Effect of clamshell exercise on postpartum lumbo-pelvic stability and low back pain: a randomized controlled trial

Document Type : Original Article

Authors

1 Geriatric Health Center, Directorate of Health Affairs, Port Said, Egypt.

2 Department of Physical Therapy for Women’s Health, Faculty of Physical Therapy, Cairo University, Egypt

3 Department of Obstetrics and Gynecology, Faculty of Medicine, Al Azhar University, Egypt

10.21608/iptccu.2025.440723

Abstract

Background: Compensatory changes that occur during pregnancy affect the core muscle’s function and balance, resulting in low back pain (LBP). Clamshell exercise, as a core stability exercise, targets the hip abductor muscles that are key muscles in hip stability and mobility. Purpose: This study aimed to determine the effect of clamshell exercise on lumbo-pelvic stability in LBP. Participants and methods: This randomized controlled trial was conducted on 40 females with postpartum LBP & pelvic instability, selected from outpatient clinic of specialist obstetrics and gynecology hospital in Port Said. Their age ranged from 25-35 years, and their body mass index (BMI) ranged from 25-30 kg/m2. They were randomized into two equal groups; the control group A (n=20), performed abdominal bracing maneuver 3 times per week for 6 weeks, and the study group B (n=20), performed clamshell exercises 3 times per week for 6 weeks in addition to abdominal bracing maneuver as group A. The outcome measures were the visual analogue scale (VAS) for assessing LBP severity, Oswestry disability index (ODI) for assessing functional disability and quality of life, universal goniometry and special tests (dip test- runner pose test - single leg squat test) for lumbo-pelvic stability. Results: Within groups, there was a statistically significant difference (P ≤ 0.05) when comparing pre-to-post study results in both groups, while no statistically significant difference was found between groups. Conclusion: clamshell exercises added to abdominal bracing improved lumbo-pelvic stability, decreased LBP and improved functional disability in postpartum women, with no difference between both intervention on any of the variables.

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