- 期刊
【論文摘要】Influence of Mode of Delivery on Pain, Physical Functions, and Lumbopelvic Muscles in Postpartum Women With Pelvic Girdle Pain
【論文摘要】分娩方式對於產後骨盆帶疼痛婦女之疼痛失能與腰椎骨盆肌肉的影響
摘要
Background and Purpose: Pregnancy-related pelvic girdle pain (PPGP) is a common problem affecting the physical functions and quality of life of women. Pelvic instability is believed to attribute to PPGP. Taiwan is one of the countries performing more Caesarean (CS) with a rate of 35% in all delivery women each year. Multiple layers of skin, muscles, fascia, and uterus are incised during the CS, while traumatic laceration of the pelvic floor muscles (PFMs) might occur during the vaginal delivery (VD). The mode of delivery may affect each lumbopelvic muscle differently in those postpartum women with PPGP. To date, only limited studies found that women received CS tended to have more chronic pain and impairments of the abdominal muscles than women received VD. The purpose of this study was to investigate the influence of mode of delivery in pain, physical functions, and the activations of the lumbopelvic muscles in postpartum women with PPGP. Methods: Postpartum women with PPGP were classified into two groups based on their mode of delivery: CS (n = 16) or VD (n = 16). Age, height, weight, and postpartum year did not differ between groups. Pain was assessed using the Visual Analog Scale. Physical functions were assessed using the active straight leg raise (ASLR) test and timed up and go test. Muscle activations of the abdominal muscles (rectus abdominis, external oblique muscles, internal oblique muscles, and transversus abdominis) and PFMs during resting and ASLR were assessed using the ultrasonography. Independent t tests were used for examining the group differences. Results: The CS group had a higher perception of difficulty during ASLR (3.06 ± 1.06 vs. 2.25 ± 0.78, p ＜ 0.019), reduced PFMs contraction during right ASLR (5.98 ± 4.02 vs. 2.90 ± 3.75 mm, p ＜ 0.032) and during left ASLR (8.45 ± 3.70 vs. 3.03 ± 4.70 mm, p ＜ 0.001) compared to the VD group. However, there were no differences in pain, performance of timed up and go, and muscle activations of abdominal muscles. Conclusion: Caesarean might have more impacts on the PFMs but not abdominal muscles in postpartum women with PPGP. Clinical Relevance: Current findings suggest comprehensive assessment and training of the PFMs might be required in postpartum women with PPGP who received CS during delivery.