COMPARATIVE ROLES OF SUPERVISED ABDOMINAL EXERCISE MODES IN EFFECTING FLAT ABDOMEN ON WOMEN AFTER CHILDBIRTH

Background: Post-delivery flabby abdominal muscles present undesirable clumsiness, weakness and compromised function, especially in the subsequent pregnancies. This condition has become a serious source of concern to mothers who hope that their fitness will help them expedite postnatal recovery. Most women desire per-pregnancy body shape after childbirth and more often than not make conscious efforts to reduce such undesired bulk. Apart from good cosmetic appearance most women engage in different forms of exercises in order to keep fit and healthy.

Purpose: Women under study located in Ebonyi State, Southeastern Nigeria lack sufficient awareness on the use of guided exercises to flatten postnatal abdomen. Popular postnatal practices among this population include subjective strapping of abdominal segment and intermittent prone lying. While these traditional practices appear to serve their purpose, they are indeed restrictive and may lead to unevaluated abdominal muscle atrophy and weakness. This study was undertaken to assess the efficacy of two modes of exercises in bringing about flat abdomen among postpartum women, with the aim to enhancing abdominal action which will engender muscle strength and effect retraction.

Methods: The study was a single blinded randomized control trial. Sixty women of four to eight weeks postpartum who attended antenatal classes at the Federal Teaching Hospital Abakaliki, met inclusion criteria and consented to the study were randomly assigned into four groups of 15 participants each in isometric, isotonic and combined isometric/isotonic abdominal exercise modes as well as control, placed on routine calf exercises. For each participant, both baseline and weekly post-exercise abdominal girths were measured and recorded for six consecutive weeks, using a portable electronic myotape device. Independent t test was utilized to draw comparison of baseline means of all four groups for all variables. A group/time ANOVA with repeated measures on time factor compared means of retraction scores.

Results: Findings showed significant decrease (p< 0.05) in the mean abdominal girth across the groups, except control, at the third to sixth weeks. The periodic difference in mean abdominal flattening between multigravidas and primigravidas was found to be statistically significant (p< 0.05). The mean abdominal retraction index (Ri ≥ 50%) was achieved by all groups except the control, at different periods, underscoring response levels to different exercise modes. In all, combined isotonic/isometric group achieved retraction benefit earlier than other groups. This mode represents a leading clinical option when strategizing for remedy in flabby abdomen among mothers.

Conclusion(s): From the outcome of this research it can be concluded that exercise is a viable noninvasive option for women who desire to flatten flabby abdomen, especially after childbirth. However, further randomized clinical trials utilizing additional outcome measures such as electromyography results of the abdominal muscles would give additional information.  

Implications: Physiotherapists should integrate combination of isometric and isotonic exercises in strengthening abdominal muscles during postnatal exercise classes, as this may benefit clients. Clinicians may prognosticate therapeutic effects of abdominal strengthening exercises of postpartum mothers from third week. There is therefore the need for clients to be encouraged that expected effects may not be instantaneous.

Funding, acknowledgements: This research was fully self-funded.

Keywords: Flabby abdomen, Exercises, Postpartum

Topic: Research methodology, knowledge translation & implementation science

Did this work require ethics approval? Yes

Institution: Federal Teaching Hospital Abakaliki, Ebonyi State, Nigeria

Committee: Ethics and Institution Review Committee

Ethics number: FETHA/HEC/218/VOL 3