Physical Therapy in Addition to Standard of Care Improves Patient Satisfaction and Recovery Post-cesarean Section

Abstract

Supplemental Digital Content is Available in the Text. Background: Cesarean section represents the most commonly performed inpatient surgical procedure in the United States. The few studies currently available regarding the role of physical therapy in postoperative recovery only look at the first few days or weeks postpartum. The goal of this pilot randomized controlled trial was to assess the impact of physical therapy post-cesarean delivery and to serve as a potential basis for future research. Objective: To evaluate the short- and long-term impact of an individualized, comprehensive physical therapy program on post-cesarean delivery recovery. Study Design: Unblinded randomized controlled trial. Methods: The intervention group went through an individualized 6-week physical therapy program, which included in-clinic treatment and home exercises in addition to usual postoperative care. Outcome measures used were a visual pain rating scale, Oswestry Disability Index, patient satisfaction questionnaire, and self-rated exercise confidence scale. Results: Seventy-two participants were included in final analysis. Satisfaction was significantly higher at 14 weeks (P = .048) and 6 months (P = .047) in the intervention group. Pain rating was significantly lower at 14 weeks (P = .049) in the intervention group. A significant change was found between baseline and 14-week/6-month follow up for Oswestry (P < .0001), patient satisfaction (P = .024), and self-efficacy with exercise (P = .034) in the intervention group. A significant main effect for self-efficacy with exercise (P = .025) in the intervention group was found at all time points compared with standard of care. Significant differences between variables were found for the Oswestry intervention group [8-14 weeks (P = .003), 8 weeks to 6 months (P = .001), and 8 weeks to 1 year (P = .007)] and the standard of care group [8 weeks to 6 months (P = .001) and 8 weeks to 1 year (P = .006)]. Conclusions: Participants who received physical therapy had significantly improved outcomes compared with the standard of care group. This suggests that physical therapy may be a helpful adjunct to cesarean delivery recovery, although larger studies should be done for definitive conclusions.