Effects of Music Therapy, Breathing Exercises, and Virtual Reality on Obstetric Recovery, Pain, and Gastrointestinal Symptoms After Cesarean Section

NCT07551401 | Not Yet Recruiting

• 1 other identifier: SU-CS-INTERVENTION-2026-01
• Study Type: interventional
• Target: 192
• Locations: 1 country
• Sites: 1

Brief Summary

Cesarean section is a common surgical procedure performed to deliver a baby when vaginal birth may pose risks to the mother or infant. Although it is often life-saving, recovery after cesarean section is frequently associated with multiple physical and psychological challenges, including postoperative pain, delayed gastrointestinal function, reduced mobility, fatigue, and decreased overall well-being. These factors may negatively affect a woman's ability to care for her newborn, initiate breastfeeding, and adapt to the postpartum period. In recent years, there has been increasing interest in non-pharmacological interventions that can safely support postoperative recovery without causing additional side effects. Among these, music therapy, breathing exercises, and virtual reality applications have been identified as promising approaches. Music therapy may promote relaxation and reduce pain and anxiety through auditory stimulation and emotional regulation. Breathing exercises may enhance parasympathetic activity, improve oxygenation, reduce stress, and support gastrointestinal motility. Virtual reality applications, by providing immersive audiovisual experiences, may reduce pain perception, decrease anxiety, and improve overall comfort through distraction and relaxation mechanisms. Although these interventions have individually demonstrated beneficial effects in postoperative care, the existing literature is limited in directly comparing their relative effectiveness within the same study design. Furthermore, most studies have primarily focused on pain outcomes, while other important aspects of recovery, such as obstetric recovery quality and gastrointestinal symptoms, have received less attention. This randomized controlled trial aims to comparatively investigate the effects of music therapy, breathing exercises, and virtual reality application on obstetric recovery, pain, and gastrointestinal symptoms in women following cesarean section. Participants will be randomly assigned to one of three intervention groups or a control group receiving routine care. Standardized protocols will be applied for each intervention to ensure consistency. The primary outcomes of this study include obstetric recovery, pain intensity, and gastrointestinal symptoms. By evaluating these outcomes simultaneously, the study aims to provide a more comprehensive understanding of post-cesarean recovery. The findings of this study are expected to contribute to evidence-based clinical practice by identifying effective, safe, and feasible non-pharmacological interventions that can be integrated into routine post-cesarean care. Ultimately, this research may help improve maternal comfort, accelerate recovery, and enhance the overall postpartum experience for women undergoing cesarean section.

Conditions

Cesarean Section; Obstetric Recovery; Cesarean Section Pain; Gastrointestinal Symptoms

Keywords

Cesarean Section; Obstetric Recovery; Postoperative Pain; Gastrointestinal Symptoms; Music Therapy; Breathing Exercises; Virtual Reality; Postpartum Care

Outcome Measures

Primary Outcomes (3)

• Obstetric Recovery (ObsQoR-11)

  Obstetric recovery will be assessed using the Obstetric Quality of Recovery Score-11 (ObsQoR-11), a validated patient-reported outcome measure evaluating physical comfort, emotional status, functional independence, and pain.

  At 4 and 12 hours postoperatively

• Postoperative Pain (VAS)

  Pain intensity will be assessed using the Visual Analog Scale (VAS), a validated 10-cm scale ranging from no pain to worst possible pain.

  At 4 and 12 hours postoperatively

• Gastrointestinal Symptoms (GSRS)

  Gastrointestinal symptoms will be evaluated using the Gastrointestinal Symptom Rating Scale (GSRS), which assesses abdominal pain, reflux, diarrhea, indigestion, and constipation. Higher scores indicate more severe symptoms.

  At 4 and 12 hours postoperatively

Secondary Outcomes (1)

• Time to First Flatus

  At 4 and 12 hours postoperatively

Study Arms (4)

Music Therapy Group

EXPERIMENTAL

Participants in this group will receive music therapy in addition to routine postoperative care. The intervention will be administered in two sessions at the 4th and 12th postoperative hours following cesarean section. Each session will last 20 minutes. Standardized music content will be delivered via wireless headphones in a quiet and controlled environment. Outcome measures will be assessed at the 4th and 12th postoperative hours.

Behavioral: Music Therapy

Breathing Exercises Group

EXPERIMENTAL

Participants in this group will perform guided breathing exercises in addition to routine postoperative care. The intervention will be conducted in two sessions at the 4th and 12th postoperative hours. Each session will last 20 minutes and will consist of slow, controlled breathing techniques under researcher supervision. Outcome measures will be assessed at the 4th and 12th postoperative hours.

Behavioral: Breathing Exercises

Virtual Reality Group

EXPERIMENTAL

Participants in this group will receive a virtual reality intervention in addition to routine postoperative care. The intervention will be applied in two sessions at the 4th and 12th postoperative hours. Each session will last 20 minutes and will involve standardized immersive audiovisual content delivered via a virtual reality headset in a controlled environment. Outcome measures will be assessed at the 4th and 12th postoperative hours.

Behavioral: Virtual Reality

Control Group

NO INTERVENTION

Participants in this group will receive routine postoperative care according to hospital protocols without any additional intervention. Outcome measures will be assessed at the 4th and 12th postoperative hours.

Interventions

Music Therapy BEHAVIORAL

Participants will receive music therapy using standardized audio content delivered through wireless headphones. The intervention will be applied in two sessions at the 4th and 12th postoperative hours, each lasting 20 minutes, in a quiet and controlled environment.

Music Therapy Group

Breathing Exercises BEHAVIORAL

Participants will perform guided breathing exercises under researcher supervision. The intervention will be conducted in two sessions at the 4th and 12th postoperative hours, each lasting 20 minutes, using slow and controlled breathing techniques.

Breathing Exercises Group

Virtual Reality BEHAVIORAL

Participants will receive a virtual reality intervention using a headset to view standardized immersive audiovisual content. The intervention will be applied in two sessions at the 4th and 12th postoperative hours, each lasting 20 minutes.

Virtual Reality Group

Eligibility Criteria

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

You may qualify if:

• Women aged 18 years and older
• Able to speak and understand Turkish
• Gestational age between 37 and 42 weeks
• Undergoing cesarean section under spinal anesthesia
• Able to communicate and willing to participate
• No major intraoperative or early postoperative complications (within 0-12 hours), such as severe hemorrhage (\>1000 mL), anesthesia-related cardiorespiratory complications, major surgical complications, wound dehiscence, sepsis, or need for intensive care
• No visual or hearing impairments
• Having a live, healthy, singleton newborn

You may not qualify if:

• Passage of flatus before the intervention
• Presence of any diagnosed medical condition during pregnancy
• Development of maternal postpartum complications such as postpartum hemorrhage (\>1000 mL), infection, wound dehiscence, sepsis, thromboembolism, or need for intensive care
• Presence of neonatal complications such as neonatal distress requiring intensive care, congenital anomalies, severe respiratory distress, infection, or perinatal mortality
• History of chronic pain, gastrointestinal disease, or respiratory disease
• Diagnosed and treated psychiatric disorders

Sponsors & Collaborators

• Selcuk University: lead

Study Sites (1)

Konya City Hospital

Konya, 42020, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Pain, Postoperative

Interventions

Music Therapy; Breathing Exercises

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Intervention Hierarchy (Ancestors)

Sensory Art Therapies; Complementary Therapies; Therapeutics; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Psychotherapy; Behavioral Disciplines and Activities; Mind-Body Therapies; Exercise Movement Techniques; Physical Therapy Modalities

Central Study Contacts

Sureyya Kilic, Specialist Midwife

CONTACT

+90 501 578 99 08; sureyyakilic117@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Due to the nature of the interventions (music therapy, breathing exercises, and virtual reality), participants and intervention providers cannot be blinded. However, outcome assessment will be conducted using standardized measurement tools. Data analysis will be performed by an independent statistician who will be blinded to group allocation. Group assignments will be coded (e.g., Group A, B, C, D) to ensure blinding during statistical analysis.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: Participants will be randomized in a 1:1:1:1 ratio to one of four parallel groups: music therapy, breathing exercises, virtual reality, or routine care control. Randomization will be performed using stratified block randomization according to parity (primiparous/multiparous) and education level (primary, secondary, higher education) to ensure baseline balance across groups. Outcome assessments will be conducted at postoperative 4th and 12th hours using a pretest-posttest design. Each participant will receive only the intervention assigned to her group, and no crossover between groups will occur.

Study Record Dates

• First Submitted: April 18, 2026
• First Posted: April 24, 2026
• Study Start: May 1, 2026
• Primary Completion (Estimated): January 1, 2027
• Study Completion (Estimated): March 1, 2027
• Last Updated: April 30, 2026

Record last verified: 2026-04

Locations

TU (1)