Postpartum Rehabilitation Research Articles

Effect of Leonurus japonicus alkaloids on endometrial inflammation and its mechanisms.

The aerial parts of Leonurus japonicus Houtt. (Chinese motherwort) are famous for their efficacy in treating obstetrical and gynecological diseases in traditional Chinese medicine (TCM). Alkaloids are the major bioactive components of motherwort and have gained extensive attention for alleviating several symptoms of obstetrical and gynecological diseases such as postpartum hemorrhage, postpartum rehabilitation, irregular menstruation, and dysmenorrhea. However, the effects of motherwort alkaloids on endometritis remain unclear. The aim of this study was to investigate the effect of motherwort total alkaloids (MTAs) on endometritis and explore the molecular mechanisms using an integrating network analysis and in vitro experimental verification. Ultra-high performance liquid chromatography-tandem quadrupole-orbitrap high-resolution mass spectrometry (UPLC-Q-Orbitrap HRMS) was used to analyze and identify the components in the MTAs. The effects of MTAs were evaluated using bacteria-induced endometritis in rats. Network pharmacology was conducted to predict possible mechanism pathways of MTAs in endometritis. Finally, lipopolysaccharide-stimulated mouse mononuclear macrophage (RAW 264.7) cells and human endometrial epithelial cells were used to identify signaling pathways through which MTAs exert their effects. Thirty-nine alkaloids were identified in MTAs using the UPLC-Q-Orbitrap HRMS analysis. Their corresponding putative targets were then predicted. The MTAs exerted pharmacological effects on endometritis through a multi-ingredient and multi-target pattern. Network pharmacology showed that the MTAs had 152 candidate targets in treating endometritis. According to the KEGG analysis, the MTAs were found to potentially affect the PI3K-AKT and NF-κB signaling pathways. The following experiments showed that the MTAs exhibited significant effects on endometritis in vivo, significantly reduced the overproduction of inflammatory mediators, and promoted endometrial cell repair via the PI3K/AKT/NF-κB signaling pathway. Motherwort alkaloids can be used to treat endometrial inflammation by regulating the PI3K/AKT/NF-κB pathway. This study provides a scientific basis for the use of MTAs for treating endometritis.

Pelvic floor muscle training after childbirth: A systematic review

Introduction: the training of pelvic floor muscles is a recommended strategy to improve the quality of life in postpartum women, addressing common issues such as urinary incontinence and pelvic organ prolapse. This systematic review evaluated the effectiveness of various interventions, including supervised programs, biofeedback, electrical stimulation, and core stabilization exercises.Methods: thirteen studies were identified through searches in PubMed, Cochrane, and Google Scholar. Results: the results indicated that supervised interventions, especially those supported by technologies like mobile applications and feedback devices, show significant improvements in muscle strength, symptom reduction, and quality of life, outperforming unsupervised methods. However, some studies did not find significant differences in aspects such as pain relief or prolapse recovery, highlighting the importance of personalizing protocols. Additionally, variability in study designs and methodologies limits the generalization of the findings. Conclusions: supervised pelvic floor training, complemented by innovative technologies, is an effective tool for postpartum rehabilitation. However, it is necessary to standardize protocols and evaluate long-term effects to optimize future interventions.

The impact of antenatal cluster management on maternal delivery and postpartum rehabilitation

ObjectivePregnancy care can improve maternal pregnancy outcomes. Cluster nursing, an evidence-based, patient-centered model, enhances pregnancy care, can provide patients with high-quality nursing services, has been widely used in clinical practice in recent years. However, most previous studies evaluated cluster nursing program only for a single clinical scenario. In this study, we developed and implemented a antenatal cluster care program for various prenatal issues faced by puerpera to analyze its application effect.MethodsThis is a historical before and after control study. 89 expectant mothers who had their prenatal information files registered in the outpatient department of a grade III, level A hospital from June 2020 to September 2021 were finally enrolled in observation group, and received prenatal cluster management. Another set of 89 expectant mothers from January 2019 to December 2019 were included in the control group and received traditional routine prenatal management. The effect of cluster nursing management on maternal delivery and postpartum rehabilitation was evaluated and compared between the two groups.ResultsCompared with the control group, the observation group had a significantly higher natural delivery rate, better neonatal prognosis, higher rates of exclusive breastfeeding, lower incidence of postpartum complications, shorter postpartum hospital stay, better postpartum health status, and higher satisfaction with nursing services. Compared with before intervention, the SAS and SDS scores of the observation group showed significant improvement after intervention.ConclusionAntenatal cluster care is beneficial to improve maternal and neonatal outcomes, and can have positive effects on natural pregnancy and breastfeeding, while improving the multimedia health education ability of medical care and emphasizing the importance of social support.

Advancements in Postpartum Rehabilitation: A Systematic Review.

Postpartum rehabilitation plays a crucial role in promoting maternal health and well-being following childbirth. This systematic review aims to explore recent trends and advancements in postpartum rehabilitation interventions across various categories. A comprehensive search was conducted on PubMed and Embase databases, yielding a total of 358 search results. After applying strict inclusion and exclusion criteria, 20 relevant studies were selected for detailed analysis. These studies were categorized into four distinct categories: exercise-based techniques, technology integration, medical interventions, and multi-modal approaches. Within the exercise-based technique category, pelvic floor exercises, trunk stabilization exercises, and physiotherapy emerged as the most commonly utilized interventions. Studies in this category typically involved population sizes ranging from n = 20to 200participants, with study durations spanning from six weeks to 12 weeks. In the technology integration category, predominant techniques included electrical stimulation, biofeedback, acupuncture, and vibrating vaginal balls. Population sizes ranged from n = 50to 200participants, with study durations ranging from three days to three months. Only one study was identified in the medical intervention category, which investigated the use of intrathecal analgesia and continuous ropivacaine after cesarean section, involving 200participants. Multimodal approaches encompassed various combinations of technology, artificial intelligence, image processing, and exercise-based interventions, with population sizes ranging from n = 10to 500participants and study durations ranging from six weeks to 12 months. This systematic review provides insights into the diverse landscape of postpartum rehabilitation interventions, highlighting the prominence of exercise-based techniques and the growing utilization of technology integration. While medical interventions remain limited, multimodal approaches show promise in optimizing postpartum care outcomes. Continued research and innovation in this field are warranted to further refine rehabilitation strategies and improve maternal health outcomes following childbirth.

A Pre and Postnatal Physical Therapy Protocol for Recreational Athletes: A Case Series.

Recent changes to medical recommendations for exercise in pregnancy and postpartum have expanded to include recreational athletes. While women are transitioning into motherhood at the height of their athletic careers, there is limited guidance on musculoskeletal training from pregnancy through safe return to activity. The lack of education and support in this population may lead to increased prevalence of symptoms and delay of treatment, ultimately hindering athletic performance. The purpose of this case series is to assess pelvic floor symptoms through implementing a new pre- and postnatal exercise training paradigm in a group of women aiming to return to recreational athletics. Case series. Six recreationally athletic women between 25-35 years of age were referred to physical therapy during pregnancy to participate in this protocol. The women completed a standardized pregnancy and postpartum rehabilitation plan focused on core and pelvic floor control in addition to specific strength and mobility training. Pain, urinary dysfunction, and pelvic floor muscle strength were assessed at six weeks postpartum and at discharge. Meaningful improvement was noted in pain, urinary dysfunction, and muscle strength by the time of discharge. The decrease in symptoms and improvements in measures of musculoskeletal health suggests that a physical therapist guided rehabilitation protocol may be useful as part of the standard of care to reduce prevalence of pain and dysfunction, particularly in the recreational athlete population. Improving understanding of exercise training in this population may minimize musculoskeletal symptoms and encourage additional research to improve the standard of care for this group of patients. Level 4.

Prioritise safety, optimise success! Return to rugby postpartum.

Pregnancy and childbirth involve substantial physical, physiological and psychological changes. As such, postpartum rugby players should be supported and appropriately prepared to return to the demands of rugby alongside the additional demands of motherhood. This review aims to discuss specific perinatal considerations that inform a rugby player's readiness to return-to-sport postpartum and present an approach to rehabilitation. Before engaging in full rugby training and matchplay, postpartum players should have progressed through the initial phases of rehabilitation and graded sports-specific training to prepare them for the loads they will be exposed to. Additional rehabilitation considerations include minimising deconditioning during pregnancy; medical concerns; the abdominal wall; the pelvic floor; perinatal breast changes, breastfeeding and risk of contact breast injury; body mass; nutritional requirements; hormonal considerations; athlete identity and psychological considerations; joining team training; return to contact and tackle training; evaluating player load tolerance and future research, policy and surveillance needs. A whole-systems, biopsychosocial approach following an evidence informed return-to-sport framework is recommended when rehabilitating postpartum rugby players. Health and exercise professionals are encouraged to use the perinatal-specific recommendations in this review to guide the development of postpartum rehabilitation protocols and resources.

Therapeutic effect of manual massage on early postpartum rectus abdominis separation and postpartum depression.

Rectus abdominis separation (DRA) affects pelvic stability and body image. No studies have explored the effects of manual massage on early postpartum DRA and postpartum depression. To analyze the curative effect of massage on early postpartum DRA and its impact on postpartum depression and thus its ability promote the overall psychosomatic rehabilitation of postpartum women. Data were retrospectively collected on 70 primiparous women with postpartum DRA who underwent rehabilitation at the Postpartum Rehabilitation Center of Huzhou Maternal and Child Health Hospital from October 2022 to September 2023. The patients were divided into the Group S (35 cases, biomimetic electrical stimulation treatment) and Group L (35 cases, biomimetic electrical stimulation combined with manual massage treatment). Baseline data, the edinburgh postpartum depression scale (EPDS) score, and the visual analog scale (VAS) scores for rectus abdominis distance, waist circumference, and lower back pain before and after treatment were compared. No significant differences were found in the baseline data, rectus abdominis distance, waist circumference, and VAS and EPDS scores between the two groups before treatment (P > 0.05). After treatment, the distance between rectus abdominis and waist circumference in Group L were significantly smaller than those in Group S (P < 0.05). Furthermore, lower back pain (VAS score) and the EPDS score in Group L were significantly lower than those in Group S (P < 0.05). Manual massage can significantly reduce early postpartum DRA, waist circumference, and back pain and improve the patient's mental state and postpartum depression.

Effect of low-intensity focused ultrasound therapy on postpartum uterine involution in puerperal women: A randomized controlled trial.

Short-term poor uterine involution manifests as uterine contraction weakness. This is one of the important causes of postpartum hemorrhage, posing a serious threat to the mother's life and safety. The study aims to investigate whether low-intensity focused ultrasound (LIFUS) can effectively shorten lochia duration, alleviate postpartum complications, and accelerate uterine involution compared with the sham treatment. A multicenter, concealed, randomized, blinded, and sham-controlled clinical trial was conducted across three medical centers involving 176 subjects, utilizing a parallel group design. Enrollment occurred between October 2019 and September 2020, with a 42-day follow-up period. Participants meeting the inclusion and exclusion criteria based on normal prenatal examinations were randomly divided into the LIFUS group or the sham operation group via computer-generated randomization. Patients in the LIFUS group received usual care with the LIFUS protocol, wherein a LIFUS signal was transmitted to the uterine site through coupling gel, or sham treatment, where no low-intensity ultrasound signal output was emitted. The primary outcome, lochia duration, was assessed via weekly telephonic follow-ups post-discharge. The involution of the uterus, measured by uterine fundus height, served as the secondary outcome. Among the 256 subjects screened for eligibility, 176 subjects were enrolled and randomly assigned to either the LIFUS group (n = 88) or the Sham group (n = 88). Data on the height of the uterine fundus were obtained from all the patients, with 696 out of 704 measurements (99%) successfully recorded. Overall, a statistically significant difference was noted in time to lochia termination (hazard ratio: 2.65; 95% confidence interval [CI]: 1.82-3.85; P < 0.001). The decline in fundal height exhibited notable discrepancies between the two groups following the second treatment session (mean difference: -1.74; 95% CI: -1.23 to -2.25; P < 0.001) and the third treatment session (mean difference: -3.26; 95% CI: -2.74 to -3.78; P < 0.001) after delivery. None of the subjects had any adverse reactions, such as skin damage or allergies during the treatment. This study found that LIFUS treatment can promote uterine involution and abbreviate the duration of postpartum lochia. Ultrasound emerges as a safe and effective intervention, poised to address further clinical inquiries in the domain of postpartum rehabilitation.

Spatial Function Diversification: A Case Study of Medical Care Institutions

With the continuous improvement of living levels, people's health needs and psychological needs are getting higher and higher. the functional needs of living conditions and lifestyles are becoming more and more refined, so that the design of diversified spatial functions has emerged. In a limited space, the diversified design is rich in functions, efficient and coordinated, and has the characteristics of adaptability, richness, harmony, unity and intensification of multiple orders. This article explores the human activities, time dimensions and space dimensions in the design of diversified spatial functions. Taking the medical care institution—postpartum rehabilitation center as an example, the design reflects the diversified characteristics of spatial functions.

Stress urinary incontinence prevalence and risk factors in female rugby players: a common health problem across four nations

ObjectivesFemale athletes engaging in high-impact sports have a higher prevalence of experiencing stress urinary incontinence (SUI). However, the prevalence of sport-specific SUI and associated risk factors in female rugby players...

Association between functional constipation and vaginal wind in women at 6 weeks postpartum

Introduction and hypothesisThe pathogenesis of vaginal wind remains unclear. This study was aimed at assessing the association between functional constipation and vaginal wind in women at 6 weeks postpartum.MethodsThis is a multicenter cross-sectional study. We collected data, such as baseline demographic, clinical characteristics, pelvic organ prolapse quantification score. and surface electromyography parameters of pelvic floor muscles, of women at 6 weeks postpartum who visited the postpartum rehabilitation clinic between May 2022 and September 2022. The cohort data were from women who visited the postpartum rehabilitation clinic of the First Affiliated Hospital of Gannan Medical University and the Women and Children's Health Care Hospital of Yudu County. Follow-up for the control and study cohorts was conducted until 6 weeks postpartum.ResultsAmong the 377 women, 101 (26.79%) reported vaginal wind. Multivariate regression analysis showed that postpartum women with functional constipation were at a higher risk for vaginal wind than women without functional constipation (odds ratio [OR], 2.41). The results remained stable across the propensity score analyses (OR, 1.86–2.30). In addition, we found age, body mass index, mode of delivery, changes in the anatomical location of Bp points, urinary incontinence, pelvic floor muscle strength, and birth weight of the neonate were not associated with increased odds of vaginal wind in women at 6 weeks postpartum.ConclusionsVaginal wind is common among women at 6 weeks postpartum and is associated with functional constipation. Functional constipation may serve as a reference for the pathogenesis, prevention, and treatment of vaginal wind.

Sonographic Findings of Abdominal Wall Endometriosis in Persistent Abdominal Wall Pain: A Case Report

Introduction/Background: Endometriosis is considered a chronic neuroinflammatory disease of debilitating pain, most often in the pelvic area. In rare cases, endometriosis can develop through iatrogenic implantation of endometrial cells/fragments into a scar area during the cesarean delivery. Case Description: A case of a 32-year-old female patient who underwent physical therapy for abdominal muscle pain with occasional irradiation of pain to the sacral region is presented. The pain developed soon after a cesarean delivery, which was performed 3 years ago. Outcomes: Palpation performed at the initial examination and after removal of the lesions showed a significant reduction in tone at the site of the lesions and a reduction in palpation pain. The objective primary tools and specific outcome measures used in this case were musculoskeletal sonography and a patient questionnaire (36-Item Short Form Health Survey [SF-36]). Abdominal wall lesions were found to be 34 × 13 × 40 mm and 30 × 15 × 22 mm in size and were surgically removed by a specialized surgeon with histological confirmation of endometriosis. The SF-36 scores considerably improved in all domains following removal of the lesions compared with the condition at the initial examination. Discussion: The presented case is an example of the musculoskeletal sonography evaluation following palpation of the abdominal wall in women after a cesarean delivery. The described sonographic examination performed by a physical therapist can be part of a comprehensive assessment of scar healing, diastasis, and the ability to activate the abdominal muscles during postpartum rehabilitation. Informed Consent: The patient signed informed consent, in which she agreed to the anonymous publication of her case. A supplemental video abstract available at: https://www.youtube.com/watch?v=Vd87WB8ZQd0&amp;t=16s

DYNAMICS OF THE PARAMETERS OF THE METABOLIC SYNDROME IN OBESE WOMEN WHO HAVE UNDERGONE CAESAREAN SECTION UNDER THE INFLUENCE OF PHYSICAL THERAPY

Purpose: to determine the effectiveness of restoring the health status of obese women who underwent cesarean section, based on the dynamics of metabolic syndrome parameters.&#x0D; Methods. During the research, 44 women aged 25.5±1.6 years at the end of the late postpartum period (2 months after childbirth) were examined. The control group consisted of 17 women with normal body weight who gave birth vaginally and recovered independently in the postpartum period. The comparison group consisted of 14 obese women who independently recovered in the postpartum period. The experimental group consisted of 13 obese women who, for 3 months, performed a physical therapy program (therapeutic exercises for the muscles of the back, abdomen, upper and lower limbs, functional training; pressotherapy; vacuum massage; nutritional recommendations. The criteria for metabolic syndrome were studied: abdominal obesity, fasting hyperglycemia, impaired glucose tolerance (according to the results of a 2-hour loading test), total cholesterol, high triglyceride content, decreased high-density lipoprotein content.&#x0D; Research results. During the observation period (3 months), the women of the control group increased their body weight by 0.61 kg on average, the comparison group - by 1.66 kg, while the women of the experimental group decreased their body weight by 2.57 kg, which was reflected in the dynamics body mass index. In the women of the research group, it was possible to achieve a statistically significant decrease in waist circumference (p&lt;0.05), which can be explained not only by the decrease in the amount of abdominal fat, but also by the toning of the muscles of the anterior abdominal wall, weakened by overstretching during pregnancy. Such dynamics influenced the parameters of the ratio of waist circumference to hip circumference in the direction of its improvement, although normalization was not achieved. Under the influence of physical therapy, the expressiveness of biochemical manifestations of metabolic and dyslipidemic manifestations in the women of the research group decreased relative to the parameters of the first examination. Fasting glucose parameters reached the normal range, tissue sensitivity to glucose was restored. Positive changes in the concentrations of lipid fractions in the direction of decreasing atherogenicity were observed. At the same time, women in the comparison group showed a tendency to increase body weight, worsening of atherogenic dyslipidemia, i.e. signs of metabolic syndrome. In women of the control group with normal body weight, there were no changes in the studied indicators.&#x0D; Conclusions. Obesity as an independent pathological process increases the risks during pregnancy and childbirth for both the mother and the child, leading to an increase in the frequency of abdominal delivery with appropriate postpartum rehabilitation in such women. The improvement of anthropometric indicators and the reduction of dysmetabolic and dyslipidemic manifestations indicate the sufficient effectiveness of physical therapy in correcting body weight in women with obesity in the postpartum period, although in order to achieve normal body weight indicators and complete normalization of indicators, the duration of recovery measures should be longer than three months, and for all patients of this profile need lifelong adherence to a balanced diet.

Impact of a postpartum care rehabilitation program to prevent postpartum depression at a secondary municipal hospital in Qingdao China: a cross-sectional study

BackgroundThe emerging postpartum rehabilitation (PPR) program in Chinese hospitals characterized by applying ongoing medical care through traditional cultural practices shows a protective effect in early puerperium in China. This study explores the benefit of PPR program practices to postpartum depression (PPD) and the influencing factors for PPD among Chinese women during the first postnatal six weeks.MethodsThe cross-sectional study included 403 participants and was conducted in a Secondary Municipal Hospital in Qingdao, China, from 01 to 2018 to 31 December 2021. Information on this PPR program was collected during the six-weeks postpartum consultation, including the Edinburgh postnatal depression scale (EPDS) scores, the measurement results for diastasis recti abdominis, and the international physical activity questionnaire (long form) (IPAQ-L) scores. Logistic regression models were used to examine the effect of the PPR program on PPD among the local population. The secondary aim of this study was to investigate possible influencing factors for PPD, such as coronavirus disease 2019 (COVID-19), physical exercises, etc.ResultsPPR program has shown a positive effect in preventing PPD (p < 0.001) and diastasis recti prevalence (p < 0.001) during the six-weeks postnatal control in Qingdao, China. Better post-pregnancy weight reduction (p = 0.04) and higher metabolic equivalent of task (MET) value (p < 0.001) were noticed in the non-PPR group. Furthermore, lower PPD risk was associated with factors such as longer relationship duration years (2–5 years) (p = 0.04) and exercising one to three times a week (p = 0.01). A higher PPD risk was related to factors such as urinary incontinence during the postpartum period (p = 0.04) and subjective insomnia (p < 0.001). No significant effect was shown between COVID-19 and the EPDS score in this study (p = 0.50).ConclusionOur results suggested that the PPR program provided protection against PPD and diastasis recti during the first six weeks after delivery. Urinary incontinence and subjective insomnia were the main risk factors for PPD, while longer relationship duration years and exercising one to three times a week gave protective effects to PPD. This study emphasized that a comprehensive ongoing medical care program, such as the PPR program, effectively improves women’s mental and physical health in the early postpartum in China.

Research on the Different Frequencies of Transcutaneous Electrical Acupoint Stimulation for Postpartum Pelvic Girdle Pain

Objective: To observe the clinical effect of different frequencies of transcutaneous electrical acupoint stimulation in treating postpartum pelvic girdle pain and promoting postpartum rehabilitation. Methods: From January to September 2022, 300 patients with pelvic girdle pain after spontaneous delivery in a hospital in Shaanxi Province were selected and randomly divided into three groups, low frequency, high frequency, and alternating frequency, with 100 cases in each group. In addition to routine postpartum care and psychological counseling, the three groups received transcutaneous electrical acupoint stimulation at low-frequency (2 Hz,) high-frequency (100 Hz), and alternating frequency (2/100 Hz), respectively. The differences in initial pain, pain scores before and after treatment, satisfaction with analgesic effect, and postpartum rehabilitation effect were evaluated among the three groups of patients. Results: There was a significant correlation between maternal age and postpartum pelvic girdle pain (P &lt; 0.001), but no correlation was observed between newborn birth weight and postpartum pelvic girdle pain (P &gt; 0.05). After 1d/2d of treatment, the pain scores and rehabilitation effect of patients in the alternating-frequency group and low-frequency group were significantly better than those in the high-frequency group, and the postpartum curative effect of patients in the alternating-frequency group was the best, followed by the low-frequency group, and the high-frequency group; the differences were statistically significant (P &lt; 0.001). Among the three groups, the alternating-frequency group had the highest satisfaction with the analgesic effect and the highest rate of selecting the same analgesic regimen the next time; the differences were statistically significant (P &lt; 0.001). Conclusion: Transcutaneous electrical acupoint stimulation at different frequencies is safe and effective in treating postpartum pelvic girdle pain and beneficial to postpartum rehabilitation. Sparse-dense wave stimulation is effective in treating postpartum pelvic girdle pain. It has the best effect in promoting postpartum rehabilitation and the highest patient satisfaction. Therefore, its application in clinical practice is highly recommended.

Application Study on Postpartum Rehabilitation Instrument Combined with Manual Massage to the Lactation of Parturients in Cesarean Section

Application Study on Postpartum Rehabilitation Instrument Combined with Manual Massage to the Lactation of Parturients in Cesarean Section

Dynamic Evaluation of the Rectus Abdominis Muscle before and after Delivery by Ultrasonography.

Objective To evaluate the changes of rectus abdominis thickness and inter-rectus distance before and after delivery with high-frequency ultrasound. Methods A total of 148 pregnant women at 12 weeks of gestation who underwent prenatal examination in our hospital from January 2019 to March 2020 were selected, and 140 of them cooperated with rectus abdominis examination. According to the results of rectus abdominis examination 42 days after delivery, 97 patients were divided into the DRA group with rectus abdominis isolated and 43 patients were divided into the normal group with rectus abdominis not isolated. At 12 weeks, 24 weeks, and 37 weeks of pregnancy, 3 days and 42 days after delivery, the thickness and spacing of the left and right rectus abdominis muscle were measured by high-frequency ultrasound along the white linea at three positions: 5 cm above the navel, 3 cm below the umbilical edge, and 3 cm below the navel. Results The thickness of rectus abdominis at 5 cm above the navel, 3 cm below the navel, and at the navel margin of the abdominal white line in the pregnant women of the two groups was gradually decreased with the increase of the pregnancy cycle and gradually recovered after delivery. At 42 days after delivery, the thickness of rectus abdominis in the DRA group was significantly lower than that in the normal group, which was 5 cm above the umbilicus, 3 cm below the umbilicus, and the umbilical margin of the abdominal white line (P < 0.05). The space between rectus abdominis 5 cm above the navel, 3 cm below the navel, and the navel margin of the abdominal white line in the pregnant women of the two groups was gradually increased with the increase of the pregnancy cycle and gradually recovered after delivery. At 37 weeks of pregnancy, 3 days after delivery, and 42 days after delivery, the space of rectus abdominis along the umbilicus 5 cm above, 3 cm below the umbilicus, and the umbilicus border of the abdominal white line in the DRA group was significantly larger than that of the normal group (P < 0.05). Conclusion Ultrasound can accurately measure the inter-rectus distance and rectus thickness, accurately evaluate the degree of DRA, and realize the one-stop evaluation from prenatal diagnosis and prediction to postpartum rehabilitation monitoring, so as to intervene during pregnancy and reduce the risk of postpartum DRA.

Investigating the Efficacy of an 18-Week Postpartum Rehabilitation and Physical Development Intervention on Occupational Physical Performance and Musculoskeletal Health in UK Servicewomen: Protocol for an Independent Group Study Design.

BackgroundPostpartum women are at an increased risk of pelvic floor dysfunction, musculoskeletal injury, and poor psychological health and have reduced physical fitness compared to before pregnancy. There is no formal, evidence-based rehabilitation and physical development program for returning UK servicewomen to work following childbirth.ObjectiveThis study aims to examine the efficacy of a rehabilitation and physical development intervention for returning postpartum UK servicewomen to occupational fitness.MethodsEligible servicewomen will be assigned to a training or control group in a nonrandomized controlled trial 6 weeks after childbirth. Group allocation will be based on the location of standard pregnancy and postpartum care. The control group will receive standard care, with no prescribed intervention. The training group will start an 18-week core and pelvic health rehabilitation program 6 weeks post partum and a 12-week resistance and high-intensity interval training program 12 weeks post partum. All participants will attend 4 testing sessions at 6, 12, 18, and 24 weeks post partum for the assessment of occupational physical performance, pelvic health, psychological well-being, quality of life, and musculoskeletal health outcomes. Occupational physical performance tests will include vertical jump, mid-thigh pull, seated medicine ball throw, and a timed 2-km run. Pelvic health tests will include the Pelvic Organ Prolapse Quantification system, the PERFECT (power, endurance, repetitions, fast, every contraction timed) scheme for pelvic floor strength, musculoskeletal physiotherapy assessment, the Pelvic Floor Distress Inventory–20 questionnaire, and the International Consultation on Incontinence Questionnaire–Vaginal Symptoms. Psychological well-being and quality of life tests will include the World Health Organization Quality of Life questionnaire and the Edinburgh Postnatal Depression Scale. Musculoskeletal health outcomes will include body composition; whole-body areal bone mineral density; tibial volumetric bone mineral density, geometry, and microarchitecture; patella tendon properties; muscle architecture; muscle protein and collagen turnover; and muscle mass and muscle breakdown. Data will be analyzed using linear mixed-effects models, with participants included as random effects, and group and time as fixed effects to assess within- and between-group differences over time.ResultsThis study received ethical approval in April 2019 and recruitment started in July 2019. The study was paused in March 2020 owing to the COVID-19 pandemic. Recruitment restarted in May 2021. The results are expected in September 2022.ConclusionsThis study will inform the best practice for the safe and optimal return of postpartum servicewomen to physically and mentally demanding jobs.Trial RegistrationClinicalTrials.gov NCT04332757; https://clinicaltrials.gov/ct2/show/NCT04332757International Registered Report Identifier (IRRID)DERR1-10.2196/32315

EFFECTIVENESS OF RECOVERY OF THE PSYCHO-EMOTIONAL AND PHYSICAL STATUS OF WOMEN WHO HAVE SUFFERED A CAESAREAN SECTION BY MEANS OF PHYSICAL THERAPY

Purpose: to determine the influence of the developed program of physical therapy on the dynamics of the parameters of the psycho-emotional and physical status of women in the postpartum period after cesarean section.&#x0D; Methods. 112 women were examined after childbirth. The comparison group consisted of 47 women who gave birth naturally. The main group 1 consisted of 32 women who were given general recommendations for self-care in the postpartum period after cesarean section (hygiene, restriction of motor activity due to postoperative scarring, etc.), as they found desire to recover on their own. The main group 2 consisted of 33 women after cesarean section who underwent postpartum physical therapy for 12 months (kinesitherapy, abdominal bandage, kinesiology taping, abdominal massage and general; health nutrition, psychological relaxation, women's education). The basis of kinesitherapy was functional training (to normalize the motor stereotype, restore the muscles of the torso and limbs, posture) with reference to household movements for child care. During the first weeks after the cesarean section, the movements that contributed to the tension of the postoperative suture were restricted, and the facilitated starting positions were chosen. Women were taught the optimal dynamic stereotype with the prevention of overload during habitual movements - lifting, feeding the baby, carrying a stroller, and the like.&#x0D; Determination of psycho-emotional status (according to the Edinburgh Postnatal Depression Scale) and physical condition (according to the result of PWC170 and the value of VO2max) was carried out in the early and late postpartum periods; 6 and 12 months after birth.&#x0D; Results. In women in the late postpartum period, regardless of the type of delivery, there were signs of psycho-emotional depression (according to Edinburgh Postnatal Depression Scale), a decrease in physical performance (according to the results of PWC170), a deterioration in cardio-respiratory reserves (according to the VO2max value). Within a year after childbirth, there was a gradual improvement in the physical performance of women and the normalization of their psycho-emotional state, regardless of delivery and the implementation of active restorative interventions. The use of a physical therapy program starting from the early postpartum period after cesarean section revealed the advantages of the state of the psycho-emotional and physical state relative to women who underwent natural delivery and recovered after cesarean section on their own, already in the late postpartum period. 1 year after delivery, women who underwent cesarean section and performed the developed physiotherapy intervention showed a statistically significantly better result according to Edinburgh Postnatal Depression Scale, PWC170, VO2max compared with women who underwent vaginal delivery and recovered from cesarean section on their own. Women who had cesarean section but recovered on their own with general advice failed to reach the levels of women who gave birth by vaginal birth and women who underwent a physical therapy program in physical performance tests 1 year postpartum.&#x0D; Conclusions. Physical therapy means should be prescribed from the first day of postpartum rehabilitation to improve the psycho-emotional state and increase the physical performance of women.

Evaluation on the Advantages of Health Education in Postpartum Rehabilitation Nursing of Primiparas

Evaluation on the Advantages of Health Education in Postpartum Rehabilitation Nursing of Primiparas