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Physical therapy exercise program lowers postnatal depression risk

Posted Apr 02 2010 12:00am

APTA.org - A physical therapy exercise program with health education is effective in improving postnatal well-being and reducing the risk for postpartum depression, or postnatal depression (PND), according to a randomized controlled trial published in the March 2010 issue of Physical Therapy, (PTJ) the scientific journal of the American Physical Therapy Association (APTA).

Postnatal depression (PND) is a major health issue affecting up to 13 percent of all new mothers throughout the world, with most cases beginning in the first 3 months of the postnatal period. Although its duration varies among mothers, it is thought to be determined by sociocultural factors, such as self-esteem of the mother, the childbirth experience, and the availability of support and local services [1].

Previous studies have shown that general exercise improves mood states in younger[2] and older women[3], improves well-being[4], and leads to a reduction in depressive symptoms in mothers diagnosed with post-natal depression[5]. However, no studies have evaluated the benefits of group physical therapy exercise approaches to improve psychological health outcomes of women postnatally.

“Giving birth involves many changes in a woman’s physical, emotional, and social health,” said Mary P. Galea, BAppSci (Physio), BA, PhD, Professor of Clinical Physiotherapy in the School of Physiotherapy at the University of Melbourne, Victoria, Australia, one of the authors of this study. “A group exercise program led by a physical therapist, who is an expert in improving and restoring motion to people’s daily lives, can help mothers who may be at risk for PND improve their well-being and enable them to better care for their children.”

In this study, 161 English-speaking women who were being discharged from the postnatal ward of The Angliss Hospital were randomly assigned to an experimental Mother and Baby (M&B) Program or an education only (EO) group. Once a week for 8 weeks the M&B group, comprised of 62 women, undertook 1 hour of exercise with their babies, facilitated by a women’s health physical therapist, combined with 30 minutes of parenting education delivered by health care professionals. Seventy-three women were assigned to the EO group and received only the same written educational materials. Twenty-six of the women did not receive either of the allocated interventions.

Results revealed there was significant improvement in well-being scores and depressive symptoms of the M&B group compared with the EO group over the study period. More specifically, there was a significant positive effect on well-being scores and depressive scores at 8 weeks, and this score was maintained 4 weeks after completion of the program. The number of women identified as at risk for postnatal depression pre-intervention was reduced by 50 percent by the end of the intervention.

The primary outcome measure was a psychological well-being scale called the Positive Affect Balance Scale. This 10-question scale indicates psychological reactions of people in the general population to events in their daily lives. Participants also completed the Edinburgh Postnatal Depression Scale and answered questions regarding the amount of physical activity performed each week. These outcome measures were assessed at baseline, after 8 weeks, and then 4 weeks later.

References:

1) Milgrom J, et al. Treating Postnatal Depression: A Psychological Approach for Treating Health Care Practitioners. London, United Kingdom: John Wiley & Sons Ltd; 1999.

2) Annesi JJ. Mood states of formerly sedentary younger and older women at weeks 1 and 10 of a moderate exercise program. Psychol Rep. 2004;94(3 pt 2):1337–1342.

3) Lee C, Russell A. Effects of physical activity on emotional well-being among older Australian women: cross-sectional and longitudinal analyses. J Psychosom Res. 2003;54:155–160.

4) Berger BG, Motl RW. Exercise and mood: a selective review and synthesis of research employing the profile of mood states. J App Sport Psychol. 2000;12:69–92.

5) Armstrong K, Edwards H. The effects of exercise and social support on mothers reporting depressive symptoms: a pilot randomized controlled trial. Int J Mental Health Nurs. 2003;12:130–138.

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