Postpartum Balance and Kinesiophobia in Cesarean Delivery: Impact of Abdominal Fascial Scars

Abstract

Considering that the incisions made during cesarean delivery may damage subcutaneous tissue and fascia, and pelvic floor muscle contractions are effective in femoral head movements, it is hypothesized that the mode of delivery may have an impact on balance and kinesiophobia. This study aimed to investigate the effect of cesarean delivery on balance, kinesiophobia, and body awareness.A total of 70 women participated in the study. Demographic and obstetric data of the participants were recorded. Thoracolumbar fascia was assessed using a goniometric platform, trunk flexibility with the Modified Schober test, static balance with the Flamingo Balance test, and dynamic balance with the Y Balance Test. The Tampa Scale of Kinesiophobia was used to evaluate movement fear, and the Body Awareness Questionnaire was used to assess body awareness.No significant differences were found between cesarean and vaginal deliveries in terms of thoracolumbar fascia assessment, static balance, or dynamic balance measurements (p>0.05). In women who delivered vaginally, dynamic balance was observed to decrease with advancing age (p<0.05). Moreover, in vaginal deliveries, a shorter time since last birth was associated with improved anterior dynamic balance, while an increased number of deliveries was linked to impaired anterior dynamic balance (p<0.05). Regardless of the mode of delivery, all women experienced a decline in static balance and reduced anterior reach with increasing age. Additionally, an increased number of deliveries was associated with impaired static balance, and shorter postpartum duration was linked to decreased dynamic balance (p<0.05). No significant difference was found between vaginal and cesarean deliveries in terms of kinesiophobia (p>0.05). However, in women who delivered vaginally, body awareness decreased with age (p<0.05). In conclusion, the study found that cesarean scars had no adverse effects on balance, kinesiophobia, or body awareness. Nevertheless, further research focusing on balance is recommended.