Repair by Rehabilitation of Pelvic Floor Lesions After Vaginal Delivery Identified by Transperineal Ultrasound 3/4 D

NCT03686956 | Completed

• 1 other identifier: Rehabilitation of the avulsion
• Study Type: interventional
• Target: 92
• Locations: 1 country
• Sites: 1

Brief Summary

SUMMARY: (Objective, design, scope of the study, subjects of study, instrumentation, results, conclusions) Objectives: To evaluate if the physiotherapy treatment in pelvic floor dysfunctions, identified by transperineal ultrasound 3 / 4D, in postpartum improve the tone and functionality of pelvic floor. Design: Post-authorization, prospective, longitudinal randomized intervention study Scope: Full-term deliveries at the University Hospital. Subjects of study: Full-term primiparous and full-term pregnancies with pelvic floor lesion, identified by transperineal ultrasound 3 / 4D, which are randomized between the physiotherapy treatment of pelvic floor and the non-work. Variables: Primary variable: Assess the improvement in contractility / tone, evaluation by manometry and assess the anatomical improvement of the area of ?? the genital hiatus, stay by transperineal ultrasound 3 / 4D. Secondary variables: Identify the levator ani muscle injury rate, estimate the sonographic changes in the levator ani muscle through rehabilitation. Analyze the improvement of the symptoms associated with the public organic prolapse and evaluate the improvement of the quality of life. Data analysis: To detect a difference of 10% in the reduction of the size of the index between the study groups (not intervened / intervened) after 6 months of intervention, standard deviation 10%, Error-alpha 5%, Error- beta 10% (P90%) we need 23 women in each group. Assuming a loss of 10% in the follow-up, the final size would be 52 women, 26 per group.

Conditions

Pelvic Floor Disorders; Obstetric Trauma; Physical Disorder; Physical Activity

Outcome Measures

Primary Outcomes (2)

• To evaluate the changes in pressure in the contractility evaluated by manometry (mm Hg)

  To evaluate the changes in pressure in the contractility evaluated by manometry (mm Hg), of the medical floor produced by the treatment of postpartum physiotherapy of the pelvic floor

  6 months after randomisation

• Changes in muscle thickness (millimeters) of the levator ani muscle

  Changes in muscle thickness (millimeters) of the levator ani muscle, measured with transperineal ultrasound 3-4D

  6 months after randomisation

Study Arms (2)

Experimental group

EXPERIMENTAL

The therapy lasted two months, at a rate of two sessions per week, with a duration of 45 minutes per session. The program consisted of pelvic floor exercises assisted by manometric biofeedback, which were performed in supine position for 20 minutes. In addition, active lumbopelvic stabilization exercises, including the contraction of pelvic floor muscles was performed in supine, plank and quadruped position. Together with the treatment at the clinic, patients were asked to perform a series of exercises at home, consisting in: 8-12 sustained contractions of 6 seconds, with a subsequent rest period of double the work-time, followed by 3-5 fast contractions of 2 seconds with maximum intensity, resting double the work-time. Domiciliary exercises were performed in supine, siting and standing position.

Other: Physiotherapy treatment

Control group

NO INTERVENTION

The control group received an information brochure with recommendations, including the same program of pelvic floor exercises taught to the patients in the experimental group, but without carrying out any kind of supervision by the physiotherapist.

Interventions

Physiotherapy treatment OTHER

Physiotherapy treatment consisted of pelvic floor exercises assisted by manometric biofeedback. In addition, active lumbopelvic stabilization exercises, including the contraction of pelvic floor muscles was performed in supine, plank and quadruped position.

Experimental group

Eligibility Criteria

• Age: 18 Years+
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Vaginal delivery
• Cephalic presentation
• Primiparity
• At term gestation (37-42 weeks)
• No prior pelvic floor corrective surgery
• Written informed consent

You may not qualify if:

• Pregnancies with severe maternal or fetal pathology

Sponsors & Collaborators

• Hospital Universitario de Valme: lead

Study Sites (1)

Hospital Nuestra Señora de Valme

Seville, 41014, Spain

Location

Related Publications (1)

• Sainz-Bueno JA, Bonomi MJ, Suarez-Serrano C, Medrano-Sanchez EM, Armijo A, Fernandez-Palacin A, Garcia-Mejido JA. Quantification of 3/4D ultrasound pelvic floor changes induced by postpartum muscle training in patients with levator ani muscle avulsion: a parallel randomized controlled trial. Quant Imaging Med Surg. 2022 Apr;12(4):2213-2223. doi: 10.21037/qims-21-877.

  PMID: 35371949 DERIVED

MeSH Terms

Conditions

Pelvic Floor Disorders; Motor Activity

Condition Hierarchy (Ancestors)

Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Pregnancy Complications; Male Urogenital Diseases; Behavior

Study Officials

• José Antonio García Mejido

  Hospital Universitario de Valme

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Dr.

Study Record Dates

• First Submitted: September 21, 2018
• First Posted: September 27, 2018
• Study Start: August 1, 2018
• Primary Completion: March 1, 2019
• Study Completion: June 1, 2019
• Last Updated: August 17, 2020

Record last verified: 2020-08

Locations

ES (1)