الفهرس 
Effect of therapeutic exercises and mode of delivery on iliac rotation asymmetry and sacroiliac joint pain in postpartum women
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Abstract
Purpose of the study: To determine the effect of therapeutic exercises and mode of
delivery on iliac rotation asymmetry and the severity of sacroiliac joint (SIJ) pain in
postpartum women. Participant: Forty primiparous postpartum breastfeeding right
handed women with right sided SIJ pain, delivered by vaginal delivery with mediolateral
episiotomy or lower segment cesarean section with spinal anesthesia shared in this study.
They were selected from the outpatient clinic, Fakous General Hospital in Sharkia. Their
ages ranged from 20 to 35 years and their body mass index was less than 30 Kg/ m2
and
waist/hip ratio (WHR) more than 0.85. The patients were divided according to their
mode of delivery into 2 equal groups (A&B). group (A) delivered by vaginal delivery
with mediolateral episiotomy and group (B) delivered by elective lower segment
cesarean section with spinal anesthesia. Methods: Both groups (A&B) received an
exercise program composed of muscle energy technique, core stability and pelvic floor
exercises 3 times/week for 6 weeks in addition to instructions concerning SIJ pain.
Assessment of pain severity by visual analogue scale (VAS), pain threshold assessed by
pressure algometer, degree of anterior pelvic tilt and iliac rotation asymmetry by PALM
and physical as well as, mental components of health related quality of life (QoL) by SF36 were done before and after treatment for both groups.
Results: Analysis showed that group (B) had statistically significant greater pretreatment
values (p<0.05) of pain severity, degree of anterior pelvic tilt angle and iliac rotation
asymmetry. While, it had statistically significant lesser pretreatment values (p<0.05) of
pain threshold and physical component of health related QoL than group (A) and no
statistically significant difference (p>0.05) between both groups in the pretreatment
values of mental component of health related QoL. Both groups (A&B) showed
statistically significant improvement (p<0.05) in all variables when comparing pre and
post treatment values except the mental component of health related QoL that did not
show significant improvement (p>0.05) in group (B). On comparing both groups, group
(A) showed significant greater improvement than group (B). Also, correlations between
the different variables were detected.
Conclusion: Performing an exercise program of muscle energy technique, core stability
exercises, and pelvic floor exercises could positively affect SIJ pain and asymmetry in
postpartum women, regardless of their mode of delivery. Also, women delivered
vaginally showed higher improvement than women delivered with elective cesarean
section in terms of decreased pain severity and pelvic asymmetry as well as, increased
pain threshold and QoL.