• The effectiveness of a multimedia exercise programme among postpartum women with lumbopelvic pain in Taiwan

      Tseng, Pei-Ching (University of BedfordshireUniversity of Bedfordshire, 2018-12)
      Background: A substantial number of women are affected by Lumbo Pelvic Pain (LPP) follow-ing pregnancy and childbirth. Physical exercise is indicated as a beneficial method to relieve LPP, but individual studies appear to suggest mixed findings relating to its effectiveness and do not provide sufficient evidence on their own to warrant definite conclusions about effec-tiveness. Studies examining the effectiveness of different modes of exercise instruction for postpartum women for LPP are sparse. Aim: The aim of the study was to synthesise the evidence relating to the effectiveness of var-ious exercise programmes on LPP and to assess the effectiveness and acceptability (uptake, adherence and completion rate) of an exercise programme delivered using Digital Versatile Disc (DVD), the Internet or leaflet (usual care), on LPP among postnatal women in Taiwan. Methods: Phase 1: a systemic review of randomised controlled trials (RCTs) published be-tween January 1990 and July 2014 was conducted by searching several databases, electronic libraries and grey literature. Phase 2: a primary study (pragmatic randomised controlled trial) design with two intervention groups and a control group with outcomes measured at dis-charge period (as baseline), six weeks and four months follow-ups. The outcomes of LPP, physical endurance, exercise uptake, adherence and completion rate across the three modes of delivery were assessed. Findings: Phase 1 of the systematic review established that four RCTs met the selection crite-ria, involving 251 postnatal women. The trials included physical exercise programmes with varying components, differing modes of delivery, follow up times and outcome measures. Intervention in one trial, involving physical therapy with specific stabilising exercises, proved to be effective in reducing LPP intensity. An improvement in gluteal pain on the right side was reported in one trial and a significant difference in pain frequency in another. Phase 2 PRCT study: Of 213 pregnant women with LPP recruited, 158 took part in the trial. The women reported significant reduction in LPP in the Internet-based group (pain in the past week, p< 0.005) at six weeks postpartum. Physical endurance of DRI outcome revealed a significant result in the DVD-based group at six weeks postpartum (standing bent over a sink (p<0.008)). Acceptability of exercise interms of completion rate, adherence and uptake was not significantly different between the three groups; even though the Internet-based group undertook exercise more frequently. Conclusion: The systematic review revealed that only a few RCTs evaluated the effectiveness of exercise on LPP, and there is variability in the components of the exercise programmes, modes of delivery, follow up times and outcome measures. The trial determined that the Internet-based postpartum exercise programme was effective in reducing pain and the DVD-based exercise programme in improving disability status, in women with LPP post-pregnancy. However, the Internet-based instruction increased adherence to exercise in postpartum women. The findings have implications for developing appropriate intervention programmes.