Combined ultrasound and electric field stimulations improve pain and functional capacity in immediate cesarean delivery: a randomized clinical trial, double-blind, and placebo-controlled

Bertotti, Thalita Cristina Wolff; Gallo, Rubneide Barreto Silva; Silva, Laysse Candido da; Zotz, Talita Gnoato; Moreira, Natália Boneti; Korelo, Raciele Ivandra Guarda

doi:10.5935/2595-0118.20230083-en

Thalita Cristina Wolff Bertotti

Statistical Analysis

Data Collection

Conceptualization

Resource Management

Project Management

Research

Methodology

Writing - Preparation of the Original

Writing - Review and Editing

Software

Supervision

Validation

Visualization

Federal University of Paraná, Prevention and Rehabilitation in Physical Therapy Department, Curitiba, PR, Brazil

http://orcid.org/0000-0003-0123-6413

Rubneide Barreto Silva Gallo

Statistical Analysis

Data Collection

Conceptualization

Resource Management

Project Management

Research

Methodology

Writing - Preparation of the Original

Writing - Review and Editing

Software

Supervision

Validation

Visualization

University of Sergipe, Physical Therapy Department, Sergipe, SE, Brazil

http://orcid.org/0000-0001-9953-0260

Laysse Candido da Silva

Statistical Analysis

Data Collection

Conceptualization

Resource Management

Project Management

Research

Methodology

Writing - Preparation of the Original

Writing - Review and Editing

Software

Supervision

Visualization

Federal University of Paraná, Prevention and Rehabilitation in Physical Therapy Department, Curitiba, PR, Brazil

http://orcid.org/0000-0002-7039-8451

Talita Gnoato Zotz

Conceptualization

Methodology

Writing - Preparation of the Original

Writing - Review and Editing

Supervision

Visualization

Federal University of Paraná, Prevention and Rehabilitation in Physical Therapy Department, Curitiba, PR, Brazil

http://orcid.org/0000-0001-9974-7320

Natália Boneti Moreira

Conceptualization

Methodology

Writing - Preparation of the Original

Writing - Review and Editing

Supervision

Visualization

Federal University of Paraná, Prevention and Rehabilitation in Physical Therapy Department, Curitiba, PR, Brazil

http://orcid.org/0000-0003-1975-6708

Raciele Ivandra Guarda Korelo

Statistical Analysis

Data Collection

Conceptualization

Resource Management

Project Management

Research

Methodology

Writing - Preparation of the Original

Writing - Review and Editing

Software

Supervision

Validation

Visualization

Federal University of Paraná, Prevention and Rehabilitation in Physical Therapy Department, Curitiba, PR, Brazil

http://orcid.org/0000-0002-6754-098X

Correspondence to: Natália Boneti Moreira E-mail: nataliamoreira@ufpr.br

Conflict of interests: none

Responsible associate editor: Marcelo Lourenço da Silva

https://orcid.org/0000-0003-2319-9692

Variables	CG (n = 9) n(%)	TG (n = 11) (n(%)	PG (n = 10) (n(%)
Marital Status
Married	5 (16.7)	6 (20.0)	4 (13.3)
Single	4 (13.3)	5 (16.7)	5 (16.7)
Separated	0 (0.0)	0 (0.0)	1 (3.3)
Schooling level
Primary incomplete/complete	1 (3.3)	4 (13.3)	3 (10.0)
Secondary incomplete/complete	7 (23.3)	6 (20.0)	5 (16.7)
College incomplete/complete	1 (3.3)	1 (3.3)	2 (6.7)
Occupational status
Employed	8 (26.7)	4 (13.3)	8 (26.7)
Housewife	1 (3.3)	5 (16.7)	2 (6.7)
Student	0 (0.0)	2 (6.7)	0 (0.0)
Lifestyle
Smoking habits	1 (3.3)	1 (3.3)	0 (0.0)
Alcohol consumption	4 (13.3)	0 (0.0)	3 (10.0)
Gestational characteristics
Primiparous	4 (13.3)	8 (26.7)	5 (16.7)
Planned pregnancy	5 (16.7)	2 (6.7)	2 (6.7)
Risk pregnancy	4 (13.3)	2 (6.7)	1 (3.3)
	Mean (SD)	Mean (SD)	Mean (SD)
Gestational BMI (kg/m²)	31.0 ± 3.8	31.0 ±4.3	29.9 ±5.2
Gestational age (weeks)	39.2 ±1.3	39.6 ± 1.5	39.0 ± 1.2
Delivery duration (min)	61.3 ± 16.4	58.5 ± 26.2	40.8 ± 12.3
Newborn weight (grams)	3381 ± 579.6	3619 ± 465.1	3241 ± 525.6

Dimension		CG (n = 9)	TG (n = 11)	PG (n = 10)	CG vs. TG (95%CI)	Cohen’s d	CG vs. PG (95%CI)	Cohen’s d	TG vs. PG (95%CI)	Cohen’s d
Total	NWC	F (4, 54) = 2.64, p = 0.043*, partial eta squared = 0.164
	T0	16.4 (1.3)	14.0 (1.2)	16.3 (1.2)	-2.4 (-7.0 – 2.2)	1.9	-0.1 (-4.9 – 4.6)	0.0	-2.3 (-6.8 – 2.2)	0.7
	T1	15.5 (2.2)	7.2 (2.0)	9.1 (2.1)	-8.2 (-16.1 – -0.4)*	3.9	-6.4 (-14.4 – 1.5)	2.2	-1.8 (-9.0 – 5.7)	0.6
	T2	15.5 (2.0)	8.6 (1.8)	13.6 (1.9)	-6.9 (-13.8 – 0.04)	3.6	-1.9 (-9.0 – 5.1)	0.6	-4.9 (-11.7 – 1.8)	1.7
	PRI	F (4, 54) = 2.39, p = 0.062, partial eta squared = 0.151
	T0	33.4 (3.7)	29.8 (3.3)	38.2 (3.5)	-3.6 (-16.5 – 9.2)	1.0	4.7 (-8.4 – 17.9)	1.7	-8.3 (-20.9 – 4.1)	2.9
	T1	29.2 (4.7)	14.0 (4.2)	17.6 (4.4)	-15.2 (-31.5 – 1.0)	3.4	-11.7 (-28.3 – 4.9)	4.0	-3.5 (-19.3 – 12.3)	1.2
	T2	29.3 (8.3)	15.6 (7.5)	39.3 (7.8) -13.6 (-42.3 – 14.9)	1.7	9.9 (-19.2 – 39.2)	3.4	-23.6 (-51.4 – 4.1)	8.1
	PPI	F (4, 54) = 0.43, p = 0.782, partial eta squared = 0.031
	T0	2.6 (0.7)	3.7 (0.6)	4.0 (0.6)	1.1 (-1.3 – 3.6)	1.7	1.3 (-1.2 – 3.9)	0.4	-0.2 (-2.6 – 2.2)	0.1
	T1	2.4 (0.5)	2.6 (0.5)	2.7 (0.5)	-0.2 (-1.6 – 2.1)	0.4	0.3 (-1.6 – 2.1)	0.1	-0.09 (-1.9 – 1.7)	0.1
	T2	2.4 (0.5)	2.4 (0.4)	2.9 (0.5)	0.06 (-1.7 – 1.9)	0.0	-0.4 (-2.2 – 1.3)	0.1	0.5 (-1.3 – 2.3)	0.1
Sensory	NWC	F (4, 54) = 1.99, p= 0.108, partial eta squared = 0.129
	T0	8.1 (0.8)	6.9 (0.7)	8.3 (0.7)	-1.2 (-3.9 – 1.5)	1.6	0.1 (-2.6 – 3.0)	0.07	-1.3 (-4.1 – 1.3)	0.4
	T1	7.7 (1.1)	3.7 (1.0)	4.9 (1.0)	-4.0 (-7.9 – -0.1)*	3.8	-2.8 (-6.8 – 1.0)	0.9	-1.1 (-4.9 – 2.6)	0.4
	T2	7.7 (1.0)	4.6 (0.9)	6.9 (1.0)	-3.1 (-6.8 – 0.5)	3.2	-0.8 (-4.6 – 2.8)	0.2	-2.2 (-5.8 – 1.3)	0.7
	PRI	F (4, 54) = 2.85, p = 0.032*, partial eta squared = 0.174.
	T0	17.1 (2.1) 15.6 (1.9) 20.2 (2.0)	-1.4 (-8.8 –5.8)	0.7	3.0 (-4.4 – 10.5)	1.0	-4.5 (-11.6 – 2.5)	1.5
	T1	16.3 (2.4)	7.1 (2.2)	9.6 (2.3)	-9.1 (-17.6 – -0.6)*	4.0	6.7 (-15.4 – 1.9)	2.3	-2.4 (-10.6 – 5.8)	0.8
	T2	16.3 (2.4)	9.0 (2.2)	14.6 (2.3)	-7.3 (-15.7 – 1.0)	3.1	-1.7 (3-6.8 – 10.3)	0,5	-5.6 (-13.7 – 2.5)	1.9
	PPI	F (4, 54) = 3.96, p = 0.007*, partial eta squared = 0.227
	T0	2.2 (0.6)	4.4 (0.5)	3.1 (0.5)	2.1 (0.1 – 4.3)*	0.3	0.9 (-3.1 – 1.2)	0.3	1.2 (-0.8 – 3.3)	0.4
	T1	2.4 (0.7)	3.2 (0.6)	2.0 (0.7)	0.8 (-1.8 – 3.4)	1.2	-0.3 (-3.0 – 2.2)	0.1	1.1 (-1.3 – 3.7)	0.4
	T2	2.4 (0.7)	3.1 (0.6)	3.1 (0.7)	0.7 (-1.8 – 3.3)	1.0	0.7 (-1.9 – 3.3)	0.2	0.03 (-2.4 – 2.5)	0.0
Affective	NWC	F (4, 54) = 2.01, p = 0.106, partial eta squared = 0.130
	T0	4.2 (0.4)	3.6 (0.4)	4.2 (0.4)	-0.5 (-2.2 – 1.0)	1.5	-0.02 (-1.6 – 1.6)	0.0	-0.5 (-2.1 – 1.0)	0.2
	T1	4.0 (0.6)	1.8 (0.5)	2.2 (0.5)	-2.1 (-4.3 – -0.2)*	4.0	-1.8 (-4.0 – 0.4)	0.6	-0.3 (-2.4 – 1.7)	0.1
	T2	4.0 (0.5)	1.8 (0.4)	3.0 (0.5)	-2.1 (-3.9 – 0.3)*	4.9	-1.0 (-2.8 – 0.8)	0.3	-1.1 (-2.9 – 0.5)	0.4
	PRI	F (4, 54) = 0.84, p = 0.505, partial eta squared = 0.059
	T0	8.5 (1.3)	7.4 (1.2)	9.2 (1.2)	-1.1 (-5.7 – 3.5)	0.8	0.6 (-4.1 – 5.4)	0.2	-1.7 (-6.3 – 2.8)	0.6
	T1	6.4 (1.1)	3.1 (1.2)	4.0 (1.2)	-3.1 (-7.9 – 1.4)	2.8	-2.4 (-7.2 – 2.3)	0.8	-0.8 (-5.4 – 3.7)	0.3
	T2	6.4 (1.1)	3.0 (1.0)	4.9 (1.1)	-3.3 (-7.4 – 0.7)	3.2	-1.5 (-5.7– 2.6)	0.5	-1.8 (-5.7 – 2.1)	0.6
	PPI	F (4, 54) = 2.24, p = 0.076, partial eta squared = 0.143
	T0	2.6 (0.4)	3.5 (0.3)	3.6 (0.4)	0.9 (-0.5 – 2.4)	2.5	0.9 (-0.5 – 2.5)	0.3	-0.03 (-1.5 – 1.4)	0.03
	T1	2.7 (0.6)	2.0 (0.5)	1.9 (0.5)	-0.6 (-2.7 – 1.4)	1.2	-0.8 (-3.0 – 1.3)	0.2	0.1 (-1.8 – 2.2)	0.0
	T2	2.7 (0.5)	2.2 (0.5)	2.7 (0.5)	-0.4 (-2.4 – 1.5)	1.0	0.01 (-2.0 – 2.0)	0.0	-0.4 (-2.4 – 1.4)	0.1
Evaluative	NWC	F (4, 54) = 1.18, p =0.327, partial eta squared = 0.081
	T0	1.0 (0.3)	1.3 (0.2)	0.9 (0.3)	0.3 (-0.7 – 1.4)	1.2	-0.1 (-1.2 – 1.0)	0.03	0.4 (-0.6 – 1.5)	0.1
	T1	0.8 (0.3)	1.0 (0.2)	0.6 (0.2)	0.2 (-0.8 – 1.2)	0.8	-0.2 (-1.3 – 0.7)	0.07	0.4 (-0.5 – 1.5)	0.1
	T2	0.8 (0.1)	0.5 (0.1)	0.9 (0.1)	-0.3 (-0.8 – 0.1)	3.0	0.01 (-0.4 – 0.4)	0.03	-0.3 (-0.8 – 0.1)	0.1
	PRI	F (4, 54) = 2.76, p = 0.036*, partial eta squared = 0.170
	T0	2.0 (0.4)	1.8 (0.3)	3.2 (0.4)	-0.1 (-1.6 – 1.3)	0.5	1.2 (-0.3 – 2.7)	0.4	-1.3 (-2.8 – 0.06)	0.4
	T1	2.1 (0.4)	1.1 (0.4)	1.2 (0.4)	-0.9 (-2.5 – 0.7)	2.5	-0.9 (-2.6 – 0.7)	0.3	-0.01 (-1.6 – 1.5)	0.0
	T2	2.1 (0.4)	0.9 (0.4)	2.1 (0.4)	-1.2 (-2.8 – 0.4)	3.0	-0.01 (-1.6 – 1.6)	0.0	-1.1 (-2.7 – 0.3)	0.4
	PPI	F (4, 54) = 3.61, p = 0.011*, partial eta squared = 0.211
	T0	2.8 (0.5)	3.7 (0.5)	2.9 (0.5)	0.8 (-1.0 – 2.7)	1.8	0.01 (-1.9 – 1.9)	0.03	0.8 (-1.0 – 2.6)	0.2
	T1	2.5 (0.6)	2.0 (0.5)	1.7 (0.6)	-0.4 (-2.7 – 1.7)	0.9	-0.8 (-3.1 – 1.4)	0.2	0.3 (-1.7 – 2.5)	0.1
	T2	2.5 (0.5)	1.5 (0.5)	2.7 (0.5)	-1.0 (-3.0 – 1.0)	2.0	0.1 (-1.9 – 2.2)	0.07	-1.1 (-3.1 – 0.8)	0.4
Miscellaneous	NWC	F (4, 54) = 1.41, p =0.239, partial eta squared = 0.095
	T0	3.0 (0.3)	2.6 (0.2)	3.0 (0.3)	-0.3 (-1.4 – 0.6)	1.6	0.0 (-1.0 – 1.0)	0.0	-0.3 (-1.3 – 0.6)	0.1
	T1	2.8 (0.8)	2.0 (0.7)	2.8 (0.8)	-0.8 (-3.7 – 2.0)	1.0	-1.2 (-4.2 – 1.6)	0.0	0.4 (-2.4 – 3.2)	0.2
	T2	2.8 (0.7)	2.3 (0.7)	2.8 (0.7)	-0.5 (-3.2 – 2.2)	0.7	-0.08 (-2.8 – 2.7)	0.0	-0.4 (-3.1 – 2.2)	0.2
	PRI	F (4, 54) = 0.68, p = 0.605, partial eta squared = 0.048
	T0	5.7 (0.7)	4.9 (0.6)	5.7 (0.6)	-0.8 (-3.3 – 1.6)	1.2	-0.07 (-2.6 – 2.4)	0.0	-0.7 (-3.2 – 1.6)	0.2
	T1	4.4 (1.7)	3.9 (1.6)	3.0 (1.6)	-0.5 (-6.6 – 5.5)	0.3	-1.4 (-7.6 – 4.7)	0.4	0.9 (-5.0 – 6.8)	0.3
	T2	4.4 (1.6)	3.9 (1.5)	4.6 (1.6)	-0.5 (-6.3 – 5.3)	0.3	0.1 (-5.8 – 6.1)	0.1	-0.6 (-6.3 – 4.9)	0.2
	PPI	F (4, 54) = 1.81, p = 0.140, partial eta squared = 0.118
	T0	2.9 (0.4)	3.7 (0.4)	3.2 (0.4)	0.8 (-0.7 – 2.4)	0.2	0.2 (-1.3 – 1.9)	0.1	0.5 (-1.0 – 2.0)	0.1
	T1	2.2 (0.5)	1.2 (0.5)	2.0 (0.5)	-1.0 (-3.0 – 1.0)	0.3	-0.1 (-2.2 – 1.9)	0.07	-0.8 (-2.8 – 1.1)	0.2
	T2	2.2 (0.5)	1.9 (0.4)	2.7 (0.5)	-0.2 (-2.1 – 1.6)	0.1	0.5 (-1.3 – 2.4)	-0.1	-0.7 (-2.6 – 1.0)	0.2

Activities		CG (n = 9)	TG (n = 11)	PG (n = 10)	CG vs. TG (95%CI)	Cohen’s d	CG vs. PG (95%CI)	Cohen’s d	TG vs. PG (95%CI)	Cohen’s d
Rest	T0	5.6 (0.7)	6.3 (0.6)	5.5 (0.7)	0.6 (-1.9 – 3.3)	0.4	-0.1 (-2.8 – 2.5)	0.03	0.8 (-1.6 – 3.4)	0.2
	T2	4.2 (0.7)	2.0 (0.6)	4.7 (0.7)	0.4 (-2.2 – 3.1)	0.7	-0.4 (-3.1 – 2.2)	0.1	2.7 (0.1 – 5.2)*	0.9
Sitting	T0	5.8 (0.5)	6.6 (0.4)	7.0 (0.5)	0.7 (-1.1 – 2.6)	0.2	1.1 (-0.8 – 3.0)	0.4	-0.3 (-2.2 – 1.4)	0.1
	T2	4.8 (0.7)	3.5 (0.7)	4.9 (0.7)	-1.3 (-4.0 – 1.3)	0.4	0.01 (-2.7 – 2.7)	0.0	-1.3 (-3.9 – 1.2)	0.4
Standing	T0	6.3 (0.6)	7.5 (0.5)	7.6 (0.5)	1.2 (-0.8 – 3.2)	0.4	1.2 (-0.8 – 3.3)	0.4	-0.05 (-2.0 – 1.9)	0.03
	T2	4.3 (0.8)	4.8 (0.7)	5.9 (0.8)	0.4 (-2.5 – 3.4)	0.1	1.5 (-1.4 – 4.6)	0.5	-1.0 (-3.9 – 1.8)	0.3
Walking	T0	7.4 (0.4)	7.1 (0.4)	7.8 (0.4)	-0.2 (-1.8 – 1.3)	0.1	0.3 (-1.2 – 1.9)	0.1	-0.6 (-2.1 – 0.9)	0.2
	T2	5.8 (0.5)	3.8 (0.4)	4.8 (0.5)	-2.0 (-3.9 – -0.1)*	0.6	-1.0 (-3.0 – 0.8)	0.3	-0.9 (-2.8 – 0.8)	0.3
Lying down	T0	6.3 (0.6)	6.2 (0.6)	6.2 (0.6)	-0.06 (-2.4 – 2.2)	0.0	-0.1 (-2.5 – 2.2)	0.0	0.07 (-2.2 – 2.3)	0.0
	T2	5.7 (0.8)	2.4 (0.7)	4.9 (0.7)	-3.3 (-6.1 – -0.4)*	1.1	-0.8 (-3.7 – 2.0)	0.2	-2.4 (-5.2 – 0.3)	0.8

[1] Correspondence to: Natália Boneti Moreira E-mail: nataliamoreira@ufpr.br

Brasil

Brasil

Combined ultrasound and electric field stimulations improve pain and functional capacity in immediate cesarean delivery: a randomized clinical trial, double-blind, and placebo-controlled

ABSTRACT

BACKGROUND AND OBJECTIVES:

METHODS:

RESULTS:

CONCLUSION:

HIGHLIGHTS