Comprehensive Rehabilitation Approach for Post-Cesarean Pain and Kinesiophobia: A Case Report

Comprehensive Rehabilitation Approach for Post-Cesarean Pain and Kinesiophobia: A Case Report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Comprehensive Rehabilitation Approach for Post-Cesarean Pain and Kinesiophobia: A Case Report Tanisha Khandelwal, Mansi Subhedar, Amisha Zade This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5977827/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This case report examines the postoperative management of a 19-year-old female who underwent a Lower Segment Caesarean Section (LSCS) for her first child. Postoperatively, the patient experienced significant pain, which was addressed through a multidisciplinary approach involving pharmacological treatment, targeted physiotherapy, and neuroscience education. The Tampa Scale for Kinesiophobia (TSK) was used to evaluate the patient's fear of movement, which was identified as a key factor influencing her pain experience. Neuroscience education was incorporated to enhance her understanding of pain mechanisms and promote effective self-management strategies. These interventions collectively improved her quality of life, reducing pain levels and aiding in functional recovery. The case highlights the effectiveness of combining pain management strategies with educational support to optimize outcomes in postoperative LSCS care. Lower segment caesarean section (LSCS) pain Tampa scale kinesiophobia pain neuroscience education quality of life of patient Introduction According to data from the WHO, 15% of deliveries have a clear indication that a cesarean section is necessary to preserve the mother's or the fetus's life. The increasing frequency of Lower Segment Caesarean Sections has brought up the question of whether LSCSs should be regarded as conventional delivery methods in the twenty-first century. There are conflicting results on the safety of cesarean sections. While cesarean births are conducted for a variety of obstetrical reasons, some are simply carried out at the mother's request and involve significant risks for the unborn child [ 1 , 2 ].Cesarean sections are an essential obstetric operation and the most effective approach to deliver infants in a range of scenarios. However, a variety of factors, such as the number of pregnancies, the number of previous cesarean sections, the degree of placental adhesion, the presence of uterine myomas, maternal obesity, and other conditions, may influence how tough it is. Furthermore, because to time constraints, emergency cesarean sections require prompt operation. Throughout their cesarean section training, surgeons must first master the principles of controlling term head presentation. After that, they must master the management of challenging cases such placenta previa, abruption placenta, uterine myomas, malpresentation, and preterm birth. A cesarean section is a simple procedure. However, there are many difficult cases, and several issues, including placenta accrete and incision scar abnormalities, can arise following a cesarean section [ 3 , 4 ].It is thought that fear plays a significant role in explaining why pain and its related effects continue even after tissue damage has healed and how acute pain can turn chronic for certain people [ 5 ]. The fear-avoidance model of pain is one of the theoretical models that has garnered the most empirical attention in this regard to explain how impairment develops and persists after an acute episode of pain. In accordance with this concept, those who are predisposed to thinking catastrophically and feeling dread in reaction to pain are more likely to experience chronic pain following an accident than people who do not. These people have avoidance behaviors that try to stop further harm by overreacting to real or perceived threats. There are many different conceptual definitions of fear in regard to pain, but the most widely used ones are pain-related dread, fear-associated attitude, fright of movement, and kinesiophobia. The word kinesiophobia, often known as fight of movement, refers to an intense, unreasonable, and paralyzing dread of moving about because it makes one feel as though they may get hurt again or incur a terrible injury. Fundamentally, these two ideas are identical and have comparable therapeutic implications. Although there isn't a specific tool for measuring fight of movement, kinesiophobia is commonly assess using the Tampa Scale for Kinesiophobia. Between 50 and 70 percent of individuals with chronic pain also experience kinesiophobia. Either a direct bad event or social learning can teach it [ 6 ]. Kinesiophobia may be linked to pain and its connected outcome in a number of way. Kinesiophobia first alters a person's stride, maybe in an attempt to first avoid discomfort. It causes changes in motor behavior, which affects how actions associated to managing and controlling pain and pain-related disability are carried out. Second, people with CMP may process pain and information related to pain differently depending on how kinesiophobia is perceived. In actuality, kinesiophobia is positively correlated with pain threshold. Numerous investigations have been carried out about kinesiophobia in CMP [ 7 , 8 ]. Numerous studies have indicated a connection between kinesiophobia and discomfort, impairment, and a lower quality of life [ 9 ].In the last twenty years, patient care has increasingly focused on quality of life. There are several measuring tools available to evaluate a person's social, psychological, and physical well-being [ 10 ]. Healthcare providers can assess each patient's optimal quality with the use of these instruments. Nonetheless, it appears that not much research has been done on the pregnant woman's quality of life [ 11 ].Though most women worry to some extent about their own health as well as the health of their unborn child, pregnancy is a unique circumstance that is neither a sickness nor a normal state of a woman's health [ 12 , 13 ]. Throughout pregnancy, women's bodies go through a number of biochemical, physiological, and anatomical changes. These are the first, irreversible alterations that make people internally susceptible in terms of both psychology and physical health. Women's emotions can be impacted by hormonal changes, which can lead to psychological issues including worry and hopelessness. Even in a regular pregnancy, these changes might make it difficult for any woman to go about her everyday business. Different gestational ages cause changes in a pregnant woman's bodily and spiritual well-being in addition to her overall quality of life [ 14 , 15 ]. Case presentation A 19-year-old female underwent a Lower Segment Caesarean Section (LSCS) for the delivery of her first child. Her obstetric history is as follows: Gravida 1, Parity 1, Abortion 0, Living 1, Stillbirth 0. This reflects a single pregnancy resulting in a live birth with no previous miscarriages or stillbirths. The LSCS was performed due to indications that warranted surgical intervention, and the patient postoperative course was managed according to standard care protocols, ensuring a focus on both maternal and neonatal health also for this, she was referred to physiotherapy treatment. Clinical findings Informed consent was obtained from the patient before the examination, and she was examined. Upon assessment, she demonstrated cooperation and a good sense of location, time, and people. The patient had a constant heart rate and was afebrile. With his head raised to a 30-degree angle, the patient was observed in a supine-laying position. Her speech, vision, and hearing were normal. During the neurological evaluation, sensations were intact. All deep tendon reflexes were normal. During the first few days after the LSCS, the patient was having difficulty doing their work they required the slight assistance of someone while getting up from the bed. Also, she was having a gait pattern of step walking. Her pain levels, as measured by the numerical pain rating scale (NPRS), are 3 out of 10 at rest and 7 out of 10 during activity. Physiotherapy Management: Pain Neuroscience Education certainly here is a table focused specially on the goals, Intervention, and dosage for pain neuroscience education in the context of managing post-cesarean section pain in Table 1. Table 1: Physiotherapy management on pain neuroscience education. Goals Intervention Dosage Enhance understanding of pain Educational sessions about pain mechanism and neuroplasticity. Information on pain as a bio psychosocial phenomenon 1-2 sessions per week. 30-45 minutes per session. Improving coping strategies Teach self-management techniques. Discuss coping strategies and stress reduction methods. 1-2 sessions per week. 30-45 minutes per session. Reduce pain perception Educate on the role of inflammation and how it affects pain. Techniques to challenges and change pain perception. 1-2 sessions per week. 30-45 minutes per session Promote self-efficacy Provide tools and resources for self-care. Encourage active participation in pain. 1-2 sessions per week. 15-20 minutes per session. Additional physiotherapy techniques: Various physiotherapy technique except pain neuroscience education to achieve various goals are listed below in Table 2. Table 2: Physiotherapy interventions. Goals Intervention Dosage Psychosocial support and education Peer assistance was provided in several contexts together with counseling and emotional support. Further explain to the patient how physiotherapy will aid in their recuperation Frequent appointments according to patient requirements Promote healing as well as improving scar mobility Scar massage and scar mobilization 10 Repetitions x 1 Set Enhance strengthening and function Progressive muscle strengthening exercises. Core stabilization exercises. 2-3 times per day. 15-20 min per session. 10 Repetitions x 1 Set. Improve mobility and transfers Gentle stretching. Range of motion exercise. Gradual mobilization technique. Log rolling (supine-side lying-sitting); ambulation. 2-3 times per week. 20-30 minute per session. Daily progressively increasing duration. Independence in activity of daily living Practicing self-care skills (grooming, washing, and dressing). Integrated into daily session. Relaxation Technique Segmental breathing, to promote the diaphragmatic excursion. Thoracic expansion: This results in more airflow via peripheral airways and collateral ventilation channels. 10 Repetitions x 1 Set. Breast feeding ergonomics Education on ergonomics for breastfeeding. Integrated into sessions. Outcome measures The outcome measures presented in Table 3 indicate significant improvements across all assessed domains following the intervention. Pain scores dropped, fear of movement (Tampa Scale) decreased, and quality of life improved. These results highlight reduced pain, increased confidence in movement, and enhanced well-being. Table 3: Outcome measures. Outcome Measure Pre Post Numerical Pain rating Scale 7/10 1/10 Tampa Scale 55/68 32/68 SF 36 (Quality of life) 55/100 80/100 Discussion The case report demonstrate the effectiveness of a multidisciplinary approach to managing postoperative pain following a lower caesarean section (LSCS). The integration of pain neuroscience education and physiotherapy led to significant improvement in the patient pain perception, functional recovery and quality of life. The numerical pain rating scale decreased, indicating a substantial reduction in pain intensity. Additionally her Tampa scale for kinesiophobia score decreased, highlighting a reduction in fear of movement and avoidance behaviours. The SF-36, a quality of life measure, also improved, reflecting enhanced overall well being. These outcome emphasize the importance of addressing both physical and psychological aspects of pain management, using education to empower patients and reduce the fear associated with post surgical recovery. The case underscore the value of a holistic, patient centered approach in optimizing postoperative outcomes for LSCS patients. Science many women would rather not employ intrusive or pharmacological methods to control the labor pain, complementary pain management treatments could be more common [ 16 ]. A significant number of women have moderate to severe pain following cesarean surgery, poor management of acute pain can have a detrimental effect on the mother mental health, daily activities, breastfeeding, and baby care [ 17 ]. Pain neuroscience education (PNE) can serve as the foundation for an interdisciplinary approach to chronic pain. In the context of the PNE paradigm, this outlines a cooperative, noninvasive, and nonpharmaceutical approach to providing comprehensive pain treatment using biopsychological therapy strategies. For the purpose of self management and long term recovery, patient with chronic pain can continue to feel more empowered and knowledgeable [ 18 ]. To determine the predictive importance of kinesiophobia on pain, disability and quality of life in people with chronic muscle pain and the extent of the association between kinesiophobia and these factors using longitudinal analyses [ 19 ]. The presence of kinesiophobia in patients, since it may be a role in long term pain and disability. One popular self report survey is the TSK [ 20 ]. Patient who have greater degrees of kinesiophobia are 41% more likely to experience a physical disability. Patients fear movement because it causes them pain and they think it will exacerbate their disease, according to kinesiophobia paradigm [ 21 ]. Conclusions The integrated approach used in this case report- combining pharmacological treatment, physiotherapy, and pain neuroscience education- proven highly effective in managing postoperative pain and improving quality of life for a young women following an LSCS. The significant reductions in pain levels, kinesiophobia, and improvement in overall well-being highlight the benefits of addressing both physical and psychological aspects of recovery. Declarations Ethics Approval and consent to participant: Ethical approval was obtained from patients, and written informed consent was obtained from the patient for participation in this study Consent for publication: Written informed consent was obtained from the patient for the publication of this case report Competing Interests: The authors declare that they have no competing interests . Authors' Contributions: T.K. and M.S. wrote the main manuscript text. A.Z. conducted the literature review and provided critical revisions to the manuscript. All authors reviewed and approved the final manuscript. Acknowledgments: Not applicable. Availability of data and materials: Not applicable. Consent to Publish declaration: The patient has provided informed consent for the publication of this case report and accompanying images. Funding Declaration Statement No funding was received for the preparation of this case report. References Sharma S, Dhakal I: Cesarean vs Vaginal Delivery : An Institutional Experience. JNMA J Nepal Med Assoc. 2018, 56:535–9. Lumbiganon P, Laopaiboon M, Gülmezoglu AM, et al.: Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007-08. Lancet Lond Engl. 2010, 375:490–9. 10.1016/S0140-6736(09)61870-5 Hiramatsu Y: Lower-Segment Transverse Cesarean Section. Surg J N Y N. 2020, 6:S72–80. 10.1055/s-0040-1708060 Di Spiezio Sardo A, Saccone G, McCurdy R, Bujold E, Bifulco G, Berghella V: Risk of Cesarean scar defect following single- vs double-layer uterine closure: systematic review and meta-analysis of randomized controlled trials. Ultrasound Obstet Gynecol Off J Int Soc Ultrasound Obstet Gynecol. 2017, 50:578–83. 10.1002/uog.17401 Turk DC, Wilson HD: Fear of pain as a prognostic factor in chronic pain: conceptual models, assessment, and treatment implications. Curr Pain Headache Rep. 2010, 14:88–95. 10.1007/s11916-010-0094-x Roelofs J, van Breukelen G, Sluiter J, et al.: Norming of the Tampa Scale for Kinesiophobia across pain diagnoses and various countries. Pain. 2011, 152:1090–5. 10.1016/j.pain.2011.01.028 Bränström H, Fahlström M: Kinesiophobia in patients with chronic musculoskeletal pain: differences between men and women. J Rehabil Med. 2008, 40:375–80. 10.2340/16501977-0186 Picavet HSJ, Vlaeyen JWS, Schouten JSAG: Pain catastrophizing and kinesiophobia: predictors of chronic low back pain. Am J Epidemiol. 2002, 156:1028–34. 10.1093/aje/kwf136 Luque-Suarez A, Martinez-Calderon J, Falla D: Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med. 2019, 53:554–9. 10.1136/bjsports-2017-098673 Parvizi S, Yazdanpanahi Z, Rahmanian F, Tayebi N, Akbarzadeh M: Investigating the relationship between personality types and resilience in pregnant women. A cross-sectional study. Med Clínica Práctica. 2024, 7:100468. 10.1016/j.mcpsp.2024.100468 Morin M, Vayssiere C, Claris O, Irague F, Mallah S, Molinier L, Matillon Y: Evaluation of the quality of life of pregnant women from 2005 to 2015. Eur J Obstet Gynecol Reprod Biol. 2017, 214:115–30. 10.1016/j.ejogrb.2017.04.045 Keles E, Kaya L, Yakşi N, Kaya Z: Effect of mode of delivery on postpartum health-related quality of life. Rev Assoc Medica Bras 1992. 2024, 70:e20231003. 10.1590/1806-9282.20231003 Casarin ST, Barboza MCN, Siqueira HCH de: Quality of life in pregnancy: literature systematic review. Rev Enferm UFPE Line. 2010, 4:1046–53. 10.5205/reuol.892-7739-3-LE.0403esp201015 Boutib A, Chergaoui S, Marfak A, Hilali A, Youlyouz-Marfak I: Quality of Life During Pregnancy from 2011 to 2021: Systematic Review. Int J Womens Health. 2022, 14:975–1005. 10.2147/IJWH.S361643 Dodd JM, Newman A, Moran LJ, et al.: The effect of antenatal dietary and lifestyle advice for women who are overweight or obese on emotional well-being: the LIMIT randomized trial. Acta Obstet Gynecol Scand. 2016, 95:309–18. 10.1111/aogs.12832 Smith CA, Levett KM, Collins CT, Armour M, Dahlen HG, Suganuma M: Relaxation techniques for pain management in labour. Cochrane Database Syst Rev. 2018, 3:CD009514. 10.1002/14651858.CD009514.pub2 Chen H-Z, Gao Y, Li K-K, An L, Yan J, Li H, Zhang J: Effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section. World J Clin Cases. 2024, 12:6195–203. 10.12998/wjcc.v12.i28.6195 Eneberg-Boldon K, Schaack B, Joyce K: Pain Neuroscience Education as the Foundation of Interdisciplinary Pain Treatment. Phys Med Rehabil Clin N Am. 2020, 31:541–51. 10.1016/j.pmr.2020.07.004 Luque-Suarez A, Martinez-Calderon J, Falla D: Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med. 2019, 53:554–9. 10.1136/bjsports-2017-098673 Dupuis F, Cherif A, Batcho C, Massé-Alarie H, Roy J-S: The Tampa Scale of Kinesiophobia: A Systematic Review of Its Psychometric Properties in People With Musculoskeletal Pain. Clin J Pain. 2023, 39:236. 10.1097/AJP.0000000000001104 Domingues de Freitas C, Costa DA, Junior NC, Civile VT: Effects of the pilates method on kinesiophobia associated with chronic non-specific low back pain: Systematic review and meta-analysis. J Bodyw Mov Ther. 2020, 24:300–6. 10.1016/j.jbmt.2020.05.005 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5977827","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":414020098,"identity":"976f02e8-0ae3-4779-b39a-18473e97e228","order_by":0,"name":"Tanisha Khandelwal","email":"","orcid":"","institution":"Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (DU), Sawangi (Meghe)","correspondingAuthor":false,"prefix":"","firstName":"Tanisha","middleName":"","lastName":"Khandelwal","suffix":""},{"id":414020099,"identity":"e1096e76-8e50-4468-9230-53923ca2a7be","order_by":1,"name":"Mansi Subhedar","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABEElEQVRIiWNgGAWjYNACAyCSYGAAIhs5fpBAQgHxWtKMJRtAWgyIsQii5XDihgNQQ3AB3fazBz/+KKhL3C7dfPDGzz3MjJvPr0788MCAQZ5f7ABWLWZn8pKleQwOJ+6ccyzZsucZG7PZjbebJYAOM5w5OwG7lgM5BtIMBgcSN9zIMZPgOcDDZnbj7AaQlgSD2zi0nH9j/POHQR1QS/43yT8HJHiMZ5zd/AOvFrDhBswgW9ikeQ4YSBjw927Db8uNN2bWQL8Y75yRZmwtcyDBQOIG7zYLIIXbL+dzjG/++FMnu10i+eHNNwf+1/f3n91880eFjTy/NHYtWIAEWKUEscpBgP8AKapHwSgYBaNgBAAAVdBlq6/uXpAAAAAASUVORK5CYII=","orcid":"","institution":"Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (DU), Sawangi (Meghe)","correspondingAuthor":true,"prefix":"","firstName":"Mansi","middleName":"","lastName":"Subhedar","suffix":""},{"id":414020100,"identity":"503322a6-8fc9-424c-9d82-838dbb4101c3","order_by":2,"name":"Amisha Zade","email":"","orcid":"","institution":"Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research (DU), Sawangi (Meghe)","correspondingAuthor":false,"prefix":"","firstName":"Amisha","middleName":"","lastName":"Zade","suffix":""}],"badges":[],"createdAt":"2025-02-07 05:08:06","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5977827/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5977827/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":79866611,"identity":"52b9b155-38a9-4f3d-a233-534e0ba88f99","added_by":"auto","created_at":"2025-04-03 19:16:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":426047,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5977827/v1/66dc8ae9-dcad-479c-8c13-804a67a3ed5e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Comprehensive Rehabilitation Approach for Post-Cesarean Pain and Kinesiophobia: A Case Report","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAccording to data from the WHO, 15% of deliveries have a clear indication that a cesarean section is necessary to preserve the mother's or the fetus's life. The increasing frequency of Lower Segment Caesarean Sections has brought up the question of whether LSCSs should be regarded as conventional delivery methods in the twenty-first century. There are conflicting results on the safety of cesarean sections. While cesarean births are conducted for a variety of obstetrical reasons, some are simply carried out at the mother's request and involve significant risks for the unborn child [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].Cesarean sections are an essential obstetric operation and the most effective approach to deliver infants in a range of scenarios. However, a variety of factors, such as the number of pregnancies, the number of previous cesarean sections, the degree of placental adhesion, the presence of uterine myomas, maternal obesity, and other conditions, may influence how tough it is. Furthermore, because to time constraints, emergency cesarean sections require prompt operation. Throughout their cesarean section training, surgeons must first master the principles of controlling term head presentation. After that, they must master the management of challenging cases such placenta previa, abruption placenta, uterine myomas, malpresentation, and preterm birth. A cesarean section is a simple procedure. However, there are many difficult cases, and several issues, including placenta accrete and incision scar abnormalities, can arise following a cesarean section [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].It is thought that fear plays a significant role in explaining why pain and its related effects continue even after tissue damage has healed and how acute pain can turn chronic for certain people [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The fear-avoidance model of pain is one of the theoretical models that has garnered the most empirical attention in this regard to explain how impairment develops and persists after an acute episode of pain. In accordance with this concept, those who are predisposed to thinking catastrophically and feeling dread in reaction to pain are more likely to experience chronic pain following an accident than people who do not. These people have avoidance behaviors that try to stop further harm by overreacting to real or perceived threats. There are many different conceptual definitions of fear in regard to pain, but the most widely used ones are pain-related dread, fear-associated attitude, fright of movement, and kinesiophobia. The word kinesiophobia, often known as fight of movement, refers to an intense, unreasonable, and paralyzing dread of moving about because it makes one feel as though they may get hurt again or incur a terrible injury. Fundamentally, these two ideas are identical and have comparable therapeutic implications. Although there isn't a specific tool for measuring fight of movement, kinesiophobia is commonly assess using the Tampa Scale for Kinesiophobia. Between 50 and 70 percent of individuals with chronic pain also experience kinesiophobia. Either a direct bad event or social learning can teach it [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Kinesiophobia may be linked to pain and its connected outcome in a number of way. Kinesiophobia first alters a person's stride, maybe in an attempt to first avoid discomfort. It causes changes in motor behavior, which affects how actions associated to managing and controlling pain and pain-related disability are carried out. Second, people with CMP may process pain and information related to pain differently depending on how kinesiophobia is perceived. In actuality, kinesiophobia is positively correlated with pain threshold. Numerous investigations have been carried out about kinesiophobia in CMP [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Numerous studies have indicated a connection between kinesiophobia and discomfort, impairment, and a lower quality of life [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].In the last twenty years, patient care has increasingly focused on quality of life. There are several measuring tools available to evaluate a person's social, psychological, and physical well-being [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Healthcare providers can assess each patient's optimal quality with the use of these instruments. Nonetheless, it appears that not much research has been done on the pregnant woman's quality of life [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].Though most women worry to some extent about their own health as well as the health of their unborn child, pregnancy is a unique circumstance that is neither a sickness nor a normal state of a woman's health [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Throughout pregnancy, women's bodies go through a number of biochemical, physiological, and anatomical changes. These are the first, irreversible alterations that make people internally susceptible in terms of both psychology and physical health. Women's emotions can be impacted by hormonal changes, which can lead to psychological issues including worry and hopelessness. Even in a regular pregnancy, these changes might make it difficult for any woman to go about her everyday business. Different gestational ages cause changes in a pregnant woman's bodily and spiritual well-being in addition to her overall quality of life [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e"},{"header":"Case presentation","content":"\u003cp\u003eA 19-year-old female underwent a Lower Segment Caesarean Section (LSCS) for the delivery of her first child. Her obstetric history is as follows: Gravida 1, Parity 1, Abortion 0, Living 1, Stillbirth 0. This reflects a single pregnancy resulting in a live birth with no previous miscarriages or stillbirths. The LSCS was performed due to indications that warranted surgical intervention, and the patient postoperative course was managed according to standard care protocols, ensuring a focus on both maternal and neonatal health also for this, she was referred to physiotherapy treatment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical findings\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from the patient before the examination, and she was examined. Upon assessment, she demonstrated cooperation and a good sense of location, time, and people. The patient had a constant heart rate and was afebrile. With his head raised to a 30-degree angle, the patient was observed in a supine-laying position. Her speech, vision, and hearing were normal. During the neurological evaluation, sensations were intact. All deep tendon reflexes were normal.\u003c/p\u003e\n\u003cp\u003eDuring the first few days after the LSCS, the patient was having difficulty doing their work they required the slight assistance of someone while getting up from the bed. Also, she was having a gait pattern of step walking. Her pain levels, as measured by the numerical pain rating scale (NPRS), are 3 out of 10 at rest and 7 out of 10 during activity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePhysiotherapy Management:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePain Neuroscience Education certainly here is a table focused specially on the goals, Intervention, and dosage for pain neuroscience education in the context of managing post-cesarean section pain in Table 1.\u003c/p\u003e\n\u003cp\u003eTable 1: Physiotherapy management on pain neuroscience education.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eGoals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eIntervention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eDosage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eEnhance understanding of pain\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eEducational sessions about pain mechanism and neuroplasticity.\u003c/p\u003e\n \u003cp\u003eInformation on pain as a bio psychosocial phenomenon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e1-2 sessions per week.\u003c/p\u003e\n \u003cp\u003e30-45 minutes per session.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eImproving coping strategies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTeach self-management techniques.\u003c/p\u003e\n \u003cp\u003eDiscuss coping strategies and stress reduction methods.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e1-2 sessions per week.\u003c/p\u003e\n \u003cp\u003e30-45 minutes per session.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eReduce pain perception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eEducate on the role of inflammation and how it affects pain.\u003c/p\u003e\n \u003cp\u003eTechniques to challenges and change pain perception.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e1-2 sessions per week.\u003c/p\u003e\n \u003cp\u003e30-45 minutes per session\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePromote self-efficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eProvide tools and resources for self-care.\u003c/p\u003e\n \u003cp\u003eEncourage active participation in pain.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e1-2 sessions per week.\u003c/p\u003e\n \u003cp\u003e15-20 minutes per session.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAdditional physiotherapy techniques:\u003c/p\u003e\n\u003cp\u003eVarious physiotherapy technique except pain neuroscience education to achieve various goals are listed below in Table 2.\u003c/p\u003e\n\u003cp\u003eTable 2: Physiotherapy interventions.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eGoals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eIntervention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eDosage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePsychosocial support and education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePeer assistance was provided in several contexts together with counseling and emotional support. Further explain to the patient how physiotherapy will aid in their recuperation\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eFrequent appointments according to patient requirements\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePromote healing as well as improving scar mobility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eScar massage and scar mobilization\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e10 Repetitions x 1 Set\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eEnhance strengthening and function\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eProgressive muscle strengthening exercises.\u003c/p\u003e\n \u003cp\u003eCore stabilization exercises.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e2-3 times per day.\u003c/p\u003e\n \u003cp\u003e15-20 min per session.\u003c/p\u003e\n \u003cp\u003e10 Repetitions x 1 Set.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eImprove mobility and transfers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eGentle stretching.\u003c/p\u003e\n \u003cp\u003eRange of motion exercise.\u003c/p\u003e\n \u003cp\u003eGradual mobilization technique.\u003c/p\u003e\n \u003cp\u003eLog rolling (supine-side lying-sitting); ambulation.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e2-3 times per week.\u003c/p\u003e\n \u003cp\u003e20-30 minute per session.\u003c/p\u003e\n \u003cp\u003eDaily progressively increasing duration.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eIndependence in activity of daily living\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePracticing self-care skills (grooming, washing, and dressing).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eIntegrated into daily session.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eRelaxation Technique\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eSegmental breathing, to promote the diaphragmatic excursion.\u003c/p\u003e\n \u003cp\u003eThoracic expansion: This results in more airflow via peripheral airways and collateral ventilation channels.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e10 Repetitions x 1 Set.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eBreast feeding ergonomics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eEducation on ergonomics for breastfeeding.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eIntegrated into sessions.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eOutcome measures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe outcome measures presented in Table 3 indicate significant improvements across all assessed domains following the intervention. \u0026nbsp;Pain scores dropped, fear of movement (Tampa Scale) decreased, and quality of life improved. These results highlight reduced pain, increased confidence in movement, and enhanced well-being.\u003c/p\u003e\n\u003cp\u003eTable 3: Outcome measures.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eOutcome Measure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePre\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePost\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eNumerical Pain rating Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e7/10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e1/10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eTampa Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e55/68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e32/68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eSF 36 (Quality of life)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e55/100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003e80/100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe case report demonstrate the effectiveness of a multidisciplinary approach to managing postoperative pain following a lower caesarean section (LSCS). The integration of pain neuroscience education and physiotherapy led to significant improvement in the patient pain perception, functional recovery and quality of life. The numerical pain rating scale decreased, indicating a substantial reduction in pain intensity. Additionally her Tampa scale for kinesiophobia score decreased, highlighting a reduction in fear of movement and avoidance behaviours. The SF-36, a quality of life measure, also improved, reflecting enhanced overall well being. These outcome emphasize the importance of addressing both physical and psychological aspects of pain management, using education to empower patients and reduce the fear associated with post surgical recovery. The case underscore the value of a holistic, patient centered approach in optimizing postoperative outcomes for LSCS patients.\u003c/p\u003e \u003cp\u003eScience many women would rather not employ intrusive or pharmacological methods to control the labor pain, complementary pain management treatments could be more common [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. A significant number of women have moderate to severe pain following cesarean surgery, poor management of acute pain can have a detrimental effect on the mother mental health, daily activities, breastfeeding, and baby care [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Pain neuroscience education (PNE) can serve as the foundation for an interdisciplinary approach to chronic pain. In the context of the PNE paradigm, this outlines a cooperative, noninvasive, and nonpharmaceutical approach to providing comprehensive pain treatment using biopsychological therapy strategies. For the purpose of self management and long term recovery, patient with chronic pain can continue to feel more empowered and knowledgeable [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. To determine the predictive importance of kinesiophobia on pain, disability and quality of life in people with chronic muscle pain and the extent of the association between kinesiophobia and these factors using longitudinal analyses [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. The presence of kinesiophobia in patients, since it may be a role in long term pain and disability. One popular self report survey is the TSK [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Patient who have greater degrees of kinesiophobia are 41% more likely to experience a physical disability. Patients fear movement because it causes them pain and they think it will exacerbate their disease, according to kinesiophobia paradigm [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe integrated approach used in this case report- combining pharmacological treatment, physiotherapy, and pain neuroscience education- proven highly effective in managing postoperative pain and improving quality of life for a young women following an LSCS. The significant reductions in pain levels, kinesiophobia, and improvement in overall well-being highlight the benefits of addressing both physical and psychological aspects of recovery. \u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEthics Approval and consent to participant:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from patients, and written informed consent was obtained from the patient for participation in this study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent for publication:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from the patient for the publication of this case report\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCompeting Interests:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests\u003cstrong\u003e\u003cem\u003e.\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAuthors\u0026apos; Contributions:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eT.K. and M.S. wrote the main manuscript text.\u003c/li\u003e\n \u003cli\u003eA.Z. conducted the literature review and provided critical revisions to the manuscript.\u003c/li\u003e\n \u003cli\u003eAll authors reviewed and approved the final manuscript.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAcknowledgments:\u003cbr\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAvailability of data and materials:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eConsent to Publish declaration:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe patient has provided informed consent for the publication of this case report and accompanying images.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFunding Declaration Statement\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received for the preparation of this case report.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSharma S, Dhakal I: Cesarean vs Vaginal Delivery : An Institutional Experience. 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Am J Epidemiol. 2002, 156:1028\u0026ndash;34. 10.1093/aje/kwf136\u003c/li\u003e\n\u003cli\u003eLuque-Suarez A, Martinez-Calderon J, Falla D: Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med. 2019, 53:554\u0026ndash;9. 10.1136/bjsports-2017-098673\u003c/li\u003e\n\u003cli\u003eParvizi S, Yazdanpanahi Z, Rahmanian F, Tayebi N, Akbarzadeh M: Investigating the relationship between personality types and resilience in pregnant women. A cross-sectional study. Med Cl\u0026iacute;nica Pr\u0026aacute;ctica. 2024, 7:100468. 10.1016/j.mcpsp.2024.100468\u003c/li\u003e\n\u003cli\u003eMorin M, Vayssiere C, Claris O, Irague F, Mallah S, Molinier L, Matillon Y: Evaluation of the quality of life of pregnant women from 2005 to 2015. Eur J Obstet Gynecol Reprod Biol. 2017, 214:115\u0026ndash;30. 10.1016/j.ejogrb.2017.04.045\u003c/li\u003e\n\u003cli\u003eKeles E, Kaya L, Yakşi N, Kaya Z: Effect of mode of delivery on postpartum health-related quality of life. Rev Assoc Medica Bras 1992. 2024, 70:e20231003. 10.1590/1806-9282.20231003\u003c/li\u003e\n\u003cli\u003eCasarin ST, Barboza MCN, Siqueira HCH de: Quality of life in pregnancy: literature systematic review. Rev Enferm UFPE Line. 2010, 4:1046\u0026ndash;53. 10.5205/reuol.892-7739-3-LE.0403esp201015\u003c/li\u003e\n\u003cli\u003eBoutib A, Chergaoui S, Marfak A, Hilali A, Youlyouz-Marfak I: Quality of Life During Pregnancy from 2011 to 2021: Systematic Review. Int J Womens Health. 2022, 14:975\u0026ndash;1005. 10.2147/IJWH.S361643\u003c/li\u003e\n\u003cli\u003eDodd JM, Newman A, Moran LJ, et al.: The effect of antenatal dietary and lifestyle advice for women who are overweight or obese on emotional well-being: the LIMIT randomized trial. Acta Obstet Gynecol Scand. 2016, 95:309\u0026ndash;18. 10.1111/aogs.12832\u003c/li\u003e\n\u003cli\u003eSmith CA, Levett KM, Collins CT, Armour M, Dahlen HG, Suganuma M: Relaxation techniques for pain management in labour. Cochrane Database Syst Rev. 2018, 3:CD009514. 10.1002/14651858.CD009514.pub2\u003c/li\u003e\n\u003cli\u003eChen H-Z, Gao Y, Li K-K, An L, Yan J, Li H, Zhang J: Effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section. World J Clin Cases. 2024, 12:6195\u0026ndash;203. 10.12998/wjcc.v12.i28.6195\u003c/li\u003e\n\u003cli\u003eEneberg-Boldon K, Schaack B, Joyce K: Pain Neuroscience Education as the Foundation of Interdisciplinary Pain Treatment. Phys Med Rehabil Clin N Am. 2020, 31:541\u0026ndash;51. 10.1016/j.pmr.2020.07.004\u003c/li\u003e\n\u003cli\u003eLuque-Suarez A, Martinez-Calderon J, Falla D: Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med. 2019, 53:554\u0026ndash;9. 10.1136/bjsports-2017-098673\u003c/li\u003e\n\u003cli\u003eDupuis F, Cherif A, Batcho C, Mass\u0026eacute;-Alarie H, Roy J-S: The Tampa Scale of Kinesiophobia: A Systematic Review of Its Psychometric Properties in People With Musculoskeletal Pain. Clin J Pain. 2023, 39:236. 10.1097/AJP.0000000000001104\u003c/li\u003e\n\u003cli\u003eDomingues de Freitas C, Costa DA, Junior NC, Civile VT: Effects of the pilates method on kinesiophobia associated with chronic non-specific low back pain: Systematic review and meta-analysis. J Bodyw Mov Ther. 2020, 24:300\u0026ndash;6. 10.1016/j.jbmt.2020.05.005\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Lower segment caesarean section (LSCS), pain, Tampa scale, kinesiophobia, pain neuroscience education, quality of life of patient","lastPublishedDoi":"10.21203/rs.3.rs-5977827/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5977827/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis case report examines the postoperative management of a 19-year-old female who underwent a Lower Segment Caesarean Section (LSCS) for her first child. Postoperatively, the patient experienced significant pain, which was addressed through a multidisciplinary approach involving pharmacological treatment, targeted physiotherapy, and neuroscience education. The Tampa Scale for Kinesiophobia (TSK) was used to evaluate the patient's fear of movement, which was identified as a key factor influencing her pain experience. Neuroscience education was incorporated to enhance her understanding of pain mechanisms and promote effective self-management strategies. These interventions collectively improved her quality of life, reducing pain levels and aiding in functional recovery. The case highlights the effectiveness of combining pain management strategies with educational support to optimize outcomes in postoperative LSCS care.\u003c/p\u003e","manuscriptTitle":"Comprehensive Rehabilitation Approach for Post-Cesarean Pain and Kinesiophobia: A Case Report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-02-13 05:43:08","doi":"10.21203/rs.3.rs-5977827/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ad65bd0c-0427-40d2-bd4a-4c1d2661fd33","owner":[],"postedDate":"February 13th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-04-03T19:08:21+00:00","versionOfRecord":[],"versionCreatedAt":"2025-02-13 05:43:08","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5977827","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5977827","identity":"rs-5977827","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}