Assessment of Lumbar Spine Active Range of Motion in Women Who Were Experienced Cesarean or Vaginal Birth

Study Overview
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Brief Summary
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Pregnancy may impact the musculoskeletal apparatus of females through pregnancy-associated biomechanical, vascular, and hormonal changes. Pregnant females may complain of lumbopelvic pain, especially during their last trimester. This lumbopelvic pain can be the result of an enlarged uterus and unstable lumbopelvic joints.

Detailed Description
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Cesarean birth can affect the lumbopelvic biomechanics through its impact on the sacroiliac joints and the abdominal muscles. while vaginal birth can trigger lumbopelvic pain through its impact on the pelvic joints like the symphysis pubis and sacroiliacs. When puerperium is finished, most of these pregnancy-related changes assume its prepregnant conditions. Physiotherapists are responsible for providing PT care for women to improve their quality of life during the puerperium and even during the delayed postpartum interval.

Official Title
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After Ending the Puerperium: Kinematic Assessment of Lumbar Spine Active Range of Motion in Women Who Experienced Cesarean or Vaginal Birth

Conditions
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Cesarean and Vaginal Birth Complications

Intervention / Treatment
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* Device: Bubble Inclinometer and Digital Pelvic Inclinometer


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All women either primiparous or multiparous have not had anaesthesia (epidural, spinal, or general) for at least one year prior to the last obstetric anaesthesia. Their ages ranged from 18 to 35 years. Participants had a body mass index (BMI) of not more than 30 kg/m2 and a waist-to-hip ratio of not more than 1. Participants were assessed between the 6th week to the 12th week postnatal. All participants were able to continue all assessment procedures. They might have a mild or moderate myofascial LBP Exclusion Criteria: Women with urinary tract infections and diastasis recti. Women who were below 18 years old or above 35 years. Women who had a (BMI) above 30 kg/m2 or a waist-to-hip ratio above 1. Women who did not continue all assessment procedures. Women who had a severe myofascial LBP or any specific low back conditions.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group A<br>40 females who experienced cesarean birth | Device: Bubble Inclinometer and Digital Pelvic Inclinometer<br>* They are valid and reliable devices to measure the range of motion of the lumbar spine<br>|
| Group B<br>15 females who experienced vaginal birth | Device: Bubble Inclinometer and Digital Pelvic Inclinometer<br>* They are valid and reliable devices to measure the range of motion of the lumbar spine<br>|
| Group C<br>40 females who were the controls, did not experience any pregnancy | Device: Bubble Inclinometer and Digital Pelvic Inclinometer<br>* They are valid and reliable devices to measure the range of motion of the lumbar spine<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lumbar Spine Flexion Active Range of Motion | It represent the non-painful full range of motion from standing upright to leaning forward in the sagittal plane | Assessment will be done 6-12 weeks after Cesarean or Vaginal birth | 
| Lumbar Spine Extension Active Range of Motion | It represent the non-painful full range of motion from standing upright to leaning backward in the sagittal plane | Assessment will be done 6-12 weeks after Cesarean or Vaginal birth | 
| Lumbar Spine Right Side Bending Active Range of Motion | It represent the non-painful full range of motion from standing upright to leaning sideway to the right in the frontal plane | Assessment will be done 6-12 weeks after Cesarean or Vaginal birth | 
| Lumbar Spine Left Side Bending Active Range of Motion | It represent the non-painful full range of motion from standing upright to leaning sideway to the left in the frontal plane | Assessment will be done 6-12 weeks after Cesarean or Vaginal birth | 
| Lumbar Spine Right Axial Rotation Active Range of Motion | It represents the non-painful full range of motion from standing with trunk forward bended 90 degree then head, neck, shoulders, and trunk rotation to the right side | Assessment will be done 6-12 weeks after Cesarean or Vaginal birth | 
| Lumbar Spine Left Axial Rotation Active Range of Motion | It represents the non-painful full range of motion from standing with trunk forward bended 90 degree then head, neck, shoulders, and trunk rotation to the left side | Assessment will be done 6-12 weeks after Cesarean or Vaginal birth |