{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:54:11Z","timestamp":1791406451428,"version":"4.3.3"},"reference-count":16,"publisher":"Open Medical Publishing","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec id=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postpartum perineal trauma commonly causes pain and delayed maternal recovery, yet randomized evidence supporting rehabilitation interventions remains fragmented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the effectiveness of physical and electrophysical rehabilitation modalities for postpartum perineal pain, wound healing, and oedema following episiotomy or childbirth-related perineal trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis was conducted in accordance with PRISMA 2020. PubMed\/MEDLINE, Embase, CENTRAL, CINAHL, ClinicalTrials.gov, and ICTRP were searched from inception to April 7, 2026. Randomized controlled trials evaluating rehabilitation modalities were included. Random-effects meta-analysis was performed where appropriate, and methodological quality was assessed using the Cochrane Risk of Bias 2 tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine randomized controlled trials were included, seven of which contributed to quantitative synthesis. TENS significantly reduced short-term postpartum perineal pain compared with control (SMD \u22121.19, 95% CI \u22121.83 to \u22120.55). LLLT showed no significant benefit (SMD \u22120.16, 95% CI \u22120.52 to 0.19), while therapeutic ultrasound demonstrated no significant reduction in persistent pain. Narrative evidence indicated favorable effects of cooling interventions on oedema, immediate pain relief, and maternal satisfaction. Two studies were judged at low risk of bias, five had some concerns, and two were at high risk of bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This review provides the first comparative synthesis of randomized evidence evaluating physical and electrophysical rehabilitation modalities for postpartum perineal morbidity. The strongest evidence currently supports TENS for short-term pain relief, whereas cooling interventions appear beneficial for local symptom management. Larger, rigorously designed randomized trials are required to establish evidence-based rehabilitation strategies for postpartum perineal recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.52965\/001c.171902","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:21:02Z","timestamp":1791404462000},"source":"Crossref","is-referenced-by-count":0,"title":["Physical Rehabilitation for Postpartum Perineal Morbidity After Episiotomy and Childbirth-Related Perineal Trauma: A Systematic Review and Meta-analysis of Randomized Controlled Trials"],"prefix":"10.52965","volume":"18","author":[{"given":"Ayesha","family":"Alnashwan","sequence":"first","affiliation":[{"name":"College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia","department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmin Mibrad","family":"Alenezi","sequence":"additional","affiliation":[{"name":"Northern Border University, Arar, Saudi Arabia","department":["College of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hala Mesbah","family":"Alruwaili","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia","department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waad","family":"Alshamrani","sequence":"additional","affiliation":[{"name":"University of Jeddah, Jeddah, Saudi Arabia","department":["College of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadeem","family":"Talal S Alanazi","sequence":"additional","affiliation":[{"name":"Northern Border University, Arar, Saudi Arabia","department":["College of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thana Ali","family":"Alqarni","sequence":"additional","affiliation":[{"name":"University of Jeddah, Jeddah, Saudi Arabia","department":["College of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renad Hamed","family":"Alazwari","sequence":"additional","affiliation":[{"name":"University of Jeddah, Jeddah, Saudi Arabia","department":["College of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid Abdulbaqi","family":"Alghareeb","sequence":"additional","affiliation":[{"name":"King Faisal University, Hofuf, Saudi Arabia","department":["College of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahad Enad E.","family":"Alenezi","sequence":"additional","affiliation":[{"name":"Northern Border University, Arar, Saudi Arabia","department":["College of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatimah Farhan S.","family":"Alanazi","sequence":"additional","affiliation":[{"name":"Northern Border University, Arar, Saudi Arabia","department":["College of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alruwaili Noor","family":"Abdullah B","sequence":"additional","affiliation":[{"name":"Northern Border University, Arar, Saudi Arabia","department":["College of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raniyah Inad B.","family":"Alanazi","sequence":"additional","affiliation":[{"name":"Northern Border University, Arar, Saudi Arabia","department":["College of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrhman A.","family":"Almazrou","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Mohammad Ibn Saud Islamic University(IMSIU), Riyadh, Saudi Arabia","department":["Ophthalmology Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0091-5844","authenticated-orcid":true,"given":"Abdulelah F.","family":"Alshehri","sequence":"additional","affiliation":[{"name":"Independent Researcher, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"30777","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e1404","DOI":"10.31661\/gmj.v8i.1404","article-title":"The effects of transcutaneous electrical nerve stimulation on post-episiotomy pain severity in primiparous women: a randomized, controlled, placebo clinical trial","volume":"8","author":"R. 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