| CTRI Number |
CTRI/2026/02/104593 [Registered on: 24/02/2026] Trial Registered Prospectively |
| Last Modified On: |
24/02/2026 |
| Post Graduate Thesis |
Yes |
| Type of Trial |
Interventional |
|
Type of Study
|
Physiotherapy (Not Including YOGA) |
| Study Design |
Randomized, Parallel Group, Active Controlled Trial |
|
Public Title of Study
|
Effect of knee chest position and rebozo pelvic relaxation technique on rotation of baby in occiput posterior position and maternal fetal outcomes |
|
Scientific Title of Study
|
Effect of Knee–Chest Position and Rebozo (Pelvic Relaxation) Maneuver on Rotation of Occiput Posterior Presentation and Maternal–Fetal Outcomes: A Randomized Controlled Trial |
| Trial Acronym |
|
|
Secondary IDs if Any
|
| Secondary ID |
Identifier |
| NIL |
NIL |
|
|
Details of Principal Investigator or overall Trial Coordinator (multi-center study)
|
| Name |
Nadeera vp |
| Designation |
Postgraduate Student(MPT) |
| Affiliation |
SRM Institute of Science and Technology (SRM IST) Kattankulathur |
| Address |
Department of physiotherapy
SRM Institute of Science and Technology (SRMIST)
SRM Nagar, Kattankulathur
Chengalpattu District
Tamil Nadu – 603203
India
Kancheepuram
TAMIL NADU
603203
India |
| Phone |
9567797530 |
| Fax |
|
| Email |
313nadeera786@gmail.com |
|
Details of Contact Person
Scientific Query
|
| Name |
DR M Anbupriya |
| Designation |
Associate Professor |
| Affiliation |
SRM Institute of Science and Technology (SRM IST) Kattankulathur |
| Address |
Room no:14,Staff Room,Department of Physiotherapy
SRM Institute of Science and Technology (SRMIST)
SRM Nagar, Kattankulathur
Chengalpattu District
Tamil Nadu – 603203
India
Kancheepuram
TAMIL NADU
603203
India |
| Phone |
09841549219 |
| Fax |
|
| Email |
anbuprim@srmist.edu.in |
|
Details of Contact Person
Public Query
|
| Name |
DR M Anbupriya |
| Designation |
Associate Professor |
| Affiliation |
SRM Institute of Science and Technology (SRM IST) Kattankulathur |
| Address |
Room no:14,Staff Room,Department of Physiotherapy
SRM Institute of Science and Technology (SRMIST)
SRM Nagar, Kattankulathur
Chengalpattu District
Tamil Nadu – 603203
India
Kancheepuram
TAMIL NADU
603203
India |
| Phone |
09841549219 |
| Fax |
|
| Email |
anbuprim@srmist.edu.in |
|
|
Source of Monetary or Material Support
|
|
|
Primary Sponsor
|
| Name |
Nadeera vp |
| Address |
SRM Institute of Science and Technology (SRMIST)
SRM Nagar, Kattankulathur
Chengalpattu District
Tamil Nadu – 603203
India |
| Type of Sponsor |
Other [Self] |
|
|
Details of Secondary Sponsor
|
|
|
Countries of Recruitment
|
India |
|
Sites of Study
|
| No of Sites = 1 |
| Name of Principal
Investigator |
Name of Site |
Site Address |
Phone/Fax/Email |
| Dr M ANBUPRIYA |
SRM HOSPITAL |
SRM HOSPITAL
SRM Nagar, Kattankulathur
Chengalpattu District
Tamil Nadu – 603203
India
Kancheepuram
TAMIL NADU |
09841549219
anbuprim@srmist.edu.in |
|
|
Details of Ethics Committee
|
| No of Ethics Committees= 1 |
| Name of Committee |
Approval Status |
| SRM MEDICAL COLLEGE HOSPITAL AND RESEARCH CENTRE |
Approved |
|
|
Regulatory Clearance Status from DCGI
|
|
|
Health Condition / Problems Studied
|
| Health Type |
Condition |
| Patients |
(1) ICD-10 Condition: O648||Obstructed labor due to other malposition and malpresentation, |
|
|
Intervention / Comparator Agent
|
| Type |
Name |
Details |
| Intervention |
Rebozo Technique(Pelvic relaxation)and Knee–Chest Position for Rotation of Occiput Posterior Presentation |
Participants allocated to the intervention group will receive knee–chest maternal positioning followed by Rebozo technique during the active phase of the first stage of labor.The mother will first assume the knee-to-chest position beginning in hands-and-knees posture and lowering the chest towards the thighs. The position includes three components: on all fours, sitting on the knees, and weight-bearing on the hands. The participant will spend 3–5 minutes in each component.
This will be followed by the Rebozo technique using a hospital cotton bedsheet folded longitudinally and placed around the pelvis. Gentle rhythmic pelvic rocking (anterior and posterior sway) will be applied by the therapist for 4–5 repetitions in each position. The maneuver will be paused during uterine contractions, and sacral counterpressure may be given for comfort.
All procedures will be performed under supervision with continuous maternal and fetal monitoring.
Each session will last approximately 15–20 minutes and will be repeated every 30–60 minutes for up to four sessions. The total duration of intervention will be up to 2 hours or until fetal rotation occurs or labor progresses |
| Comparator Agent |
Standard Labour Care |
Participants in the comparator group will receive standard labour care as per hospital protocol. Routine monitoring of maternal and fetal parameters will be done. Usual comfort measures such as walking upright posture breathing techniques and analgesia will be allowed. No structured knee to chest position or rebozo maneuver will be performed. |
|
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Inclusion Criteria
|
| Age From |
18.00 Year(s) |
| Age To |
35.00 Year(s) |
| Gender |
Female |
| Details |
Pregnant women aged 18 to 35 years
Singleton pregnancy
Cephalic presentation
Occiput posterior position confirmed clinically
Gestational age 37 weeks or more
In active phase of first stage of labor
Willing to provide informed consent |
|
| ExclusionCriteria |
| Details |
Multiple pregnancy
Malpresentation other than occiput posterior
Previous cesarean section
High risk pregnancy such as preeclampsia, placenta previa, or severe anemia
Fetal distress at admission
Any contraindication to vaginal delivery |
|
|
Method of Generating Random Sequence
|
Computer generated randomization |
|
Method of Concealment
|
Sequentially numbered, sealed, opaque envelopes |
|
Blinding/Masking
|
Open Label |
|
Primary Outcome
|
| Outcome |
TimePoints |
Primary Outcome 1 Rate of rotation from Occiput Posterior OP to Occiput Anterior OA presentation
Primary Outcome 2 Mode of delivery Spontaneous vaginal or Instrumental or Cesarean section
|
Assessed before intervention and at full cervical dilatation or at the time of delivery whichever occurs earlier. |
|
|
Secondary Outcome
|
| Outcome |
TimePoints |
Duration of first stage of labour
Duration of second stage of labour
Maternal satisfaction score Birth Satisfaction Scale Revised
postpartum
Incidence & grade of perineal tear
Type of assisted delivery Forceps or Vacuum or Episiotomy
Neonatal outcomes
APGAR score at 1 & 5 minutes
Fetal heart rate changes |
For Duration of First Stage of Labour
From 4 cm cervical dilatation to full cervical dilatation 10 cm assessed during labour.
For Duration of Second Stage of Labour
From full cervical dilatation 10 cm to delivery of the baby, assessed during labour
Birth Satisfaction Scale
Within 24 hours postpartum.
APGAR Score
At 1 minute & 5 minutes after birth. |
|
|
Target Sample Size
|
Total Sample Size="128"
Sample Size from India="128"
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" |
|
Phase of Trial
|
N/A |
|
Date of First Enrollment (India)
|
29/03/2026 |
| Date of Study Completion (India) |
Applicable only for Completed/Terminated trials |
| Date of First Enrollment (Global) |
Date Missing |
| Date of Study Completion (Global) |
Applicable only for Completed/Terminated trials |
|
Estimated Duration of Trial
|
Years="1"
Months="0"
Days="0" |
|
Recruitment Status of Trial (Global)
|
Not Yet Recruiting |
| Recruitment Status of Trial (India) |
Not Yet Recruiting |
|
Publication Details
|
N/A |
|
Individual Participant Data (IPD) Sharing Statement
|
Will individual participant data (IPD) be shared publicly (including data dictionaries)?
Response - NO
|
|
Brief Summary
|
This randomized controlled trial aims to evaluate the effect of knee to chest position and rebozo pelvic relaxation maneuver on rotation of occiput posterior presentation and maternal fetal outcomes during labour. Persistent occiput posterior position is associated with prolonged labour increased operative delivery maternal exhaustion and neonatal complications. This study will include 128 pregnant women with confirmed occiput posterior position in active labour. Participants will be randomly allocated iinto interventiongroup and control group. The intervention group will receive knee to chest position along with rebozo maneuver during first stage of labour while the control group will receive routine labour care. Primary outcome is rate of rotation from occiput posterior to occiput anterior and mode of delivery. Secondary outcomes include duration of labour maternal satisfaction perineal trauma and neonatal outcomes. The study aims to promote non invasive cost effective and midwife friendly techniques to improve maternal and fetal outcomes. |