Scapular Stabilization Exercises Combined With Thoracic Mobilization in Breast Feeding Mothers With Upper Back Pain
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 70
- 试验地点
- 1
- 主要终点
- Change in Pain Intensity Assessed Using the Numeric Pain Rating Scale
研究概览
简要总结
Upper-back pain is common among breastfeeding mothers and may be associated with prolonged feeding positions, forward-bent posture, reduced thoracic mobility, and weakness of the muscles controlling the shoulder blades. This study will compare scapular stabilization exercises combined with thoracic spine mobilization with scapular stabilization exercises alone in breastfeeding mothers experiencing upper-back pain.
Seventy eligible breastfeeding mothers aged 18-35 years will be assigned to one of two treatment groups. Both groups will receive scapular stabilization exercises, while one group will additionally receive thoracic mobilization performed by a trained physiotherapist. Treatment will be provided three times per week for eight weeks.
Pain intensity, functional ability, and spinal range of motion will be assessed at baseline, Week 4, and Week 8. The study aims to determine whether adding thoracic mobilization to scapular stabilization exercises provides greater improvement in pain, mobility, and daily functioning than scapular stabilization exercises alone.
详细描述
This assessor-blinded, randomized clinical trial will be conducted at the University of Lahore Teaching Hospital, Lahore. Seventy breastfeeding mothers will be recruited using purposive sampling and randomly allocated by lottery method to two equal groups of 35 participants. Eligible participants will be women aged 18-35 years who are within three months after childbirth, exclusively breastfeeding, and experiencing breastfeeding-related upper-back pain rated between 4 and 7 on the Numeric Pain Rating Scale.
Before treatment, participants in both groups will receive a standardized warm-up consisting of a moist hot pack applied to the cervical and upper-thoracic regions, followed by gentle stretching. Group A will receive scapular stabilization exercises combined with thoracic mobilization. The exercise programme will include scapular retraction and depression, serratus anterior punches, wall slides, and prone horizontal abduction with scapular setting. Thoracic mobilization will be performed by a trained physiotherapist to improve thoracic extension and segmental mobility and reduce stiffness. Group B will receive the same scapular stabilization exercise programme without thoracic mobilization. Exercise difficulty will be progressively increased by adding repetitions and resistance.
The interventions will be delivered three times per week for eight weeks. Each exercise session will last approximately 30-35 minutes, with an additional 10-15 minutes of thoracic mobilization for Group A. The outcome assessor will remain unaware of participants' group assignments.
The primary outcome will be pain intensity, assessed using the 11-point Numeric Pain Rating Scale. Secondary outcomes will include functional ability measured using the Patient-Specific Functional Scale and spinal range of motion measured in degrees using a digital inclinometer. Assessments will be completed at baseline, Week 4, and Week 8.
Data will be analyzed using descriptive and inferential statistics. Data distribution will be assessed before analysis. Changes over time and differences between groups will be examined using repeated-measures analysis of variance, with post-hoc pairwise comparisons where appropriate. Statistical significance will be set at p≤0.05.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 35 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •Women in the early postpartum period (0-3 months following childbirth) (Ratajczak & Górnowicz, 2024).
- •Women who were exclusively breastfeeding and experiencing upper back pain associated with breastfeeding activities within the first 3 months postpartum (Ojukwu et al., 2025).
- •Participants reporting moderate upper back pain, defined as a score of 4-7 on the Numeric Pain Rating Scale (NPRS) at the time of recruitment (Bharti et al., 2024).
排除标准
- •History of cervical spine trauma, surgery, or fracture (Yan et al., 2023).
- •Presence of neurological disorders, cervical radiculopathy, myelopathy, or musculoskeletal conditions unrelated to breastfeeding that could influence neck pain, cervical mobility, or functional performance (Yonus et al., 2025).
- •Diagnosed systemic illnesses or medical conditions that may contraindicate exercise participation, such as rheumatoid arthritis, ankylosing spondylitis, osteoporosis, uncontrolled hypertension, cardiovascular disease, or other inflammatory or metabolic disorders affecting the musculoskeletal system (Womsi et al., 2025).
- •Concurrent pain in other body regions (e.g., shoulder, thoracic spine, upper back, or upper extremity pain) that could interfere with exercise participation or influence outcome measurements (Rana et al., 2024).
- •Ongoing physiotherapy, rehabilitation, or medical treatment for neck pain during the study period (Ratajczak & Górnowicz, 2024).
研究组 & 干预措施
Scapular Stabilization Exercises With Thoracic Mobilization
Participants will receive scapular stabilization exercises combined with thoracic spine mobilization three times per week for eight weeks. Exercises will include scapular retraction and depression, serratus anterior punches, wall slides, and prone horizontal abduction with scapular setting. Each exercise will be performed in three sets of 10-12 repetitions, with 5-second holds where appropriate. Exercise intensity will be progressively increased every two weeks by increasing repetitions and adding resistance bands. A trained physiotherapist will also provide thoracic mobilization for approximately 10-15 minutes per session to improve thoracic mobility and reduce stiffness.
干预措施: Scapular Stabilization Exercises (Other)
Scapular Stabilization Exercises With Thoracic Mobilization
Participants will receive scapular stabilization exercises combined with thoracic spine mobilization three times per week for eight weeks. Exercises will include scapular retraction and depression, serratus anterior punches, wall slides, and prone horizontal abduction with scapular setting. Each exercise will be performed in three sets of 10-12 repetitions, with 5-second holds where appropriate. Exercise intensity will be progressively increased every two weeks by increasing repetitions and adding resistance bands. A trained physiotherapist will also provide thoracic mobilization for approximately 10-15 minutes per session to improve thoracic mobility and reduce stiffness.
干预措施: Thoracic Spine Mobilization (Other)
Scapular Stabilization Exercises Alone
Participants will receive scapular stabilization exercises alone three times per week for eight weeks. Exercises will include scapular retraction and depression, serratus anterior punches, wall slides, and prone horizontal abduction with scapular setting. Each exercise will be performed in three sets of 10-12 repetitions, with 5-second holds where appropriate. Exercise intensity will be progressively increased every two weeks by increasing repetitions and adding resistance bands. Thoracic mobilization will not be provided to this group.
干预措施: Scapular Stabilization Exercises (Other)
结局指标
主要结局
Change in Pain Intensity Assessed Using the Numeric Pain Rating Scale
时间窗: Baseline and immediately after completion of the intervention
Pain intensity will be assessed using the Numeric Pain Rating Scale (NPRS), an 11-point self-reported scale ranging from 0 ("no pain") to 10 ("worst imaginable pain"). Participants will rate their average upper-back pain experienced during the previous 24 hours. Higher scores indicate greater pain intensity. Change in NPRS score from baseline to post-intervention will be analyzed.
次要结局
- Change in Thoracic and Cervicothoracic Range of Motion(Baseline and immediately after completion of the intervention)
- Change in Functional Ability Assessed Using the Patient-Specific Functional Scale(Baseline and immediately after completion of the intervention)
研究者
Marrium Tahir Iqbal
Student
University of Lahore