REALITIES OF POSTPARTUM WOMEN'S PERCEPTIONS OF PHYSICAL FITNESS, LOCOMOTIVE FUNCTIONS AND FATIGUE AND NERVOUSNESS

T. Araki^1,2,3, J. Noguchi⁴, K. Yamasaki⁴, S. Sugiyama⁴, E. Aota², A. Hirose²

Background: Postpartum women complain of a variety of physical complaints such as low back pain and urinary incontinence. However, there are few reports on the relationship between the symptoms and physical fitness. Also, self-reported physical and mental health status is necessary for recovery, but its actual condition among postpartum women is not clear.

Purpose: The purpose of this study was to examine postpartum women’s physical fitness and locomotive function relating to their self-reported fatigue and mental health status.

Methods: A questionnaire and physical fitness test were administered to postpartum women. The questionnaire asked about basic attributes, pregnancy and childbirth history, and the presence of pain and fatigue in postpartum.  To determine physical fitness level, we conducted the two-step test and the standing test from the locomotive syndrome risk test (Japanese Orthopedic Association), also measured the grip strength and the seated forward bending from the New Physical Fitness Test (Japan Sports Agency).  Self-reported fatigue and nervousness were measured by the Shitsu-taikan-sho-Scale (STSS, Oka et al., 2019), developed as a rating index for alexisomia. Mobility difficulties were measured by 25-question geriatric locomotive function scale (GLFS-25, Japanese Orthopedic Association).  For statistical analysis, Spearman's rank correlation coefficient was calculated for each item. We also divided the participants into two groups based on the presence or absence of pain and fatigue, then compared each measurement item between the groups.  The significance level for both analyses was set at 5%. The study was conducted with the approval of the Research Ethics Review Committee of Palmore Hospital (2019-1).

Results: Thirty-five participants participated in the study. The summary of participants was 35.9 ± 4.2 years of age, 1.3 ± 0.6 births, and 23.8 ± 31.1 months elapsed from the first birth.  Pain was the most common symptom experienced during the first year after delivery (77.1%), chronic fatigue (51.4%) and urinary incontinence (20.0%). The correlations between age, physical fitness (grip strength, seated forward bending, two-step test and stand-up test) and STSS showed significant negative correlations (r=-.343, p=0.044) only in the standing test and STSS LHM (lack of health management based on bodily feelings).  In addition, the pain group had more births and a longer time since the first birth, and also different types of symptoms were claimed. In the fatigue group, different types of symptoms were claimed, and the GLFS-25 value was high.

Conclusion(s): The correlation between physical fitness and STSS were limited.  Also, there was limited correlation in symptoms and physical fitness or STSS.  The tendency of correlation in the presence of self-reported pain or fatigue and physical fitness or STSS showed similar result, and we concluded that symptoms, physical fitness, and self-reported fatigue and tension need to be evaluated separately.

Implications: An understanding of the physical and mental health status of the patient is necessary for healthy recovery after childbirth.  A more specific understanding of physical and mental health status will lead to appropriate interventions in physiotherapy and considered to be significant for physiotherapy research.

Funding, acknowledgements: This study was supported by a research grant from the Kanagawa Physical Therapy Association in 2019.

Keywords: postpartum, physical fitness, alexisomia

Topic: Pelvic, sexual and reproductive health

Did this work require ethics approval? Yes

Institution: Palmore Hospital

Committee: The Research Ethics Review Committee

Ethics number: 2019-1