ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 21 of 33
Up
JMBS 2021, 6(4): 149–157
https://doi.org/10.26693/jmbs06.04.149
Physical Therapy and Ergotherapy

Correction of Motor Disability Impairments by Physical Therapy Means in Women after Cesarean Section

Kuravskaya Yu. S.
Abstract

In modern obstetrics, the frequency of abdominal accouchement is constantly increasing. Therefore, the problem of restoring the state of health of women after surgical delivery requires the introduction of new medical knowledge and technologies into practical rehabilitation, in particular, methods of physical therapy. The purpose of the study was to determine the influence of the developed program of physical therapy on the dynamics of the parameters of the motor ability of women in the postpartum period after cesarean section. Materials and methods. 112 women were examined after childbirth. The comparison group consisted of 47 women who had a natural childbirth. The main group 1 consisted of 32 women who did not want to carry out the proposed program of physical therapy; they were provided with general recommendations for self-observation in the postpartum period after cesarean section. The main group 2 consisted of 33 women after cesarean section who underwent postpartum physical therapy for 12 months (kinesitherapy (therapeutic exercises, functional training to improve motor skills and abilities), abdominal wall bandage, kinesiotaping, abdominal and general massage, wellness nutrition, psychological relaxation, education of women). Determination of motor ability according to the Functional Movement Screen was performed in the late postpartum period (6-8 weeks), 6 and 12 months after childbirth. Results and discussion. In women in the late postpartum period, regardless of the type of delivery, signs of impaired motor ability are revealed, which was established by the results of the Functional Movement Screen test exercises. Within a year after childbirth, there is a gradual improvement in the motor ability of women, regardless of the type of delivery and their performance of active restorative interventions. The use of a physical therapy program starting from the early postpartum period in women after cesarean section revealed advantages regarding the state of their motor ability in relation to women who underwent natural delivery and those who recovered from cesarean section on their own, according to separate Functional Movement Screen tests already at the end of the late postpartum period. After 1 year after childbirth, women who underwent cesarean section and performed the developed physiotherapy intervention on all Functional Movement Screen tests demonstrated a statistically significantly better result compared to women who underwent natural delivery and those who recovered from cesarean section on their own. Women who underwent cesarean section, but recovered on their own with the help of general recommendations, according to the signs of impaired movement capacity 1 year after childbirth could not reach the levels of women who gave birth by vaginal delivery and women who underwent a physical therapy program. Conclusion. It is advisable to prescribe physical therapy means from the first day of postpartum rehabilitation in order to level the signs of impaired motor capacity for quick postpartum recovery of women and their return to full functioning

Keywords: rehabilitation, obstetrics, abdominal delivery

Full text: PDF (Ukr) 309K

References
  1. Di Giovanni P, Garzarella T, Di Martino G, Schioppa FS, Romano F, Staniscia T. Trend in primary caesarean delivery: a five-year experience in ABRUZZO, ITALY. BMC Health Serv Res. 2018; 18(1): 514. https://www.ncbi.nlm.nih.gov/pubmed/29970095. https://doi.org/10.1186/s12913-018-3332-2
  2. Miller S, Abalos E, Chamillard M, Ciapponi A, Colaci D, Comandé D, et al. Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide. Lancet. 2016; 388(10056): 2176-2192. https://doi.org/10.1016/S0140-6736(16)31472-6
  3. Boerma T, Ronsmans C, Melesse DY, et al. Global epidemiology of use of and disparities in caesarean sections. Lancet. 2018; 392(10155): 1341-1348. https://www.ncbi.nlm.nih.gov/pubmed/27642019. https://doi.org/10.1016/S0140-6736(18)31928-7
  4. The Lancet. Stemming the global caesarean section epidemic. Lancet. 2018; 392(10155): 1279. https://www.ncbi.nlm.nih.gov/pubmed/30322560. https://doi.org/10.1016/S0140-6736(18)32394-8
  5. Ishchenko HI, Demenina NK. Dynamika operatyvnoho rozrodzhennya v suchasnomu akusherstvi (ohlyad literatury) [Dynamics of operational delivery in modern obstetrics (review of literature)]. Perinatologiya and pediatriya. 2019; 2(78): 54-57. [Ukrainian]. https://doi.org/10.15574/PP.2019.78.54
  6. Sandall J, Tribe RM, Avery L, Mola G, Visser GH, Homer CS, et al. Short-term and long-term effects of caesarean section on the health of women and children. Lancet. 2018; 392(10155): 1349-1357. https://www.ncbi.nlm.nih.gov/pubmed/30322585. https://doi.org/10.1016/S0140-6736(18)31930-5
  7. Borg-Stein J, Dugan SA. Musculoskeletal disorders of pregnancy, delivery and postpartum. Phys Med Rehabil Clin N Am. 2007; 18(3): 459-76, ix. https://doi.org/10.1016/j.pmr.2007.05.005
  8. van Benten E, Pool J, Mens J, Pool-Goudzwaard A. Recommendations for physical therapists on the treatment of lumbopelvic pain during pregnancy: a systematic review. J Orthop Sports Phys Ther. 2014; 44(7): 464-73, A1-15. https://doi.org/10.2519/jospt.2014.5098
  9. Aravitska MG. Analiz gender-zalezhnogo rukhovogo patternu u patsiyentiv z morbidnim ozhirinnyam za rezultatami testovikh vprav [FUNCTIONAL MOVEMENT SCREEN [Analysis of the gender-dependent motor pattern in patients with morbid obesity by functional movement screen test exercise results]. Art of Medicine. 2020; 2(14): 16-22. [Ukrainian]. https://doi.org/10.21802/artm.2020.2.14.16
  10. Aravitska MG. Zmini profilyu rukhovoyi diyezdatnosti cholovikiv ta zhinok z ozhirinnyam pid vplivom programi fizichnoyi terapiyi [Changing the Profile of Motor Capacity of Obese Men and Women under Influence of Physical Therapy Program]. Ukrayinskiy zhurnal meditsini, biologiyi ta sportu. 2020; 4(26): 297-306. [Ukrainian]. https://doi.org/10.26693/jmbs05.04.297
  11. Nakaz Ministra okhorony zdorovya Ukrayiny vid 27.12.2011 № 977. Klinichnyy protokol z akusherskoyi dopomohy «Kesariv roztyn» [Clinical protocol from obstetric care "Caesarean section"]. [Ukrainian]. Available from: https://zakon.rada.gov.ua/rada/show/v0977282-11#Text
  12. PROSEDOS. Powered by Gray’s Institute [web source]. Available from: https://procedos.com/
  13. Holod NR. Rezultatyvnist testovykh vprav ekranu funktsionalnoho rukhu yak pokaznyk efektyvnosti reabilitatsiynoyi prohramy dlya studentok spetsialʹnoyi medychnoyi hrupy [Effectiveness of the test exercise screen of functional movement as an indicator of the efficiency of the rehabilitation program for students of a special medical group]. Naukovyy chasopys natsionalʹnoho pedahohichnoho universytetu imeni MP Drahomanova. Seriya № 15 «Naukovo-pedahohichni problemy fizychnoyi kultury (fizychna kultura i sport)». 2015; 3К2(57)15: 88-91. [Ukrainian]
  14. Cook G, Burton L, Hoogenboom BJ, Voight M. Functional movement screening: the use of fundamental movements as an assessment of function - part 1. Int J Sports Phys Ther. 2014; 9(3): 396-409. https://www.ncbi.nlm.nih.gov/pubmed/24944860. https://www.ncbi.nlm.nih.gov/pmc/articles/4060319
  15. Cook G, Burton L, Hoogenboom BJ, Voight M. Functional movement screening: the use of fundamental movements as an assessment of function‐part 2. Int J Sports Phys Ther. 2014; 9(4): 549-563. https://www.ncbi.nlm.nih.gov/pubmed/25133083. https://www.ncbi.nlm.nih.gov/pmc/articles/4127517
  16. Gryshchenko OV, Gryshchenko MH, Kozub TO, Holovina OV. Shlyakhy znyzhennya akusherskoyi patolohiyi za rakhunok vykorystannya prohramy fizychnoyi reabilitatsiyi u vahitnykh zhinok v umovakh zhinochoyi konsultatsiyi [Ways to reduce obstetric pathology by using the program of physical rehabilitation in pregnant women in women's consultation]. Zbirnyk naukovykh prats asotsiatsiyi akusheriv-hinekolohiv Ukrayiny. 2018; 1(41); 47-52. [Ukrainian]
  17. Grygus I, Chovpylo M, Ortenburher D. Rol fizychnoyi aktyvnosti v protsesi fizychnoyi reabilitatsiyi vahitnykh [The role of physical activity in the process of physical rehabilitation of pregnant women]. Fizychne vykhovannya, sport i kultura zdorovya u suchasnomu suspilstvi. 2018; 42: 102–110. [Ukrainian]. doi: 10.29038/2220-7481-2018-02-102-110
  18. Kuravska YuS. Analiz dynamiky yakosti zhyttya zhinok pislya abdominalnoho rodorozrishennya u pislyapolohovomu periodi pid vplyvom prohramy fizychnoyi terapiyi [Analysis of the dynamics of the quality of life of women after abdominal rotation in the postpartum period under the influence of physical therapy program]. Art of Medicine. 2021; 1(17): 52-60. [Ukrainian]. https://doi.org/10.21802/artm.2021.1.17.52
  19. Unsgaard-Tøndel M, Vasseljen O, Woodhouse A, Morkved S. Exercises for Women with Persistent Pelvic and Low Back Pain after Pregnancy. Glob J Health Sci. 2016; 8(9): 54311. https://doi.org/10.5539/gjhs.v8n9p107