Community-Based Physiotherapy Intervention for Postpartum Low Back Pain Design: Community Intervention

Abstract

Background:
Postpartum low back pain is a common musculoskeletal complaint that can persist beyond childbirth and negatively affect functional ability, caregiving capacity, and quality of life. In rural settings, limited access to rehabilitation services often results in untreated or poorly managed symptoms, despite the availability of effective physiotherapy-based interventions. Community-based rehabilitation models offer a potential solution to address this gap in maternal healthcare.

Objective:
To evaluate the effectiveness of a community-based physiotherapy intervention in reducing pain intensity and functional disability among postpartum women with low back pain in rural Punjab, Pakistan.

Methods:
A quasi-experimental pre–post community intervention study was conducted over eight months in selected rural districts of Punjab. Postpartum women aged 18–40 years, within six months of delivery and experiencing nonspecific low back pain, were recruited. A structured physiotherapy program comprising core stabilization exercises, posture correction, pelvic floor strengthening, and ergonomic education was delivered twice weekly for eight weeks. Pain intensity and functional disability were assessed before and after the intervention using the Visual Analog Scale and Oswestry Disability Index, respectively. Data were analyzed using paired sample t-tests.

Results:
Out of 105 enrolled participants, 98 completed the study. Mean pain intensity significantly decreased from 7.3 ± 1.3 to 3.2 ± 1.1, while mean disability scores improved from 38.2 ± 10.5 to 16.8 ± 7.3 following the intervention (p < 0.001). Large effect sizes were observed for both outcomes, indicating clinically meaningful improvements.

Conclusion:
Community-based physiotherapy was effective in reducing postpartum low back pain and improving functional outcomes in rural women. Integrating physiotherapy into community-level maternal health services may enhance postpartum recovery and address unmet rehabilitation needs in low-resource settings.

Keywords:
Exercise Therapy, Low Back Pain, Postpartum Period, Rehabilitation, Rural Health Services, Women’s Health, Physiotherapy