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NCT Number: NCT07130747

Effect of Myofascial Release Versus Deep Friction Massage on Abdominal Recovery and Scar After Cesarean Section

This study was done to compare the effect of myofascial release versus deep friction massage on abdominal recovery and scar after cesarean section.

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Key information

Conditions

Myofascial Release Cesarean Section Complications Cicatrix Deep Friction Massage Fibrosis Pathologic Processes Pathological Conditions, Signs and Symptoms Scar

Age range

30 year–45 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

the Gynecology and Obstetrics Outpatient clinics, Alexandria University Hospitals, Alexandria, Egypt

Alexandria, Egypt

Location status: Recruiting

Location contact

Moaz Khaled Elsayed mohamed, physical therapist

CONTACT

[email protected]

+201068923232

About this study

Chronic post-C-section scar pain and discomfort affect up to 20% of women who undergo cesarean sections. This pain can lead to physical, aesthetic, psychological, and social consequences, including itching, stiffness, scar contractures, and tenderness. The myofascial release technique, a manual approach, may facilitate the healing process. Deep friction massage, used to correct structural alterations, can cause reduced mobility and viscoelasticity, potentially affecting sensory receptors and nerve fibers. This study aims to provide physiotherapists with scientific information on the effect of myofascial release on scar and abdominal recovery after cesarean section.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • All postpartum women >6 months postnatal having a post-Cesarean-section scar.
  • Postpartum women with a well-healed cesarean section scar resulted in chronic pain in the scar, pelvis, or abdomen.
  • Their ages will range from 30 to 45 years.
  • Their body mass index (BMI) is less than 30 kg/m².

Exclusion criteria

  • Pregnant women or planning for pregnancy.
  • Postpartum women with abdominal infectious diseases.
  • Cardiovascular diseases.
  • Previous spinal surgery.
  • History of skeletal deformity.
  • Participation in any other exercise training program during this study.
  • Malignant condition
  • History of acute infection
  • Neurological problem
  • Mental problem to prevent evaluation and cooperation
  • Having uncontrolled metabolic diseases like diabetes and thyroid disease

Treatment and study plan

Myofascial Release

Other

The study involves women in both groups receiving myofascial release technique for twenty minutes three times per week for eight weeks. The technique requires the patient's skin to be dry and not oily, and all techniques must be applied at the barrier of tissue resistance. The technique involves gentle, sustained pressure held at the barrier for at least five minutes to allow the patient to respond to the treatment and relax. The technique involves skin stretching and desensitization around the scar, using up and down, side-to-side, and circular maneuvers.

Deep friction massage

Other

Women in both groups (C) will receive a deep friction massage three times a week for eight weeks, applying a fingertip pad perpendicularly to post-cesarean scar tissue, moving across the band and back-and-forth motion along the scar tissue's length.

Routine daily scar care advices

Other

Each woman in all groups (A, B, and C) will receive full instructions for daily post-cesarean-section scar care. Weekly revision for post-cesarean-section scar care will conduct by the researcher

Primary outcomes

  1. assessment of pain intensity

    Time frame: at baseline and after 8 weeks

    Participants will use a visual analogue scale to assess waist pain intensity before and after treatment for all groups, rating severity from zero to 10. This reliable and time-efficient method is suitable for assessing pain levels post-c Cesarean scar site.

Secondary outcomes

  1. Assessment of post-Cesarean-section scar recovery

    Time frame: at baseline and after 8 weeks

    The modified Vancouver scale will be used to assess post-Cesarean section scar tissue, focusing on vascularity, pigmentation, pliability, and height. The scale will be tested using four characteristics of the scar: vascularity, height, pliability, and pigmentation. The overall score between 0 and 13 is calculated by adding up the scores of each characteristic. The modified scale will be evaluated through multiple photographs of the patient's scar, evaluating four parameters: irregularity of texture, height, pigmentation, and vascularity. Modifications may be suggested to improve reliability and teaching, but it is not yet a validated tool.

  2. Assessment of pressure pain threshold

    Time frame: at baseline and after 8 weeks

    A pressure algometer is a reliable device used to assess pressure pain threshold and deep tenderness in post-Cesarean scar tissue. It consists of a gauge attached to a rubber tip and calibrated in kg/cm², with a range of 1-10 kg/cm². The algometer has a probe, handheld and analogue pieces, and measures accurately to 0.1 kg/cm². Participants are instructed to relax in a comfortable supine position, and the pressure is increased by one kilogram per second until discomfort is felt. The mean pressure value is recorded as the pressure pain threshold at the post-Cesarean scar.

  3. Assessment of abdominal recovery

    Time frame: at baseline and after 8 weeks

    The study will conduct an abdominal endurance test for all participants pre- and post-treatment. Participants will lie with a 70° wooden support, and the researcher will measure their endurance and functional ability. If they cannot sustain their position, they will be recorded as having poor endurance and functional ability, while those who can sustain their position for 15-30 seconds will be classified as having perfect endurance and functional ability.

  4. Assessment of abdominal musculatures strength

    Time frame: at baseline and after 8 weeks

    The study will conduct a manual muscle test on all participants pre- and post-treatment, assessing abdominal musculature strength using Dr. Lovett's manual muscle test scale. The rectus abdominus muscle will be examined by lifting the participant to the lower end of the scapulae, leaning forward with crossed hands, and repeating this motion. The test will be recorded on a 0-5-point scale.

Study contacts

Contact information is provided by the study sponsor or research team.

Moaz Khaled Elsayed Mohamed, physical therapist

CONTACT

[email protected]

+201068923232

Sponsors and collaborators

Lead sponsor

Cairo University

Other

Registry information

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Aug 19, 2025
Registry last updated
Aug 19, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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