Postnatal exercise interventions: a systematic review of adherence and effect
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Author(s)
Mullins, Edward
Sharma, shalini
McGregor, Alison
Type
Journal Article
Abstract
Objective to evaluate adherence to and effect of postnatal physical activity (PA) interventions.
Design systematic review of PA intervention randomised controlled trials in postnatal women. The initial search was carried out in September 2018, and updated in January 2021.
Data sources Embase, MEDLINE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases, hand-searching references of included studies. The 25 identified studies included 1466 postnatal women in community and secondary care settings.
Eligibility criteria studies were included if the PA interventions were commenced and assessed in the postnatal year.
Data extraction and synthesis data was extracted using a pre-specified extraction template and assessed independently by two reviewers using Cochrane ROB 1 tool.
Results 1413 records were screened for potential study inclusion, full-text review was performed on 146 articles, 25 studies were included. The primary outcome was adherence to PA intervention. The secondary outcomes were the effect of the PA interventions on the studies’ specified primary outcome. We compared effect on primary outcome for supervised and unsupervised exercise interventions. Studies were small, median N= 66 (20-130). PA interventions were highly variable, targets for PA per week ranged from 60 -275 minutes per week. LTFU was higher (14.5% vs 10%) and adherence to intervention was lower (73.6% vs. 86%) for unsupervised vs. supervised studies.
Conclusions studies of PA interventions inconsistently reported adherence and LTFU. Where multiple studies evaluated PA as an outcome, they had inconsistent effects, with generally low study quality and high risk of bias. Agreement for effect between studies was evident for PA improving physical fitness and reducing fatigue. Three studies showed no adverse effect of physical activity on breast feeding. High-quality research reporting adherence and LTFU is needed into how and when to deliver postnatal PA interventions to benefit postnatal physical and mental health.
Registration number PROSPERO CRD42019114836
Design systematic review of PA intervention randomised controlled trials in postnatal women. The initial search was carried out in September 2018, and updated in January 2021.
Data sources Embase, MEDLINE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases, hand-searching references of included studies. The 25 identified studies included 1466 postnatal women in community and secondary care settings.
Eligibility criteria studies were included if the PA interventions were commenced and assessed in the postnatal year.
Data extraction and synthesis data was extracted using a pre-specified extraction template and assessed independently by two reviewers using Cochrane ROB 1 tool.
Results 1413 records were screened for potential study inclusion, full-text review was performed on 146 articles, 25 studies were included. The primary outcome was adherence to PA intervention. The secondary outcomes were the effect of the PA interventions on the studies’ specified primary outcome. We compared effect on primary outcome for supervised and unsupervised exercise interventions. Studies were small, median N= 66 (20-130). PA interventions were highly variable, targets for PA per week ranged from 60 -275 minutes per week. LTFU was higher (14.5% vs 10%) and adherence to intervention was lower (73.6% vs. 86%) for unsupervised vs. supervised studies.
Conclusions studies of PA interventions inconsistently reported adherence and LTFU. Where multiple studies evaluated PA as an outcome, they had inconsistent effects, with generally low study quality and high risk of bias. Agreement for effect between studies was evident for PA improving physical fitness and reducing fatigue. Three studies showed no adverse effect of physical activity on breast feeding. High-quality research reporting adherence and LTFU is needed into how and when to deliver postnatal PA interventions to benefit postnatal physical and mental health.
Registration number PROSPERO CRD42019114836
Date Issued
2021-09-30
Date Acceptance
2021-08-20
Citation
BMJ Open, 2021, 11 (9), pp.1-10
ISSN
2044-6055
Publisher
BMJ Journals
Start Page
1
End Page
10
Journal / Book Title
BMJ Open
Volume
11
Issue
9
Copyright Statement
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Identifier
https://bmjopen.bmj.com/content/11/9/e044567
Subjects
obstetrics
public health
sports medicine
1103 Clinical Sciences
1117 Public Health and Health Services
1199 Other Medical and Health Sciences
Publication Status
Published
Date Publish Online
2021-09-30