Pub Date : 2022-03-10DOI: 10.1097/jwh.0000000000000240
G. Donnelly, Megan L James, C. Coltman, E. Brockwell, Joanna Perkins, I. Moore
Background: Women are unsure about the suitability and safety of running when pregnant and postpartum, with advice from medical professionals often conflicting. Aim: To explore the exercise and running-related advice pregnant and postpartum women received and the impact it has on their running habits. Study Design: Observational, cross-sectional. Methods: A total of 883 postpartum women completed an online survey. Questions were developed using pregnancy exercise guidance and clinical postpartum running guidelines. Odds ratios (ORs) were used to assess associations between receiving prenatal advice and receiving postpartum advice, receiving prenatal advice and continuing to run through pregnancy and return-to-running postpartum and receiving broadly sourced running-related guidance. Results: Postpartum women who received prenatal exercise advice and broadly sourced postpartum running advice were 37% and 31%, respectively. Those who received prenatal advice were more likely to receive postpartum advice (OR: 1.78, 95% confidence interval [CI]: 1.33-2.38). Receiving exercise-related advice was not associated with continuing to run during pregnancy (OR: 1.17, CI: 0.89-1.54). Having returned to running postpartum was associated with receiving broadly sourced postpartum running-related guidance (OR: 2.19, CI: 1.45-3.32). Women who were aware of the return-to-running clinical guidelines took longer to return-to-running than those who were not aware [14 (10-20) vs 10 (6-16.5) weeks, respectively, U = 34 889, P < .001]. Conclusion: Exercise and running guidance was only provided to a small proportion of women. To influence exercise habits and return-to-running, guidance needs to be individualized and specific to the needs of perinatal women.
{"title":"Running During Pregnancy and Postpartum, Part B: How Does Running-Related Advice and Guidance Received During Pregnancy and Postpartum Affect Women's Running Habits?","authors":"G. Donnelly, Megan L James, C. Coltman, E. Brockwell, Joanna Perkins, I. Moore","doi":"10.1097/jwh.0000000000000240","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000240","url":null,"abstract":"Background: Women are unsure about the suitability and safety of running when pregnant and postpartum, with advice from medical professionals often conflicting. Aim: To explore the exercise and running-related advice pregnant and postpartum women received and the impact it has on their running habits. Study Design: Observational, cross-sectional. Methods: A total of 883 postpartum women completed an online survey. Questions were developed using pregnancy exercise guidance and clinical postpartum running guidelines. Odds ratios (ORs) were used to assess associations between receiving prenatal advice and receiving postpartum advice, receiving prenatal advice and continuing to run through pregnancy and return-to-running postpartum and receiving broadly sourced running-related guidance. Results: Postpartum women who received prenatal exercise advice and broadly sourced postpartum running advice were 37% and 31%, respectively. Those who received prenatal advice were more likely to receive postpartum advice (OR: 1.78, 95% confidence interval [CI]: 1.33-2.38). Receiving exercise-related advice was not associated with continuing to run during pregnancy (OR: 1.17, CI: 0.89-1.54). Having returned to running postpartum was associated with receiving broadly sourced postpartum running-related guidance (OR: 2.19, CI: 1.45-3.32). Women who were aware of the return-to-running clinical guidelines took longer to return-to-running than those who were not aware [14 (10-20) vs 10 (6-16.5) weeks, respectively, U = 34 889, P < .001]. Conclusion: Exercise and running guidance was only provided to a small proportion of women. To influence exercise habits and return-to-running, guidance needs to be individualized and specific to the needs of perinatal women.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"46 1","pages":"124 - 131"},"PeriodicalIF":0.0,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42526526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-17DOI: 10.1097/JWH.0000000000000230
S. Christopher, S. Gallagher, Amanda Olson, S. Cichowski, Rita E. Deering
Running after childbirth, specifically how or when to return, is a hot topic in the field of physical therapy and on social media; however, there are significant gaps in the literature supporting when and how to safely initiate running postpartum. During pregnancy and following childbirth (both vaginal and cesarean), the body undergoes changes that may impact strength, neuromuscular control, endurance, and the ability to withstand the high-impact forces and repetitive nature of running. Many mothers experience new or worsened symptoms of musculoskeletal or pelvic floor dysfunction following pregnancy and childbirth and require physical therapy to normalize function. After most major injuries, it is common to participate in formalized rehabilitation; however, this is not the norm for athletes returning to running postchildbirth. Because of lack of evidence, many runners and clinicians struggle to develop appropriate rehabilitation progressions for return to running after childbirth. Pelvic and sports physical therapists must understand biomechanical features of running gait and safely progress strength, endurance, and neuromuscular control of the kinetic chain when guiding a runner back to running. This clinical commentary builds on existing guidelines, research, and expert opinion to propose a 4-phase rehabilitation framework to help runners initiate and progress running after childbirth. The result is an in-depth exercise prescription (intensity, frequency, type), examples of exercises (hip, abdominal, pelvic floor, and foot), running progression, and progression goals to prepare runners for symptom-free running after childbirth (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JWHPT/A58, where authors provide more insight on this return to running framework).
{"title":"Rehabilitation of the Postpartum Runner: A 4-Phase Approach","authors":"S. Christopher, S. Gallagher, Amanda Olson, S. Cichowski, Rita E. Deering","doi":"10.1097/JWH.0000000000000230","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000230","url":null,"abstract":"Running after childbirth, specifically how or when to return, is a hot topic in the field of physical therapy and on social media; however, there are significant gaps in the literature supporting when and how to safely initiate running postpartum. During pregnancy and following childbirth (both vaginal and cesarean), the body undergoes changes that may impact strength, neuromuscular control, endurance, and the ability to withstand the high-impact forces and repetitive nature of running. Many mothers experience new or worsened symptoms of musculoskeletal or pelvic floor dysfunction following pregnancy and childbirth and require physical therapy to normalize function. After most major injuries, it is common to participate in formalized rehabilitation; however, this is not the norm for athletes returning to running postchildbirth. Because of lack of evidence, many runners and clinicians struggle to develop appropriate rehabilitation progressions for return to running after childbirth. Pelvic and sports physical therapists must understand biomechanical features of running gait and safely progress strength, endurance, and neuromuscular control of the kinetic chain when guiding a runner back to running. This clinical commentary builds on existing guidelines, research, and expert opinion to propose a 4-phase rehabilitation framework to help runners initiate and progress running after childbirth. The result is an in-depth exercise prescription (intensity, frequency, type), examples of exercises (hip, abdominal, pelvic floor, and foot), running progression, and progression goals to prepare runners for symptom-free running after childbirth (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JWHPT/A58, where authors provide more insight on this return to running framework).","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"36 1","pages":"73 - 86"},"PeriodicalIF":0.0,"publicationDate":"2022-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46981279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-18DOI: 10.1097/JWH.0000000000000228
M. James, I. Moore, G. Donnelly, E. Brockwell, Joanna Perkins, C. Coltman
Background: In the absence of complications or contraindications, running is recognized as a safe mode of exercise for women who ran before pregnancy. Despite this, participation in running decreases during pregnancy and postpartum, with limited research conducted to examine why women who were runners before pregnancy cease running during pregnancy and do not return postpartum. Objectives: To understand the experiences of women who have recently given birth and were runners before pregnancy, specifically reasons for not running during pregnancy or returning to running postpartum, as well as postpartum running concerns. Study Design: Observational, cross-sectional, mixed methods. Methods: In total, 883 postpartum females completed an online questionnaire related to running habits, reasons for not running during pregnancy, not returning to running postpartum, and concerns returning to running postpartum. Most questions were closed-ended, with opportunity to provide free-text responses. Descriptive statistics of close-ended questions and thematic analysis of free-text responses were conducted. Results: Women did not run during pregnancy due to nausea/morning sickness, fatigue, fear of or experience of miscarriage and anxiety, nervousness, and fear. Women had not returned to running postpartum due to experience of symptoms/pain and complications postpartum and were concerned about leaking urine, vaginal heaviness, and not knowing how to return safely. Pelvic floor concerns were prevalent throughout pregnancy and postpartum. Conclusion: There is a need for evidence-based guidance for women to return to running postpartum gradually and safely. This includes greater pelvic health education and support, including access to treatment. Importantly, return-to-running guidance postpartum needs to be considered as an ongoing and longitudinal process.
{"title":"Running During Pregnancy and Postpartum, Part A: Why Do Women Stop Running During Pregnancy and Not Return to Running in the Postpartum Period?","authors":"M. James, I. Moore, G. Donnelly, E. Brockwell, Joanna Perkins, C. Coltman","doi":"10.1097/JWH.0000000000000228","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000228","url":null,"abstract":"Background: In the absence of complications or contraindications, running is recognized as a safe mode of exercise for women who ran before pregnancy. Despite this, participation in running decreases during pregnancy and postpartum, with limited research conducted to examine why women who were runners before pregnancy cease running during pregnancy and do not return postpartum. Objectives: To understand the experiences of women who have recently given birth and were runners before pregnancy, specifically reasons for not running during pregnancy or returning to running postpartum, as well as postpartum running concerns. Study Design: Observational, cross-sectional, mixed methods. Methods: In total, 883 postpartum females completed an online questionnaire related to running habits, reasons for not running during pregnancy, not returning to running postpartum, and concerns returning to running postpartum. Most questions were closed-ended, with opportunity to provide free-text responses. Descriptive statistics of close-ended questions and thematic analysis of free-text responses were conducted. Results: Women did not run during pregnancy due to nausea/morning sickness, fatigue, fear of or experience of miscarriage and anxiety, nervousness, and fear. Women had not returned to running postpartum due to experience of symptoms/pain and complications postpartum and were concerned about leaking urine, vaginal heaviness, and not knowing how to return safely. Pelvic floor concerns were prevalent throughout pregnancy and postpartum. Conclusion: There is a need for evidence-based guidance for women to return to running postpartum gradually and safely. This includes greater pelvic health education and support, including access to treatment. Importantly, return-to-running guidance postpartum needs to be considered as an ongoing and longitudinal process.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"46 1","pages":"111 - 123"},"PeriodicalIF":0.0,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44204057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1097/jwh.0000000000000236
A. Simonds, Karen Abraham, T. Spitznagle
Grant Support: This Guideline was supported by grants from the APTA and the Academy of Pelvic Health Physical Therapy (formerly the Section on Women’s Health). The authors are members of the APTA and Academy of Pelvic Health Physical Therapy, both of which provided funds for travel to meetings and clerical services in support of the guideline. Funding sources did not influence the content or process of development of the guideline.
{"title":"Clinical Practice Guidelines for Pelvic Girdle Pain in the Postpartum Population","authors":"A. Simonds, Karen Abraham, T. Spitznagle","doi":"10.1097/jwh.0000000000000236","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000236","url":null,"abstract":"Grant Support: This Guideline was supported by grants from the APTA and the Academy of Pelvic Health Physical Therapy (formerly the Section on Women’s Health). The authors are members of the APTA and Academy of Pelvic Health Physical Therapy, both of which provided funds for travel to meetings and clerical services in support of the guideline. Funding sources did not influence the content or process of development of the guideline.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45357593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1097/jwh.0000000000000235
A. Simonds, Karen Abraham, T. Spitznagle
{"title":"Executive Summary of the Clinical Practice Guidelines for Pelvic Girdle Pain in the Postpartum Population","authors":"A. Simonds, Karen Abraham, T. Spitznagle","doi":"10.1097/jwh.0000000000000235","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000235","url":null,"abstract":"","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49388911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1097/JWH.0000000000000231
Patti Berg-Poppe, M. Hauer, Cassandra Jones, Mattison Munger, Cassidy Wethor
Supplemental Digital Content is Available in the Text. Background: Diastasis rectus abdominis (DRA) is a condition commonly prevalent in the immediate postpartum period and decreasing in prevalence during the first year after delivery. The condition is pathologic when it interferes with activities and quality of life. The condition is frequently assessed using the interrectus distance. Objectives: The purpose of this systematic review was to pool and analyze studies examining the use of exercise and companion modalities for the treatment of DRA among postpartum women. Study Design: Systematic review (PROSPERO CRD42021277067). Methods: A systematic search for articles published in CINAHL, MEDLINE, and PubMed was conducted. Included articles identified exercise as a component of treatment for DRA for postpartum women. The quality of the studies was evaluated using the appropriate NHLBI quality assessment tool. Risk of bias was assessed using the Cochrane ROB-2 and ROBINS-1 tools. Results: The database search yielded 38 titles; 16 more were located as secondary searches. Fourteen articles remained for final inclusion: 9 randomized controlled trials (RCT) and 5 cross-sectional studies. Interventions with significant DRA improvements included traditional abdominal exercises (AE) with deep core stability, AE with pelvic floor muscle exercises, crunch exercises, drawing-in exercises with AE, and neuromuscular electrical stimulation with AE. Article quality varied from poor to good across RCTs and poor to fair for non-RCTs. Conclusion: Although these findings support the use of AE to reduce interrectus distance and improve quality of postpartum life, future research should investigate exercise selection based on the results of more multifaceted and clinically meaningful assessments.
{"title":"Use of Exercise in the Management of Postpartum Diastasis Recti: A Systematic Review","authors":"Patti Berg-Poppe, M. Hauer, Cassandra Jones, Mattison Munger, Cassidy Wethor","doi":"10.1097/JWH.0000000000000231","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000231","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Background: Diastasis rectus abdominis (DRA) is a condition commonly prevalent in the immediate postpartum period and decreasing in prevalence during the first year after delivery. The condition is pathologic when it interferes with activities and quality of life. The condition is frequently assessed using the interrectus distance. Objectives: The purpose of this systematic review was to pool and analyze studies examining the use of exercise and companion modalities for the treatment of DRA among postpartum women. Study Design: Systematic review (PROSPERO CRD42021277067). Methods: A systematic search for articles published in CINAHL, MEDLINE, and PubMed was conducted. Included articles identified exercise as a component of treatment for DRA for postpartum women. The quality of the studies was evaluated using the appropriate NHLBI quality assessment tool. Risk of bias was assessed using the Cochrane ROB-2 and ROBINS-1 tools. Results: The database search yielded 38 titles; 16 more were located as secondary searches. Fourteen articles remained for final inclusion: 9 randomized controlled trials (RCT) and 5 cross-sectional studies. Interventions with significant DRA improvements included traditional abdominal exercises (AE) with deep core stability, AE with pelvic floor muscle exercises, crunch exercises, drawing-in exercises with AE, and neuromuscular electrical stimulation with AE. Article quality varied from poor to good across RCTs and poor to fair for non-RCTs. Conclusion: Although these findings support the use of AE to reduce interrectus distance and improve quality of postpartum life, future research should investigate exercise selection based on the results of more multifaceted and clinically meaningful assessments.","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"46 1","pages":"35 - 47"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44332016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1097/JWH.0000000000000226
S. Christopher, Lindsey Bauer, R. Maylone, G. Bullock, S. Chinworth, S. Snodgrass, S. Vallabhajosula
Supplemental Digital Content is Available in the Text. Background: Women are running as soon as 8 weeks postpartum and there is currently little understanding of the effects of pregnancy and childbirth on the postpartum runner (PPR). Pregnancy-related musculoskeletal and physiological changes could impact running gait postpartum. Objective: The purpose of the current study was to investigate differences in overground running kinetics, strength and flexibility in PPRs, and age-matched nulliparous controls. Methods: Vertical and anteroposterior ground reaction force (APGRF) data were collected during overground running and normalized to body weight (NBW). Hip and knee strength, and hamstring flexibility measures were collected using a handheld dynamometer and inclinometer, respectively. Data were averaged for both legs. Independent-samples t tests and effect size (ES) estimations were conducted using α = .05. Findings: Nine PPRs (33.10 ± 5.60 years; ≤2 years postpartum) and 9 age-matched nulliparous women (31.67 ± 4.55 years) participated. PPRs had 24.3% greater braking loading rate for APGRF than controls (mean difference [MD] 3.41 NBW/s, 95% confidence interval [CI] 0.08, 6.74; P = .046; ES 1.08). PPRs had 14% less hamstring flexibility (MD 10.98°, 95% CI 0.97, 20.99; P = .034; ES 1.14), 25.9% less hip abduction strength (MD 0.04 NBW, 95% CI 0.00, 0.08; P = .045; ES 1.07) and 51.6% less hip adduction strength (MD 0.06 NBW, 95% CI 0.02, 0.10; P = .003; ES 1.68). Interpretation: These preliminary findings suggest that PPRs demonstrate altered running braking strategies and decreased hamstring flexibility and hip strength compared with nulliparous controls. As running guidelines for PPRs have been derived mostly from expert opinion, this exploratory cohort study suggests that PPRs should be evaluated for musculoskeletal impairments before initiating or returning to running. (See the Video, Supplemental Digital Content A, available at: http://links.lww.com/JWHPT/A67, which discusses the significance, innovation, and clinical applicability of this study.)
{"title":"Biomechanical and Musculoskeletal Differences Between Postpartum Runners and Nulliparous Controls","authors":"S. Christopher, Lindsey Bauer, R. Maylone, G. Bullock, S. Chinworth, S. Snodgrass, S. Vallabhajosula","doi":"10.1097/JWH.0000000000000226","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000226","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Background: Women are running as soon as 8 weeks postpartum and there is currently little understanding of the effects of pregnancy and childbirth on the postpartum runner (PPR). Pregnancy-related musculoskeletal and physiological changes could impact running gait postpartum. Objective: The purpose of the current study was to investigate differences in overground running kinetics, strength and flexibility in PPRs, and age-matched nulliparous controls. Methods: Vertical and anteroposterior ground reaction force (APGRF) data were collected during overground running and normalized to body weight (NBW). Hip and knee strength, and hamstring flexibility measures were collected using a handheld dynamometer and inclinometer, respectively. Data were averaged for both legs. Independent-samples t tests and effect size (ES) estimations were conducted using α = .05. Findings: Nine PPRs (33.10 ± 5.60 years; ≤2 years postpartum) and 9 age-matched nulliparous women (31.67 ± 4.55 years) participated. PPRs had 24.3% greater braking loading rate for APGRF than controls (mean difference [MD] 3.41 NBW/s, 95% confidence interval [CI] 0.08, 6.74; P = .046; ES 1.08). PPRs had 14% less hamstring flexibility (MD 10.98°, 95% CI 0.97, 20.99; P = .034; ES 1.14), 25.9% less hip abduction strength (MD 0.04 NBW, 95% CI 0.00, 0.08; P = .045; ES 1.07) and 51.6% less hip adduction strength (MD 0.06 NBW, 95% CI 0.02, 0.10; P = .003; ES 1.68). Interpretation: These preliminary findings suggest that PPRs demonstrate altered running braking strategies and decreased hamstring flexibility and hip strength compared with nulliparous controls. As running guidelines for PPRs have been derived mostly from expert opinion, this exploratory cohort study suggests that PPRs should be evaluated for musculoskeletal impairments before initiating or returning to running. (See the Video, Supplemental Digital Content A, available at: http://links.lww.com/JWHPT/A67, which discusses the significance, innovation, and clinical applicability of this study.)","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"46 1","pages":"11 - 17"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43239588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1097/JWH.0000000000000227
Kathryn L. Havens, Eileen V. Johnson, Elizabeth N. Day, Caleb J. Holdener, C. Starnes
Supplemental Digital Content is Available in the Text. Background: Parents carry their infants, toddlers, and young children every day. An ergonomic aid to carry (ie, babywearing) has been used for generations by caregivers of young children worldwide. While the benefits of close physical contact for infants are well documented, little is known on how this additional load impacts the health of the caregiver. Objective: An understanding of how babies are carried during their early years, especially how this behavior affects the musculoskeletal and mental health of the caregiver, is the first step to understanding this dynamic and is the objective of this research. Study Design: Cross-sectional observational study. Methods: A survey was designed to provide insight into current practices in the United States and the self-perceived physical and mental health benefits or challenges to babywearing. Results: A total of 3758 babywearing enthusiasts with a high level of experience and frequent babywearing responded. Respondents reported babywearing to allow for multitasking (97%) and for bonding/attachment (87%). Increased babywearing frequency was associated with improvements in fatigue, insomnia, and interest in sex among caregivers. Most respondents had experienced back pain (82%). Urinary incontinence and pelvic organ prolapse appear more prevalent than other research reports, although strong relationships were not found with babywearing. Finally, respondents had mild symptoms of stress, anxiety, and depression. Surprisingly, no relationships were identified between mental health scales and babywearing frequency or experience. Conclusions: Taken together, this data provides a better understanding of physical and mental health of caregivers in the United States, especially as they relate to babywearing. See the Video, Supplemental Digital Content A (available at: http://links.lww.com/JWHPT/A72).
{"title":"Infant Carrying in the United States: A Survey of Current Practices, Physical and Mental Health Benefits, and Challenges of Babywearing","authors":"Kathryn L. Havens, Eileen V. Johnson, Elizabeth N. Day, Caleb J. Holdener, C. Starnes","doi":"10.1097/JWH.0000000000000227","DOIUrl":"https://doi.org/10.1097/JWH.0000000000000227","url":null,"abstract":"Supplemental Digital Content is Available in the Text. Background: Parents carry their infants, toddlers, and young children every day. An ergonomic aid to carry (ie, babywearing) has been used for generations by caregivers of young children worldwide. While the benefits of close physical contact for infants are well documented, little is known on how this additional load impacts the health of the caregiver. Objective: An understanding of how babies are carried during their early years, especially how this behavior affects the musculoskeletal and mental health of the caregiver, is the first step to understanding this dynamic and is the objective of this research. Study Design: Cross-sectional observational study. Methods: A survey was designed to provide insight into current practices in the United States and the self-perceived physical and mental health benefits or challenges to babywearing. Results: A total of 3758 babywearing enthusiasts with a high level of experience and frequent babywearing responded. Respondents reported babywearing to allow for multitasking (97%) and for bonding/attachment (87%). Increased babywearing frequency was associated with improvements in fatigue, insomnia, and interest in sex among caregivers. Most respondents had experienced back pain (82%). Urinary incontinence and pelvic organ prolapse appear more prevalent than other research reports, although strong relationships were not found with babywearing. Finally, respondents had mild symptoms of stress, anxiety, and depression. Surprisingly, no relationships were identified between mental health scales and babywearing frequency or experience. Conclusions: Taken together, this data provides a better understanding of physical and mental health of caregivers in the United States, especially as they relate to babywearing. See the Video, Supplemental Digital Content A (available at: http://links.lww.com/JWHPT/A72).","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":"46 1","pages":"25 - 34"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47034304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1097/jwh.0000000000000239
S. Dufour
{"title":"Optimizing the Fourth Trimester: A Call for Physical Therapists","authors":"S. Dufour","doi":"10.1097/jwh.0000000000000239","DOIUrl":"https://doi.org/10.1097/jwh.0000000000000239","url":null,"abstract":"","PeriodicalId":74018,"journal":{"name":"Journal of women's health physical therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43503258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1097/JWH.0000000000000223
Lisa Kim, Karen Weeks, J. Geynisman-Tan
Background: Following obstetric anal sphincter injuries (OASISs), women commonly report symptoms of pelvic floor dysfunction such as fecal incontinence. Few studies have looked at pelvic health physical therapy (PHPT) as a treatment for women with OASIS and its associated symptoms. Objectives: To assess the outcomes of early PHPT on the presence and severity of symptoms in women with OASIS. Study Design: Retrospective cohort study. Methods: We assessed the records of 70 subjects with third- or fourth-degree OASIS who had undergone clinical evaluation and PHPT in the institution's pelvic health clinic between 2017 and 2019. PHPT assessment focused on pelvic and abdominal muscle strength, neuromuscular control, soft and connective tissue/scar mobility, and functional movement. Outcome measures assessed changes in the Pelvic Floor Distress Inventory-20 (PFDI-20), subjective symptom reports of pelvic floor dysfunction, and manual muscle testing of pelvic floor muscle strength. These changes were calculated using the t test, McNemar's test, and Wilcoxon rank sum test, respectively. Results: PHPT started within an average of 6.2 weeks resulted in a reduction across all subjective complaints. Pelvic floor muscle strength improved from an initial Modified Oxford Grading system (MOS) score of 1 (1-2) to 2 (1-3), (P < .01). Subjects who received PHPT within 2 months postpartum had a greater reduction in subjective symptoms than those who started after 2 months (2.4 ±1.7 vs 1.1 ± 1.3, P = .02). Conclusion: PHPT intervention is associated with a reduction in subjective complaints reported by women who experienced OASIS in a single tertiary center. Earlier initiation of PHPT may lead to a greater improvement in symptoms.
背景:产科肛门括约肌损伤(OASISs)后，女性通常报告盆底功能障碍症状，如大便失禁。很少有研究将盆腔健康物理疗法(PHPT)作为女性OASIS及其相关症状的治疗方法。目的:评估早期PHPT对女性OASIS患者症状存在和严重程度的影响。研究设计:回顾性队列研究。方法:我们评估了2017年至2019年在该机构盆腔健康诊所接受临床评估和PHPT的70名三度或四度OASIS患者的记录。PHPT评估侧重于骨盆和腹部肌肉力量、神经肌肉控制、软性和结缔组织/疤痕活动以及功能性运动。结果测量评估了盆底窘迫量表-20 (PFDI-20)的变化、盆底功能障碍的主观症状报告和盆底肌肉力量的手动肌肉测试。这些变化分别采用t检验、McNemar检验和Wilcoxon秩和检验计算。结果:PHPT在平均6.2周内开始导致所有主观抱怨的减少。盆底肌力从最初的改良牛津评分系统(MOS)评分1(1-2)提高到2 (1-3)，(P < 0.01)。产后2个月内接受PHPT治疗的患者比产后2个月后接受PHPT治疗的患者主观症状明显减轻(2.4±1.7 vs 1.1±1.3,P = 0.02)。结论:PHPT干预与在单一三级中心经历OASIS的妇女主观抱怨的减少有关。早期开始PHPT可能会导致症状的更大改善。
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