A rehabilitation programme focussing on pelvic floor muscle training for persistent lumbopelvic pain after childbirth: A randomized controlled trial

Abstract

Objective To evaluate the effects of a rehabilitation programme for lumbopelvic pain after childbirth. Methods Women with lumbopelvic pain 3 months postpartum were included in a randomized controlled trial. Patients in the intervention group ( n = 48) received pelvic floor muscle training combined with neuromuscular electrical stimulation of the paraspinal muscles for 12 weeks, while patients in the control group ( n = 48) received neuromuscular electrical stimulation for 12 weeks. Outcomes were measured with the Triple Numerical Pain Rating Scale (NPRS), Modified Oswestry Disability Questionnaire (MODQ) and Short-Form Health Survey-36 (SF-36). Results The NPRS score was significantly better in the intervention group at 12 weeks compared with the control group ( p = 0.000). The MODQ score was significantly better at 6 and 12 weeks compared with the control group ( p = 0.009 and p = 0.015, respectively). The mean value of the Physical Components Summary of the SF-36, was significantly better in the intervention group at 6 weeks ( p = 0.000) and 12 weeks ( p = 0.000) compared with the control group, but there was no significant improvement in Mental Components Summary of the SF-36. Conclusion A postpartum programme for women with lumbopelvic pain is feasible and improves the physical domain of quality of life. LAY ABSTRACT Postpartum lumbopelvic pain is common, and there are a range of treatments available. The aim of this study was to establish a programme for use in clinical practice, comprising pelvic floor muscle training combined with other traditional treatments. The programme was shown to reduce pain and improve patients’ quality of life. No adverse events occurred.

The Impact of Preoperative Pain on Outcomes After Vaginal Reconstructive Surgery and Perioperative Pelvic Floor Muscle Training

“…In addition, our results suggest that perioperative pelvic muscle training may play a role in reducing postoperative pain for women with preoperative pain who are planning to undergo SSLF. The role of pelvic muscle training in women with pelvic pain has been an accepted standard 18–20 with benefits specifically from a postprocedural perspective seen in women with pelvic floor dysfunction after hysterectomy and persistent lumbopelvic pain after childbirth 21–23 . Although we identified a potential effect, this was not the primary outcome of the original trial or our study and should be interpreted with caution.…”

“…The role of pelvic muscle training in women with pelvic pain has been an accepted standard [18][19][20] with benefits specifically from a postprocedural perspective seen in women with pelvic floor dysfunction after hysterectomy and persistent lumbopelvic pain after childbirth. [21][22][23] Although we identified a potential effect, this was not the primary outcome of the original trial or our study and should be interpreted with caution. The role that pelvic muscle training may play in pain outcomes among women undergoing vaginal reconstructive surgery and in particular, sacrospinous ligament fixation should be further elucidated in future studies.…”

Lumbopelvic pain and sick leave during pregnancy: A comparison of Italy and Norway

“…Also, our definition of persistent PLPP does not align with recent literature, which classifies persistent symptoms as pain lasting beyond 12 weeks. 62 In addition, the question “During this pregnancy, do you experience pain in the lumbopelvic area” may not be sufficient to ensure a proper understanding of PLPP by the participants in this study. Therefore, to enhance the accuracy of reporting, more detailed questioning could have been included, such as the use of body charts and the opportunity for participants to provide information about the location, nature, and severity of their pain.…”

Predictive value of abdominal wall scar score for pelvic floor function rehabilitation, vaginal microecology and complications after cesarean section

“…The damage of pelvic floor muscles after cesarean section in the second pregnancy of scar uterus with a history of cesarean section is greater than that of a single pregnancy, this damage is both direct mechanical damage and indirect damage to pelvic muscles caused by pudendal nerve damage ( Ptak et al, 2019 ). The study found that compared with the maximum skeletal muscle extension rate of non pregnant women, the stretching rate of pelvic floor muscles of pregnant women with scar uterus who have a history of cesarean section was significantly increased during delivery, and the higher the stretching force of levator ani muscle, Therefore, the excessive stretching of pelvic floor muscles, soft birth canal, fascia and ligaments is more likely to lead to abnormal vaginal pressure and pelvic floor muscle strength ( Wang et al, 2021 ). In the results of this study, there were significant differences in the strength grade of class I and II muscle fibers and pelvic floor muscle potential between the two groups after delivery, suggesting that the abdominal wall scar score is related to the recovery of pelvic floor function.…”