Manual Physical Therapy for Pregnancy-Related Pelvic Pain
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial investigates how pelvic floor physical therapy (manual physical therapy) can assist pregnant women during delivery. The main focus is on reducing perineal trauma (injury to the area between the vagina and anus), shortening the pushing stage of labor, and lowering the chances of needing an emergency C-section. The treatment includes exercises and techniques such as stretching and breathing to strengthen the pelvic area. Pregnant women between 28 and 34 weeks along and planning a vaginal delivery might be suitable candidates for this study. As an unphased trial, this study offers a unique opportunity to enhance understanding of how physical therapy can improve childbirth experiences.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What prior data suggests that manual physical therapy is safe for pregnant women?
Research has shown that manual physical therapy is generally safe for most pregnant women. A review of studies found that these therapies often help with low back and pelvic pain, common during pregnancy. Although evidence is limited, studies have reported no serious side effects.
Manual physical therapy typically includes techniques like muscle stretching, gentle massage, and specific exercises. These methods are generally well-tolerated. Most studies focus on reducing pain and improving movement, with no major safety concerns noted.
Effects and safety can vary for each person. Consulting a healthcare provider is essential to determine if this therapy is appropriate.12345Why are researchers excited about this trial?
Most treatments for pregnancy-related pelvic pain, like pain relievers or standard physical therapy, focus on symptom relief rather than addressing the root causes. Manual Physical Therapy is unique because it combines internal and external myofascial release with specific exercises and breathing techniques to directly target the pelvic floor muscles. Researchers are excited because this method could improve muscle function and flexibility, potentially providing longer-lasting relief and helping with postpartum recovery. By addressing the underlying muscle and tissue issues, it offers a comprehensive approach that current options might not.
What evidence suggests that manual physical therapy is effective for pregnancy-related pelvic pain?
Studies have shown that manual physical therapy can help manage pelvic and low back pain during pregnancy. This therapy often includes exercises and stretches that may ease pain and improve movement. In this trial, pregnant women will receive manual physical therapy, which involves internal and external myofascial release of the pelvic floor muscles, pelvic floor stretching, and instruction in diaphragmatic breathing and exercises for postpartum recovery. Research indicates that these therapies, when used for pregnancy-related pelvic pain, can lead to better pain relief and reduce the need for taking time off work. Experts recommend manual therapy as part of a comprehensive approach to managing pelvic pain in pregnant women. Although few direct studies exist on how pelvic floor physical therapy affects delivery outcomes, the general benefits for pelvic pain suggest it could have positive effects.12367
Who Is on the Research Team?
Brenda Heinecke, DPT
Principal Investigator
Revitalize Physical Therapy
Are You a Good Fit for This Trial?
This trial is for pregnant women between 28-34 weeks gestation who are planning a vaginal delivery. It's not for those under 18, over 34 weeks pregnant, planning a c-section, or on pelvic rest.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive pelvic floor physical therapy including myofascial release, stretching, and exercises during pregnancy
Follow-up
Participants are monitored for postpartum recovery, including assessments of perineal trauma and pain
What Are the Treatments Tested in This Trial?
Interventions
- Manual Physical Therapy
Trial Overview
The study tests if manual physical therapy during pregnancy can reduce perineal trauma at birth, shorten the second stage of labor (pushing), and decrease emergency C-section rates.
How Is the Trial Designed?
1
Treatment groups
Experimental Treatment
Physical assessment for women 20-34 weeks gestation including evaluating pain, back and hip range of motion, strength of hip and abdominal muscles, diastasis recti, and strength, amount of scar tissue from previous pregnancies / deliveries, level of muscle overactivity, and the extent of any prolapse of pelvic floor muscles. Treatment: internal and external myofascial release of the pelvic floor muscles, pelvic floor stretching, and instruction diaphragmatic breathing and exercises for postpartum recovery to perform at home. Exercises include: Pelvic floor stretching: happy baby stretch, deep squat, butterfly stretch; Belly breathing; transverse abdominis contraction, transverse abdominis march, bridge, shoulder blade; Instruction and education on perineal massage and posture.
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Who Is Running the Clinical Trial?
University of Wisconsin, Milwaukee
Lead Sponsor
Revitalize Physical Therapy
Collaborator
Published Research Related to This Trial
Citations
The effectiveness of complementary manual therapies for ...
There is currently limited evidence to support the use of complementary manual therapies as an option for managing low back and pelvic pain ...
a systematic review - PMC
A wide variety of outcomes and outcome measurements are used in studies on pelvic girdle pain and lumbopelvic pain.
Management of women with pregnancy-related pelvic ...
This study sought to reach a consensus on the essential components of PPGP management through an international Delphi survey of experts in women's health.
Pelvic girdle pain – part 1: quantitative results from a mixed ...
2016) showed that. 48% of respondents used manual therapy as an intervention for pregnancy- related LBP. Advice on work (88%) and posture (98%), and the use of ...
Recommendations for Physical Therapists on the ...
Treating lumbopelvic pain during pregnancy with this form of therapy generally yielded better results on pain, disability, and sick leave than ...
Effects of Conventional Exercises on Lower Back Pain and/ ...
Pregnancy-related low back pain (LBP) and pelvic girdle pain (PGP) are associated with substantial direct and indirect expenditures. Evidence ...
Women's experiences of pregnancy related pelvic girdle pain
The pain from PGP, reduces mobility and consequently reduces the women's quality of life. Robinson et al. (2006) found that seven percent of pregnant women ...
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