Study designs of evaluations included in the review
Studies were included if they compared an active agent with an alternative agent, placebo or control group and where sufficient detail was reported to enable methodological assessment of the study. Included studies were of the following designs: double blind randomised controlled trials (RCTs); RCT; and cross-over trials with random assignment to first treatment.
Specific interventions included in the review
The following interventions were studied: therapeutic ultrasound with mock ultrasound as control; pulsed electromagnetic energy (PEME) with mock PEME as control; cold pack; warm pack; warm or cold sitz bath; epifoam; and witch hazel. In some studies, concomitant treatments such as topical witch hazel, ice, and salt bath were allowed.
Participants included in the review
Postnatal women receiving treatment for perineal pain following childbirth were studied. Participants included primigravida (including those with disturbed sleep and those unable to sit or walk normally due to pain), and those with the following: instrumental/breech delivery, grades 1 to 4 of perineal trauma, bruising, haematoma, episiotomy (including those with some degree of perineal pain). Where reported, age ranged from 18 to 43 years.
Outcomes assessed in the review
The following outcomes were assessed: reduction in bruising during treatment; outcome reported as 'helped', 'fair effect', or decreased pain; frequency of perineal pain at 10 days; immediate pain relief and at half hour and hour intervals; and perineal oedema.
How were decisions on the relevance of primary studies made?
The authors do not state how the papers were selected for the review, or how many of the authors performed the selection.