Effect of Myofascial Release Versus Deep Friction Massage on Abdominal Recovery and Scar After Cesarean Section

Not Applicable

Recruiting

• Conditions: Myofascial Release; Cesarean Section Complications; Deep Friction Massage; Scar

• Registration Number: NCT07130747
• Lead Sponsor: Cairo University

Brief Summary

This study was done to compare the effect of myofascial release versus deep friction massage on abdominal recovery and scar after cesarean section.

Detailed Description

Chronic post-C-section scar pain and discomfort affect up to 20% of women who undergo cesarean sections. This pain can lead to physical, aesthetic, psychological, and social consequences, including itching, stiffness, scar contractures, and tenderness. The myofascial release technique, a manual approach, may facilitate the healing process. Deep friction massage, used to correct structural alterations, can cause reduced mobility and viscoelasticity, potentially affecting sensory receptors and nerve fibers. This study aims to provide physiotherapists with scientific information on the effect of myofascial release on scar and abdominal recovery after cesarean section.

Study Timeline

• Study Start: 2025-06-01
• Status Verified: 2025-08
• Study First Submitted: 2025-08-09
• Study First Submitted QC: 2025-08-16
• Last Update Submitted: 2025-08-16
• Study First Posted: 2025-08-19
• Last Update Posted: 2025-08-19
• Primary Completion: 2025-09-01
• Study Completion: 2025-10-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: Female
• Target Recruitment: 36

Inclusion Criteria

1. All postpartum women >6 months postnatal having a post-Cesarean-section scar.
2. Postpartum women with a well-healed cesarean section scar resulted in chronic pain in the scar, pelvis, or abdomen.
3. Their ages will range from 30 to 45 years.
4. Their body mass index (BMI) is less than 30 kg/m².

Exclusion Criteria

1. Pregnant women or planning for pregnancy.
2. Postpartum women with abdominal infectious diseases.
3. Cardiovascular diseases.
4. Previous spinal surgery.
5. History of skeletal deformity.
6. Participation in any other exercise training program during this study.
7. Malignant condition
8. History of acute infection
9. Neurological problem
10. Mental problem to prevent evaluation and cooperation
11. Having uncontrolled metabolic diseases like diabetes and thyroid disease

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
assessment of pain intensity	at baseline and after 8 weeks	Participants will use a visual analogue scale to assess waist pain intensity before and after treatment for all groups, rating severity from zero to 10. This reliable and time-efficient method is suitable for assessing pain levels post-c Cesarean scar site.

Secondary Outcome Measures

Name	Time	Method
Assessment of post-Cesarean-section scar recovery	at baseline and after 8 weeks	The modified Vancouver scale will be used to assess post-Cesarean section scar tissue, focusing on vascularity, pigmentation, pliability, and height. The scale will be tested using four characteristics of the scar: vascularity, height, pliability, and pigmentation. The overall score between 0 and 13 is calculated by adding up the scores of each characteristic. The modified scale will be evaluated through multiple photographs of the patient's scar, evaluating four parameters: irregularity of texture, height, pigmentation, and vascularity. Modifications may be suggested to improve reliability and teaching, but it is not yet a validated tool.
Assessment of pressure pain threshold	at baseline and after 8 weeks	A pressure algometer is a reliable device used to assess pressure pain threshold and deep tenderness in post-Cesarean scar tissue. It consists of a gauge attached to a rubber tip and calibrated in kg/cm², with a range of 1-10 kg/cm². The algometer has a probe, handheld and analogue pieces, and measures accurately to 0.1 kg/cm². Participants are instructed to relax in a comfortable supine position, and the pressure is increased by one kilogram per second until discomfort is felt. The mean pressure value is recorded as the pressure pain threshold at the post-Cesarean scar.
Assessment of abdominal recovery	at baseline and after 8 weeks	The study will conduct an abdominal endurance test for all participants pre- and post-treatment. Participants will lie with a 70° wooden support, and the researcher will measure their endurance and functional ability. If they cannot sustain their position, they will be recorded as having poor endurance and functional ability, while those who can sustain their position for 15-30 seconds will be classified as having perfect endurance and functional ability.
Assessment of abdominal musculatures strength	at baseline and after 8 weeks	The study will conduct a manual muscle test on all participants pre- and post-treatment, assessing abdominal musculature strength using Dr. Lovett's manual muscle test scale. The rectus abdominus muscle will be examined by lifting the participant to the lower end of the scapulae, leaning forward with crossed hands, and repeating this motion. The test will be recorded on a 0-5-point scale.

Trial Locations

Locations (1)

the Gynecology and Obstetrics Outpatient clinics, Alexandria University Hospitals, Alexandria, Egypt; 🇪🇬 Alexandria, Egypt