An investigation of the correlation between post-surgical adhesions, scar tissue quality, core stability and low back pain after a C-section, using transabdominal ultrasound
Item
- Title
- An investigation of the correlation between post-surgical adhesions, scar tissue quality, core stability and low back pain after a C-section, using transabdominal ultrasound
- Author(s)
- Lombard, M
- Abstract
- Background Low back pain is one of the most common complaints of patients' who are seeking osteopathic care in the uK (NHS Choices 2015). Research suggests that this could be due to the lack of core stability and spinal hypermobility, increasing the demand on the lumbar spine (McGill 201s; Lim et al 2011).Low back pain is a common complaint in pregnancy, and can be decreased by the use of osteopathic treatment to help the body to readapt and bring restore normal function (Licciardone et al. 2010, Katonis et al 2011). Caesarean section is performed when complications from the pregnancy make vaginal birth complex. Although common, there are risks of post surgical adhesions (Bodner et al. 2011).The mother is often advised to give recovery time and follow doctor's advice before returning to exercise; startrng with low impact, toning and stretching exerctses and Kegel's exercises improving the strength of the pelvic floor (McClurg et a/2015). Low intensity core exercises, pelvic tilts, Yoga and Pilates can be advised, after a minimum of six weeks following the birth (Ashrafina el al. 2014). Objective The objective of this proposed study is to answer the research question: ls there a relationship between posf-surgical adhesions, scar fissue quality, core stability and low back pain in patients who had a Caesarean section? Design Causative study Methods Women fitting the inclusion criteria were recruited. lnclusion criteria: Under 45 years old, having between one and three horizontal Caesarean section, otherwise healthy. Exclusion criteria: Caesarean in the last 6 weeks or older than 45 years, history of spinal & abdominal surgery, pathologies in pelvis or bowel such as cancer or Crohn's disease, pregnancy, diastasis recti (separation of rectus abdominis muscle), pubic symphysis dysfunction. Each patient underwent an examination of their Caesarean scar, vta ultrasound in order to measure the visceral slide. They were also required to answer a Numerical Rating Scale (NRS) questionnaire consisting of questions regarding the changes in their life style since the Caesarean incision. Further to this they were asked to fill out the Patient and Observer Scar Assessment Scale (POSAS) with the observer in order to examine the appearance of the scar tissue. Core stability of each patient, defined as the ability to control the movement and the position of the central core of the body, which is responsible for controlled movement of the upper and lower extremities, was measured using a Modified Sphygmomanometer Test (MST) during an Active Straight Leg Raise (ASLR) test (Reed et al.2012). Results 12 women with a history of 1 to 3 Caesarean sections (mean 1.583) were assessed in this study, using trans-abdominal ultrasound. The mean value of the Modified Sphygmomanometer Test was 34.6 mHg, and the average visceral slide measured was 0.78cm. The Patient and Observer Scar Assessment Scale gave mean values of 24.66 and 27 (0-60). The average difference in Low back pain pre & post Caesarean section was 2.75 (0-10). A multiple regression approach was used to evaluate the possible effect of one outcome measure on the others. Discussion The multiple regression tests resulted in a p t.05 for the different outcome measures, which indicates that the null hypothesis can be accepted: There is no statistically significant correlation between post-surgical adhesions, scar tissue quality, core stability and low back pain after a C-section, using transabdominal ultrasound. However, the size of the sample used in this study may not be representative of the normal population due to its size. Conclusion There seem to be no statistically significant correlation between post-surgical adhesions, scar tissue quality, core stability and low back pain after a Csection, using trans-abdominal ultrasound. Further research may be required in order to widen the sample's size, aiming for greater accuracy in the results. A long term study could be suggested, with the objective of evaluating the healing process of the incision and its possible effect on the women's body.
- presented at
- European School of Osteopathy
- Date Accepted
- 2017
- Date Submitted
- 4.12.2017 17:06:21
- Type
- osteo_thesis
- Language
- English
- Submitted by:
- 62
- Pub-Identifier
- 16046
- Inst-Identifier
- 1229
- Keywords
- Scar tissue, post surgical adhesions, low back pain, core stability, Caesarian section, ultrasound
- Recommended
- 0
- Item sets
- Thesis
Lombard, M, “An investigation of the correlation between post-surgical adhesions, scar tissue quality, core stability and low back pain after a C-section, using transabdominal ultrasound”, Osteopathic Research Web, accessed May 19, 2024, https://www.osteopathic-research.com/s/orw/item/490