Effects of an 8-week pelvic core stability and nutrition community programme on maternal health outcomes.

Lori Maria Walton,Gretchen Krivak,Rose Caceras,Mini Sara Abraham,Cherisse Buddy,Veena Raigangar,Magaly Hernandez

doi:10.1002/pri.1780

Lori Maria Walton, Gretchen Krivak + Show 5 more

Open Access

https://doi.org/10.1002/pri.1780

Copy DOI

Abstract

Women, during the antenatal and post-partum period, report pelvic, low back pain, stress and urge urinary incontinence, colorectal dysfunction, and other co-morbidities that negatively affect health-related quality of life. Exercise and nutrition are important considerations for improving maternal health in this period. The purpose of this study was to examine the effects of a community-driven nutrition and exercise programme focused on pelvic floor and core stability, healthy nutrition, and breastfeeding counselling over an 8-week period on pelvic floor and urinary distress (UDI), prolapse and colorectal distress for antenatal and post-partum women with limited access to health care, and low socio-economic resources from a Midwestern Region of the United States. Purposive sample of 35 females, ages 18-44, were recruited for this prospective, preintervention to postintervention study, following ethical approval from Institutional Review Board and voluntary written consent from participants. The Health History Questionnaire, SF-36, Food Frequency Questionnaire, report of pelvic organ prolapse dysfunction (POPDI), colorectal-anal dysfunction (CRADI), and UDI as measured by the Pelvic Floor Distress Inventory (PFDI) were completed before and after intervention. Thirty-five women (n=35) 18 to 44years old (mean age of 22.72±3.45years) completed the study. A significant difference was found from preintervention to postintervention scores means for PFDI total scores, CRADI individual scores, and UDI individual scores (p<.05). POPDI scores decreased preintervention to postintervention but were not significant. A significant improvement in healthy nutrition and breastfeeding postintervention was also found (z=3.21, p=.001). Further analysis showed significant, but weak, correlation between parity and POPDI (r=.366, p=.033); between parity and UDI (r=.384, p=.03); and between parity and PFDI (r=.419, p=.014). Our study found a significant reduction in pelvic floor dysfunction, urinary, and colorectal-anal distress symptoms and improvement in breastfeeding and healthy nutrition following an 8-week community-driven nutrition and exercise programme focused on pelvic floor and core stability, healthy nutrition, and breastfeeding counselling.

Highlights

Women, during the antenatal and post‐partum period, report pelvic, low back pain, stress and urge urinary incontinence, colorectal dysfunction, and other co‐morbidities that negatively affect health‐related quality of life
Our study aims were to examine the effects of a 2‐ to 90‐min session physiotherapy and nutrition educational intervention on Pelvic Floor Distress Inventory (PFDI), colorectal‐anal dysfunction (CRADI), prolapse dysfunction (POPDI) and urinary distress (UDI) symptoms, nutritional intake, and breastfeeding frequency for women living with socio‐economic challenges and lack of access to these services within the community
We found a significant difference from preintervention to postintervention in PFDI, UDI, and CRADI but did not find a difference for POPDI scores, detailed below

Summary

Introduction

Women, during the antenatal and post‐partum period, report pelvic, low back pain, stress and urge urinary incontinence, colorectal dysfunction, and other co‐morbidities that negatively affect health‐related quality of life. Purpose: The purpose of this study was to examine the effects of a community‐ driven nutrition and exercise programme focused on pelvic floor and core stability, healthy nutrition, and breastfeeding counselling over an 8‐week period on pelvic floor and urinary distress (UDI), prolapse and colorectal distress for antenatal and post‐ partum women with limited access to health care, and low socio‐economic resources from a Midwestern Region of the United States. Limited community‐driven antenatal and post‐partum programmes that include detailed progression of pelvic and core stability exercises and healthy nutrition information exist for women who are socio‐economically challenged. Prenatal and post‐ partum community‐driven physiotherapy and nutrition education programmes may be one method towards increased access to physiotherapy and clinical nutrition services (Fraser, 2013; Gadson, Akpovi, & Mehta, 2017; de Jongh et al, 2016; WHO, 2016)

Objectives

Methods

Findings

Conclusion