Author(s): CHUA, S., KUO, Y.L., WU, M.H., LIN, K.Y., TSAI, Y.J., Institution: NATIONAL CHENG KUNG UNIVERSITY, Country: TAIWAN, Abstract-ID: 546

INTRODUCTION:
Pregnancy-related pelvic girdle pain (PPGP) is a common musculoskeletal condition in postpartum women, leading to pain, functional limitations, and reduced quality of life. Altered pelvic stability, core muscle dysfunction, and impaired load transfer contribute to its persistence. The diaphragm plays a dual role in respiration and core stabilization, working synergistically with other core muscles, such as the pelvic floor muscles, to regulate intra-abdominal pressure and postural control. However, evidence on diaphragmatic breathing training on postpartum PPGP remains limited. In addition, real-time home-based telerehabilitation may offer a feasible intervention model. This study aimed to compare the effects of real-time home-based diaphragmatic breathing training and conventional core stabilization exercise on pain, disability, quality of life, physical performance, and core muscle function in postpartum women with PPGP.
METHODS:
Thirty-four postpartum women with PPGP were randomly assigned to a diaphragmatic breathing (DB) group or a core stabilization exercise (SE) group. Participants completed an eight-week, real-time, remotely supervised home exercise program. Outcome measures included pain intensity (Numeric Rating Scale), disability (Pelvic Girdle Questionnaire), quality of life (SF-36), physical performance tests (Active Straight Leg Raising Fatigue, Timed Up and Go, and 6-meter fast walking), ultrasound-based assessments of core muscle function, and maximal inspiratory and expiratory pressures.
RESULTS:
Both groups demonstrated significant reductions in pain following the intervention (DB: p=0.001; SE: p<0.001), with no significant between-group difference. The SE group showed significant improvements in disability (p=0.001) and quality of life (p=0.009), whereas the DB group did not. Both interventions led to significant improvements in physical functions, with no between-group difference. Only the DB group demonstrated significant increases in maximal inspiratory pressures (p=0.025) and greater bladder base elevation during functional loading (p<0.05).
CONCLUSION:
Both interventions reduced pain, supporting the feasibility of real-time home-based exercise for postpartum PPGP. Core stabilization exercise improved disability and quality of life, whereas diaphragmatic breathing training enhanced inspiratory strength and bladder base elevation during loading, indicating improved coordination between the diaphragm and pelvic floor muscles. These findings suggest that diaphragmatic breathing training may complement conventional stabilization by targeting neuromuscular mechanisms related to load transfer and deep core control. In conclusion, both telerehabilitation-based interventions appear safe and effective for postpartum women with PPGP, with diaphragmatic breathing training may provide additional benefits by promoting the coordination between the diaphragm and pelvic floor muscles under functional loading conditions.