Effects of physiotherapy on pain and functional activities after cesarean delivery

Abstract

Purpose

To investigate the effects of a physiotherapy program on incision pain and functional activities in the early post-cesarean period.

Methods

Fifty women were evaluated after Cesarean operation with regard to times of ambulation and return of bowel activity, intensity of incision pain, difficulty in functional activities and number of analgesics required additional to routine pain control procedure. Twenty-four women received only routine nursing care, and a physiotherapy program was applied to the study group (n = 26), additionally.

Results

Postoperative ambulation and return of bowel activity were earlier in the study group (p < 0.05). Incision pain and difficulty in functional activities decreased significantly within 2 days in both groups, and the values were lower in the study group (p < 0.05). Study group needed less medication for pain control (p < 0.05).

Conclusions

Findings revealed the effectiveness of a physiotherapy program in the early post-cesarean period in a wider perspective than the current literature, and are considered to be valuable for increasing the quality and productivity of the postnatal care, therefore improving well-being after childbirth.

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References

  1. 1.

    Chen HM, Chang FY, Hsu CT (2005) Effect of acupressure on nausea, vomiting, anxiety and pain among post-cesarean section women in Taiwan. Kaohsiung J Med Sci 21:341–350

    PubMed  Article  Google Scholar 

  2. 2.

    Hollinger JL (1986) Transcutaneous electrical nerve stimulation after cesarean birth. Phys Ther 66:36–38

    PubMed  CAS  Google Scholar 

  3. 3.

    Navarro Nuñez C, Pacheco Carrasco M (2000) Transcutaneous electrical nerve stimulation to reduce pain after cesarean section. Ginecol Obstet Mex 68:60–63

    PubMed  Google Scholar 

  4. 4.

    Reynolds RA, Gladstone N, Ansari AH (1987) Transcutaneous electrical nerve stimulation for reducing narcotic use after cesarean section. J Reprod Med 32:843–846

    PubMed  CAS  Google Scholar 

  5. 5.

    Riley JE (1982) The impact of transcutaneous electrical nerve stimulation on the postcesarean patient. JOGN Nurs 11:325–329

    PubMed  CAS  Google Scholar 

  6. 6.

    Smith CM, Guralnic MS, Gelfond MM et al (1986) The effects of transcutaneous electrical nerve stimulation on post-cesarean pain. Pain 27:181–193

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Thompson JF, Roberts CL, Currie M et al (2002) Prevalence and persistence of health problems after childbirth: associations with parity and method of birth. Birth 29:83–94

    PubMed  Article  Google Scholar 

  8. 8.

    Arai YC, Kato N, Matsura M et al (2008) Transcutaneous electrical nerve stimulation at the PC-5 and PC-6 acupoints reduced the severity of hypotension after spinal anaesthesia in patients undergoing cesarean section. Br J Anaesth 100:78–81

    PubMed  Article  CAS  Google Scholar 

  9. 9.

    Habib AS, Itchon-Ramos N, Phillips-Bute BG et al (2006) Transcutaneous acupoint electrical stimulation with the ReliefBand for the prevention of nausea and vomiting during and after cesarean delivery under spinal anesthesia. Anesth Analg 102:581–584

    PubMed  Article  Google Scholar 

  10. 10.

    Kaplan B, Rabinerson D, Neri A (1994) The effect of respiratory physiotherapy on the pulmonary function of women following cesarean section under general anesthesia. Int J Gynaecol Obstet 47:177–178

    PubMed  Article  CAS  Google Scholar 

  11. 11.

    Harmon D, Ryan M, Kelly A et al (2000) Acupressure and prevention of nausea and vomiting during and after spinal anaesthesia for cesarean section. Br J Anaesth 84:463–467

    PubMed  CAS  Google Scholar 

  12. 12.

    Ho CM, Hseu SS, Tsai SK et al (1996) Effect of P-6 acupressure on prevention of nausea and vomiting after epidural morphine for post-cesarean section pain relief. Acta Anaesthesiol Scand 40:372–375

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Ho CM, Tsai HJ, Chan KH et al (2006) P6 acupressure does not prevent emesis during spinal anaesthesia for cesarean delivery. Anesth Analg 102:900–903

    PubMed  Article  Google Scholar 

  14. 14.

    Stein DJ, Birnbach DJ, Danzer BI et al (1997) Acupressure versus intravenous metoclopramide to prevent nausea and vomiting during spinal anesthesia for cesarean section. Anesth Analg 84:342–345

    PubMed  CAS  Google Scholar 

  15. 15.

    Youngs PJ (2000) Acupressure and prevention of nausea and vomiting. Br J Anaesth 85:807–808

    PubMed  CAS  Google Scholar 

  16. 16.

    Noble E (2003) Essential exercises for the childbearing year, 4th edn. New Life Images, USA

    Google Scholar 

  17. 17.

    Polden M, Mantle J (1994) Physiotherapy in obstetrics and gynecology. Butterworth-Heinemann, Oxford, pp 222–280

    Google Scholar 

  18. 18.

    Barr JO (1999) Transcutaneous electrical nerve stimulation for pain management. In: Nelson RM, Hayes KW, Currier DP (eds) Clinical electrotherapy, 3rd edn. Appleton & Lange, Stamford-Connecticut, pp 291–354

    Google Scholar 

  19. 19.

    Johnson M (2002) Transcutaneous electrical nerve stimulation. In: Kitchen S (ed) Electrotherapy: evidence based practice, 11th edn. Churchill Livingstone, Toronto-Canada, pp 259–286

    Google Scholar 

  20. 20.

    Goats GC, Keir KAI (1991) Connective tissue massage. Br J Sports Med 25:131–133

    PubMed  Article  CAS  Google Scholar 

  21. 21.

    Holey EA (2000) Connective tissue massage: a bridge between complementary and orthodox approaches. J Bodywork Mov Ther 4:72–80

    Article  Google Scholar 

  22. 22.

    Tappan F (1988) Healing massage techniques: holistic, classic and emerging methods. Appleton & Lange, California

    Google Scholar 

  23. 23.

    Wilder E (1988) Obstetric and gynaecologic physical therapy. Churchill Livingstone, USA

    Google Scholar 

  24. 24.

    Johnson ST (2000) From incontinence to confidence. Am J Nurs 100:69–74

    PubMed  CAS  Google Scholar 

  25. 25.

    Sochart DH, Hardinge K (1999) The relationship of foot and ankle movements to venous return in the lower limb. J Bone Joint Surg Br 81:700–704

    PubMed  Article  CAS  Google Scholar 

  26. 26.

    Holey LA, Lawler HL (1995) The effects of classical massage and connective tissue manipulation on bowel function. Br J Ther Rehabil 2:627–631

    Google Scholar 

  27. 27.

    Evron S, Schenker JG, Olshwang D et al (1981) Postoperative analgesia by percutaneous electrical stimulation in gynecology and obstetrics. Eur J Obstet Gynecol Reprod Biol 12:305–313

    PubMed  Article  CAS  Google Scholar 

  28. 28.

    Rakel B, Frantz R (2003) Effectiveness of transcutaneous electrical nerve stimulation on postoperative pain with movement. J Pain 4:455–464

    PubMed  Article  Google Scholar 

  29. 29.

    Jakobi P, Solt I, Tamir A et al (2002) Over-the-counter oral analgesia for postcesarean pain. Am J Obstet Gynecol 187:1066–1069

    PubMed  Article  Google Scholar 

  30. 30.

    Kaada B, Torsteinbø O (1989) Increase of plasma beta-endorphins in connective tissue massage. Gen Pharmacol 20:487–489

    PubMed  Article  CAS  Google Scholar 

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Acknowledgments

The authors thank the nurses and trainees of Hacettepe University Hospitals, Department of Obstetrics and Gynecology, for their valuable cooperation and help for the study. This study presents major findings of the doctoral thesis by the first author, and was supported by Scientific Research Unit of Hacettepe University (Project number: 05 T02 102 003).

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Correspondence to İlkim Çıtak Karakaya.

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Çıtak Karakaya, İ., Yüksel, İ., Akbayrak, T. et al. Effects of physiotherapy on pain and functional activities after cesarean delivery. Arch Gynecol Obstet 285, 621–627 (2012). https://doi.org/10.1007/s00404-011-2037-0

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Keywords

  • Connective tissue manipulation
  • Obstetric rehabilitation
  • Physical therapy
  • Postnatal exercise
  • Transcutaneous electrical nerve stimulation