Exercises to Enhance Uterus Involution

Bitlis Eren University45 enrolled

Overview

The goal of this randomized controlled study was to compare the effect of aerobic exercise and pelvic floor muscle strengthening exercises on uterus involution. In the scope of study following questions will be answered at the end of the study. First which of the exercise type is more effective to enhance uterus involution? Secondly, does exercises induce changes in lactation rate during the study period? Thirdly, does exercises improve the experienced pain? Study will be consisted of three groups as control group, pelvic floor exercise group and aerobic exercise group. Control group will take routine gynaecological treatment. Pelvic floor muscle strengthening exercise group will attend to seven day pelvic floor strengthening exercise programme. Aerobic exercise group will attend to seven day aerobic exercise programme consisting of walking.

A total of 45 mothers who satisfies the eligibility criteria of the study will be recruited to the study. Following to the recruitment process mothers will be randomly assigned to the one of the three groups. Mothers in the control group will only take routine gynecologic treatment. Mothers in the aerobic exercise group will attend to aerobic exercises starting from the second day of the hospitalization for one week. Mothers who will be in pelvic floor strengthening exercise group after the randomization will be asked to perform six exercises with moderate difficulty that are recommended by the national association for incontinence.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Uterus Involution

Eligibility

Sex: FEMALEMin age: 19 YearsMax age: 35 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Age of 19 to 35 years * New born APGAR score is equal or higher than 8 * First pregnancy * Giving birth in 37th to 40th weeks of the pregnancy * Birthweight ranging from 2500 g to 4000 g Exclusion Criteria: * Eclampsia * Puerperal psychosis * Severe preeclampsia * Multiple pregnancy story * Uterus abnormality story * Uterus surgery story * Use of artificial estrogen * Existence of systemic, mental or pregnancy related diseases * Occurrence of complication during or after the pregnancy * Symptoms of uterus subinvolution

Outcomes

Primary Outcomes

Uterus involution

To assess the uterus involution uterus volume, uterus diameters and thickness will be measured with ultrasound imaging. Ultrasound imaging will be performed in dorsal lithotomy position, without uterus activation, and with minimal uterus fullness. Uterus volume calculation will be performed with this formula: uterus anteroposterior diameter x uterus transverse diameter x uterus longitudinal diameter x 0.45.

Time frame: Change from baseline uterus involution at one week

Existence and Severity of Pain

Pain will be assessed with visual analog scale (VAS). VAS consists of 10 cm horizontal line. At the one edge of the line 0 point is located meaning no pain, at the other edge 10 point is located meaning worst pain. Mothers will be asked to mark the point matching to their perceived pain. Minimal clinical significance of VAS is reported to be 1.1 or 1.2 cm. VAS and ultrasound imaging will be performed in first, second and eighth days of the study.

Time frame: Change from baseline pain at one week

Secondary Outcomes

Elapsed time from giving birth to first lactation

Elapsed time will be recorded in minutes from giving birth to first lactation

Time frame: First day of the study

Daily Lactation Time

Daily lactation time and frequency will be calculated based on the mothers' reports.

Time frame: Change from baseline daily lactation time at one week

Daily Lactation Frequency

Daily lactation frequency will be calculated based on the mothers' reports.

Time frame: Change from baseline daily lactation frequency at one week