Comparative Effectiveness of Physiotherapy Interventions in Postpartum Recovery: Pelvic Floor Rehabilitation vs. Abdominal Muscle Strengthening Exercises for Restoring Function, Mobility, and Alignment

Abstract

Background: Pelvic Girdle Pain (PGP) is a common musculoskeletal condition during pregnancy, affecting nearly half of expectant mothers and impairing mobility, functional activity, and quality of life. Physiotherapy interventions such as manual mobilization and muscle strengthening have shown promise individually, but their combined effects remain underexplored. Objective: To evaluate and compare the effectiveness of Mulligan Mobilization, hip abductor strengthening exercises, and their combination on pain, disability, and quality of life in pregnant women with PGP. Methods: A randomized controlled trial was conducted among 60 pregnant women clinically diagnosed with PGP. Participants were randomly allocated into three groups: Mulligan Mobilization (Group A), hip abductor strengthening exercises (Group B), and a combined intervention (Group C). Interventions were administered thrice weekly for six weeks. Pain intensity, disability, and quality of life were assessed at baseline and post-intervention using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Short Form-36 (SF-36), respectively. Data were analyzed using ANOVA and Bonferroni-adjusted post hoc tests at a significance level of p<0.05. Results: All groups exhibited significant improvements in pain, disability, and quality of life (p<0.05). The combined intervention group achieved the greatest reductions in VAS (3.4±1.1) and ODI (18.2±2.8) scores and the highest improvement in SF-36 (20.7±3.9), with moderate-to-large effect sizes (η²=0.17–0.21). Between-group comparisons confirmed the superiority of the combined approach over single-modality treatments (p<0.01). Conclusion: The combination of Mulligan Mobilization and hip abductor strengthening exercises is a safe, effective, and comprehensive physiotherapeutic approach for managing pregnancy-related pelvic girdle pain. This integrated strategy offers greater functional recovery and quality-of-life improvements compared with individual interventions.