Relationship Between Functional Disability and Functional Ability in Women with Postpartum Low Back Pain Following Vaginal Delivery: A Secondary Analysis of a Randomized Controlled Trial

Abstract

Background
Postpartum low back pain is a common musculoskeletal condition that adversely affects functional
independence and quality of life in women following childbirth. Pregnancy-related hormonal, biomechanical,
and muscular adaptations often persist during the postpartum period, resulting in pain, reduced spinal
stability, and limitations in daily activities. Although the Oswestry Disability Index (ODI) and the Back Pain
Functional Scale (BPFS) are widely used to assess disability and functional ability, respectively, evidence
regarding their relationship in postpartum women remains limited.
Objective
To determine the relationship between functional disability, measured using the Oswestry Disability Index,
and functional ability, measured using the Back Pain Functional Scale, among women with postpartum low
back pain following vaginal delivery.
Methods
This study was a secondary analysis of data derived from a randomized controlled trial involving 60
postpartum women (18–35 years) with low back pain within three months following vaginal delivery.
Functional disability was assessed using the ODI, and functional ability was evaluated using the BPFS at
baseline and after completion of a six-week rehabilitation programme. Descriptive statistics were expressed
as mean ± standard deviation (SD). Pearson's correlation coefficient was used to determine the association
between ODI and BPFS scores, with statistical significance set at p < 0.05.
Results
The mean baseline ODI and BPFS scores were 29.52 ± 6.40 and 28.92 ± 6.14, respectively. Pearson's
correlation analysis demonstrated a very strong negative correlation between baseline ODI and BPFS scores
(r = −0.986, p < 0.001). Following the intervention, the mean ODI score decreased to 22.93 ± 6.60, while
the mean BPFS score increased to 36.42 ± 6.79. A strong negative correlation remained between post-
intervention ODI and BPFS scores (r = −0.737, p < 0.001), indicating that lower disability was associated
with better functional ability.
Conclusion
Functional disability is strongly and inversely associated with functional ability in women with postpartum
low back pain following vaginal delivery. The combined use of the ODI and BPFS provides a comprehensive
evaluation of disability and functional performance and may assist physiotherapists in monitoring recovery
and planning individualized rehabilitation programmes.