Effects of an 18-week postpartum rehabilitation and physical development intervention on occupational physical performance in UK servicewomen

Abstract

Abstract Physiological and psychological changes following childbirth can increase injury risk, and reduce physical performance in servicewomen, yet evidence to inform guidelines for preparing postpartum servicewomen to return to military service is limited. This study examined the efficacy of a rehabilitation and physical development intervention for returning servicewomen to occupational fitness postpartum. UK-based servicewomen were assigned to a training (INT; N  = 17) or control (CON; N  = 14) group 6-weeks postpartum in a non-randomised controlled trial. CON received standard postpartum care, whilst INT received standard care plus an 18-week rehabilitation (core and pelvic floor exercises) and supervised physical development (resistance training and HIIT) programme. Participants were assessed between 6 and 24 weeks postpartum for occupational performance (primary outcome) and pelvic health, psychological well-being, and musculoskeletal health (secondary outcomes). 11 INT and 9 CON participants completed all visits. INT participants demonstrated high adherence to core reconnection and physical development training (96%) and reported no adverse events. Significant group x time interactions favouring INT were shown for occupational performance outcomes, including mid-thigh pull, vertical jump, and 2 km run time-trial (all p  ≤ 0.05, 12.7–14.5% improvements), but not for medicine ball throw ( p  = 0.643). INT had superior improvements over CON in body composition, pelvic health, and psychological well-being (all p  < 0. 05). A combined rehabilitation and physical development programme was well-adhered to, did not result in any adverse events, and was more effective than standard postpartum care in improving occupational performance, pelvic health, body composition, and psychological well-being amongst servicewomen. These findings help inform best-practice guidelines for returning postpartum servicewomen to occupational fitness. Trial registration:  ClinicalTrials.gov NCT04332757, Date 05/2021.