United States military service members are required to maintain a requisite level of physical fitness. Women in the US Army are exempt from fitness standards for the 1st 6 months postpartum. While many women successfully meet the minimum standards 6 months postpartum, the time course necessary to re-attain pre-pregnancy fitness levels is unknown. PURPOSE: To determine the time course necessary to re-attain pre-pregnancy physical fitness, as determined via the Army Physical Fitness Test (APFT), in a cohort of postpartum US Army women. METHODS: 236 primagravid active duty Army women who delivered at Tripler Army Medical Center between 1 Jan 2011 and 31 March 2017 were eligible for inclusion. APFT data (push-up and sit-up repetitions, 2 mile run time) were obtained from the Digital Training Management System; the last test prior to and all available tests postpartum were used for analysis. Data were analyzed with repeated measures ANOVA and Fisher’s exact test. RESULTS: The number of postpartum APFTs available for analysis ranged from 1 to 6 per individual. Follow-up time ranged from 4.5 to 72 months postpartum. During the last pre-pregnancy APFT push-up, sit-up and 2 mile run scores were 39.2±11.6 reps, 68.2±11.5 reps and 17.1±1.8 min, respectively. 6 months post-partum, push-up and sit-up scores were lower and run time was significantly longer (34.1±11.1, 61.5±12.5 and 18.0±1.8, respectively; p<0.01 for all). While scores gradually progressed towards pre-pregnancy levels, pre-pregnancy fitness was not re-attained during the study period. By 30 months postpartum push-up reps, sit-up reps and run times were 36.7±12.4, 66.6±12.8 and 17.7±1.7, respectively, p<0.01 vs pre-pregnancy for all. The failure rate for the APFT was 3.8% pre-pregnancy, 14.2% at the first postpartum APFT and ranged from 7.7-9.9% for all time points thereafter. CONCLUSIONS: These data indicate that the postpartum US Army servicewoman fails to return to pre-pregnancy fitness levels, when followed for up to 72 months. While a majority of the women meet minimum fitness standards, ~8-10% did not. The causal factors underlying these results are unknown. However, as ~25% of women had higher scores at the first postpartum APFT vs pre-pregnancy, it is possible to re-attain pre-pregnancy fitness levels.
Read full abstract