021.10.4.05
Lipman K, Wang M, Berthiaume E, et al. Evaluating current scar assessment methods. Ann Plast Surg. 2020;84(2):222–231. https://doi.org/10.1097/SAP.0000000000002029
Copyright (c) 2024 Anam Zahra, Ghulam Fatima, Mehwish Ikram
This work is licensed under a Creative Commons Attribution 4.0 International License.
