The impact of virtual reality exercise programs on postpartum pelvic pain and disability among women with lumbopelvic pain

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Background: Postpartum lumbopelvic pain (LPP) and pelvic floor dysfunction are highly prevalent conditions that contribute to persistent disability, pain, and impaired quality of life due to pelvic girdle pain. While conventional rehabilitation including traditional exercise (TE) methods such as pelvic floor muscle training and resistance exercises remains standard, they are often limited by poor adherence and reduced patient motivation. Virtual reality (VR) provides an innovative, non-invasive rehabilitation strategy, offering immersive and gamified environment that may improve patient engagement, neuromuscular control, and treatment outcomes. Objective: To compare the effectiveness of VR-based rehabilitation with TE therapy in reducing pain, disability, and pelvic floor dysfunction among postpartum women with LPP. Methods: A single-blind randomized controlled trial was conducted, including 60 postpartum women aged 20-40 years experiencing LPP were enrolled between 2 and 12 weeks after delivery. No participants beyond this window were included. The assignment followed a simple randomization process and was done computational with equal distribution (1:1) of the VR and TE group. An independent researcher created 60 sequentially numbered, opaque and sealed envelopes. After participant enrollment, each envelope was opened to determine group assignment, ensuring equal group sizes. Both groups completed 8 sessions of pelvic floor muscle training over one month. The VR group additionally performed immersive tasks using Meta Quest 2 headsets and Lumbar Pain Rehab software. Outcomes were assessed at baseline, 4th week and 8th week assesment using the Oswestry Disability Index (ODI), Visual Analog Scale (VAS), Pelvic Girdle Questionnaire (PGQ), McGill Pain Questionnaire (SF-MPQ), Pelvic Floor Distress Inventory (PFDI-20) and Simulator Sickness (SSQ). Following approval from the Institutional Review Board of Shalamar Medical and Dental College (SMDC), which is a constituent body of Shalamar, with IRB no.0543 and reference no. SMDC-IRB/AI/18-1/2023. Results: < 0.001). Both groups achieved substantial improvement in patient-reported prolapse symptoms, with similar recovery trends in urinary and bowel dysfunction. Conclusion: VR-based rehabilitation demonstrated greater short-term effectiveness than TE in reducing disability, alleviating pain related to pelvic girdle. Its immersive design promotes adherence and engagement, making it a clinically valuable intervention for postpartum recovery, particularly in resource-limited settings. Trial registration: ClinicalTrials.gov Identifier: NCT05921747.

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