Functional training versus conventional physiotherapy for postpartum pelvic girdle pain: a randomized controlled trial

This study aimed to evaluate the efficacy of functional training in alleviating postpartum pelvic girdle pain (PGP). A total of 40 patients diagnosed with postpartum PGP who received outpatient rehabilitation treatment in our department between July 2023 and June 2024 were enrolled. Participants were randomly assigned to either the experimental group or the control group (n = 20 in each group) using a random number table. The control group received routine pelvic floor physical therapy, while the experimental group received additional functional training based on the standard treatment protocol. The two groups were compared in terms of Visual Analogue Scale (VAS) scores, Pelvic Girdle Questionnaire (PGQ) scores, surface electromyographic (sEMG) values of the pelvic floor muscles based on the Glazer protocol-specifically the mean and root mean square (RMS) values across five phases (pre-resting, phasic contraction, tonic contraction, endurance contraction, post-resting), and the angle difference in the Active Straight Leg Raise (ASLR) test. All 40 patients completed the study. There were no statistically significant differences between the two groups in baseline characteristics, including age, height, weight, BMI, parity, and neonatal birth weight (P > 0.05). The experimental group showed a significant decrease in the pre-resting and post-resting phases and a substantial increase in phasic contraction, tonic contraction, or endurance contraction phases of the Glazer's sEMG assessment (P < 0.001). In contrast, the control group showed a significant decrease only in the pre-resting and post-resting phases (P < 0.001), with no substantial increase in phasic contraction, tonic contraction, or endurance contraction phases (P > 0.05). Before treatment, the control group had significantly higher values in phasic contraction, tonic contraction, and endurance contraction phases compared to the experimental group; however, no significant differences were found between groups after treatment (P > 0.05). The experimental group demonstrated significant improvements in PGQ, VAS, and ASLR angle after treatment (P < 0.001), with greater efficacy than the control group (P < 0.05). No significant differences were observed between groups in PGQ and VAS scores prior to treatment, but the experimental group performed better after treatment (P < 0.05). No significant between-group differences were found in ASLR angle before or after treatment (P > 0.05). Functional training can significantly improve postpartum pelvic girdle pain and enhance pelvic floor muscle function.