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The purpose of the study is to find out the effect of pelvic floor rehab combined with ultrasound have effect in chronic perineal pain subjects associated with osteomyoarticular symptoms .
Chronic perineal pain is the anorectal and perineal pain without underlying organic disease, anorectal or endopelvic, which has been excluded by careful physical examination, radiological and endoscopic investigations. So, perineal and vaginal pain after vaginal delivery has been associated with tissue trauma related to operative vaginal delivery, perineal laceration, and episiotomy.
Studies assessing chronic pain after vaginal delivery report 2% to 10% of women with pain at six months and later, almost exclusively in mothers who had an assisted vaginal birth. Postpartum pain intensity is usually higher when it is related to vaginal delivery than to cesarean delivery and more severely affects the woman's quality of life and mood.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control group A | Active Comparator | They will receive traditional ultrasound therapy for six weeks |
|
| Study group B | Experimental | They will receive the same traditional ultrasound therapy in addition to pelvic floor rehabilitation for six weeks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Traditional ultrasound therapy | Device | Ultrasound therapy for 2 session per week for until completing 12 treatment sessions (six weeks) with frequencies up to 3 MHz are used clinically to promote healing |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of osteomyoarticular symptoms | It will be assessed before and after the end of treatment for each participant in both groups using Nordic Musculoskeletal Questionnaire (NMQ), an instrument characterized by multiple or binary choices facing osteomyoarticular symptoms in various anatomical regions that these symptoms appear more frequently, and a questionnaire that has good reliability (Legault et al., 2014). | 6 weeks |
| Assessment of perineal pain intensity | It will be assessed before and after the end of treatment for each participant in both groups through the visual analouge scale (VAS). It is a 10-cm horizontal line on which the patient's pain intensity was represented by a point between the extremes of "no pain at all" and "worst pain imaginable". Its simplicity, reliability and validity, as well as its ratio scale properties, make the VAS the optimal tool for describing pain intensity. Each participant will be asked to mark a point on the VAS line between the extremes that related to her perineal intensity. Then, the centimeters will be measured in each time from the left end of the line to the marked point to obtain the VAS score for perineal pain intensity | 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of pelvic floor muscle strength | It will be assessed before and after the end of treatment for each participant in both groups by Kegel perineometer | 6 weeks |
| Assessment of pelvic floor muscle tightness |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Salwa M. El Badry, Prof. | Department of Physical Therapy for Woman's Health, Faculty of physical therapy, Cairo University, Giza, Egypt. | Study Chair |
| Amel M. Yousef | Department of Physical Therapy for Woman's Health, Faculty of physical therapy, Cairo University, Giza, Egypt. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cairo University | Giza | Egypt |
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| Pelvic floor rehabilitation | Other | Pelvic floor rehabilitation for 3 sessions per week for (six weeks) until completing 18 sessions with sessions lasting between 30-45 minutes |
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It will be assessed before and after the end of treatment for each participant in both groups by the manual pelvic floor muscle examination
| 6 weeks |
| Assessment of lumbar spine mobility | It will be assessed before and after the end of treatment for each participant in both groups by the modified Schober test | 6 weeks |
| ID | Term |
|---|---|
| D059952 | Pelvic Floor Disorders |
| ID | Term |
|---|---|
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D011248 | Pregnancy Complications |
| D052801 | Male Urogenital Diseases |
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