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The postpartum period often presents challenges such as increased inter-recti distance (diastasis recti), lumbopelvic pain, and reduced core strength. This study is designed as a randomized controlled trial to evaluate the combined effects of stability-oriented breathing exercises and Kegel exercises on inter-recti distance (IRD), lumbopelvic pain, and muscle strength in postpartum women. A total sample size of 66 participants per group was determined with a 10% dropout rate accounted for.
The study will use a non-probability convenience sampling technique. It will be conducted at the University of Lahore Teaching Hospital and Sehat Medical complex. Inclusion criteria include women aged 18-40 years, with a history of cesarean sections, an IRD between 3-5 cm. Outcome measures include IRD , pelvic floor muscle strength, lumbopelvic pain (measured using a 10 cm numeric pain scale). Participants will be randomly assigned to either Group A (Kegel-only) or Group B (Kegel + breathing exercises). Both groups will train three times weekly for eight weeks. All data analysis will be performed using SPSS version 27.
The postpartum period often presents challenges such as increased inter-recti distance (diastasis recti), lumbopelvic pain, and reduced core strength. This study is designed as a randomized controlled trial to evaluate the combined effects of stability-oriented breathing exercises and Kegel exercises on inter-recti distance (IRD), lumbopelvic pain, and muscle strength in postpartum women. A total sample size of 66 participants per group was determined with a 10% dropout rate accounted for.
The study will use a non-probability convenience sampling technique. It will be conducted at the University of Lahore Teaching Hospital and Sehat Medical complex. Inclusion criteria include women aged 18-40 years, with a history of cesarean sections, an IRD between 3-5 cm. Outcome measures include IRD , pelvic floor muscle strength, lumbopelvic pain (measured using a 10 cm numeric pain scale). Participants will be randomly assigned to either Group A (Kegel-only) or Group B (Kegel + breathing exercises). Both groups will train three times weekly for eight weeks. All data analysis will be performed using SPSS version 27.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Stability oriented Breathing training | Experimental | This group will be given combined Kegel exercises and stability-oriented breathing training group with in postpartum women. This included static breathing exercises (transverse, diaphragmatic, back, and pumping breathing) in the first two weeks, followed by resistance band breathing exercises targeting core and transversus abdominis activation in weeks 3 to 4. In the final four weeks, dynamic breathing exercises such as the pelvic clock and hundreds prep will be introduced to promote core stabilization under movement. |
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| kegels exercises | Active Comparator | This group will be given kegel exercises in postpartum women. Sessions included a 10-minute warm-up of light jogging, walking, and stretching, followed by Kegel exercises starting with 10 repetitions per movement in the first two weeks and progressing to 15 repetitions in the following two weeks. In the later weeks, load was progressively increased by extending the duration of contractions (from 5 to 8 seconds) and adding dynamic limb movements. A 3-minute rest was provided between each set, and sessions concluded with a 5-minute cool-down |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Stability Oriented Breathing Training | Other | This included static breathing exercises (transverse, diaphragmatic, back, and pumping breathing) in the first two weeks, followed by resistance band breathing exercises targeting core and transversus abdominis activation in weeks 3 to 4. In the final four weeks, dynamic breathing exercises such as the pelvic clock and hundreds prep will be introduced to promote core stabilization under movement |
| Measure | Description | Time Frame |
|---|---|---|
| Numeric pain rating scale | This is the scale having that measures levels of pain from 0 to 11 it describes the intensity or severity of the pian | 8 weeks |
| Manual muscle testing | Pelvic floor muscle strength will be evaluated using a manual assessment technique. During the assessment, the participant will be instructed to lie in a supine position with knees bent and hands resting at their sides. Manual Muscle Testing (MMT) is a widely used, valid, and reliable method for assessing muscle strength through graded resistance applied by the examiner | 8 weeks |
| Finger width method | The measurement of diastasis recti abdominis width at the umbilicus using calipers demonstrated good reliability, with an intraclass correlation coefficient (ICC) of 0.83 (95% CI: 0.76 to 0.87). | 8 weeks |
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Inclusion Criteria:
• Age between 18-40 years
Exclusion Criteria:
• Pain during the training period
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| imran amjad, phd | Contact | 03324390125 | imran.amjad@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Masooma Saleem, MSPT WH | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UOL teaching hospital and sehat medical complex lahore | Recruiting | Lahore | Punjab Province | 54000 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34475166 | Background | Vesting S, Olsen MF, Gutke A, Rembeck G, Larsson MEH. Clinical assessment of pelvic floor and abdominal muscles 3 months post partum: an inter-rater reliability study. BMJ Open. 2021 Sep 2;11(9):e049082. doi: 10.1136/bmjopen-2021-049082. | |
| Background | 2. Yalfani A, Bigdeli N, Gandomi F, Anvari Ali Abad R. [Proprioception and control of the lumbopelvic in women with and without diastasis rectus and their relationship with postpartum pain and disability (Persian)]. Scientific Journal of Rehabilitation Medicine. 2020;9(4):257-67. | ||
| 34609664 |
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| kegels exercises | Other | This group will be given kegel exercises in postpartum women. Sessions included a 10-minute warm-up of light jogging, walking, and stretching, followed by Kegel exercises starting with 10 repetitions per movement in the first two weeks and progressing to 15 repetitions in the following two weeks. In the later weeks, load was progressively increased by extending the duration of contractions (from 5 to 8 seconds) and adding dynamic limb movements. A 3-minute rest was provided between each set, and sessions concluded with a 5-minute cool-down |
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| UOL teaching hospital and sehat medical complex | Recruiting | Lahore | Punjab Province | 54000 | Pakistan |
|
| Background |
| Kaufmann RL, Reiner CS, Dietz UA, Clavien PA, Vonlanthen R, Kaser SA. Normal width of the linea alba, prevalence, and risk factors for diastasis recti abdominis in adults, a cross-sectional study. Hernia. 2022 Apr;26(2):609-618. doi: 10.1007/s10029-021-02493-7. Epub 2021 Oct 5. |
| 34432175 | Background | Tuominen R, Jahkola T, Saisto T, Arokoski J, Vironen J. The prevalence and consequences of abdominal rectus muscle diastasis among Finnish women: an epidemiological cohort study. Hernia. 2022 Apr;26(2):599-608. doi: 10.1007/s10029-021-02484-8. Epub 2021 Aug 25. |
| Background | 5. Yalfani A, Bigdeli N, Gandomi F. [The effect of isometric-isotonic exercises of core stability in women with postpartum diastasis recti and its secondary disorders (randomized controlled clinical trial) (Persian)]. Journal of Health and Care. 2020;22(2):123-37. |