Impact of Pelvic Floor Rehabilitation Combined With Ultrasound Therapy on Osteomyoarticular Symptoms in Chronic Perineal Pain

Not Applicable

Completed

Interventions: Device: Traditional ultrasound therapy
Other: Pelvic floor rehabilitation

Brief Summary: The purpose of the study is to find out the effect of pelvic floor rehab combined with ultrasound have effect in chronic perineal pain subjects associated with osteomyoarticular symptoms .

Detailed Description: Chronic perineal pain is the anorectal and perineal pain without underlying organic disease, anorectal or endopelvic, which has been excluded by careful physical examination, radiological and endoscopic investigations. So, perineal and vaginal pain after vaginal delivery has been associated with tissue trauma related to operative vaginal delivery, perineal laceration, and episiotomy.

Studies assessing chronic pain after vaginal delivery report 2% to 10% of women with pain at six months and later, almost exclusively in mothers who had an assisted vaginal birth. Postpartum pain intensity is usually higher when it is related to vaginal delivery than to cesarean delivery and more severely affects the woman's quality of life and mood.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Females will be excluded if they have any spine or lower extremities injuries or previous surgeries.
Females with radicular back pain.
Inability to understand the written and verbal instruction.
Females had irregular menstrual cycle

Arm && Interventions

Group	Intervention	Description
Study group B	Traditional ultrasound therapy	They will receive the same traditional ultrasound therapy in addition to pelvic floor rehabilitation for six weeks
Study group B	Pelvic floor rehabilitation	They will receive the same traditional ultrasound therapy in addition to pelvic floor rehabilitation for six weeks
Control group A	Traditional ultrasound therapy	They will receive traditional ultrasound therapy for six weeks

Primary Outcome Measures

Name	Time	Method
Assessment of osteomyoarticular symptoms	6 weeks	It will be assessed before and after the end of treatment for each participant in both groups using Nordic Musculoskeletal Questionnaire (NMQ), an instrument characterized by multiple or binary choices facing osteomyoarticular symptoms in various anatomical regions that these symptoms appear more frequently, and a questionnaire that has good reliability (Legault et al., 2014).
Assessment of perineal pain intensity	6 weeks	It will be assessed before and after the end of treatment for each participant in both groups through the visual analouge scale (VAS). It is a 10-cm horizontal line on which the patient's pain intensity was represented by a point between the extremes of "no pain at all" and "worst pain imaginable". Its simplicity, reliability and validity, as well as its ratio scale properties, make the VAS the optimal tool for describing pain intensity. Each participant will be asked to mark a point on the VAS line between the extremes that related to her perineal intensity. Then, the centimeters will be measured in each time from the left end of the line to the marked point to obtain the VAS score for perineal pain intensity

Secondary Outcome Measures

Name	Time	Method
Assessment of lumbar spine mobility	6 weeks	It will be assessed before and after the end of treatment for each participant in both groups by the modified Schober test
Assessment of pelvic floor muscle tightness	6 weeks	It will be assessed before and after the end of treatment for each participant in both groups by the manual pelvic floor muscle examination
Assessment of pelvic floor muscle strength	6 weeks	It will be assessed before and after the end of treatment for each participant in both groups by Kegel perineometer