Effects of Pilates Exercises on Postpartum
Condition: Postpartum Disorder
MeSH terms: Puerperal Disorders
Study type: Interventional

Summary: 
      The postpartum period for the family is the period of adjustment in which a new order is
      established due to adding a new member to the family. For the mother, this period is a
      transitional period in which she has to adapt to her baby, postpartum disorders, the new
      order in the family, and changes in body image. Inactivity is common in today's world;
      increases the risk of various problems in new mothers. These problems negatively affect
      women's depression, functional level, sleep quality, and quality of life in the postpartum
      period. The Pilates method, developed by Joseph Pilates under the name of "Contrology," is
      the most well-known exercise method in the world for babies and mothers among today's
      exercise programs since it is an exercise method in which all systems, spirit, and body are
      integrated and coordinated, considering the whole physiological process.

      This study aims to understand how depression, loss of functionality, sleep quality,
      functional levels, and quality of life levels of women who do pilates exercises with a
      physiotherapist are affected in the postpartum period.
    

Detailed description: 
      The investigators conducted the study at Ankara Medipol University, Faculty of Health
      Sciences, Department of Physical Therapy and Rehabilitation. This study was conducted by the
      principles set out in the Declaration of Helsinki. Fifty postpartum women aged 25-38 will be
      included in the study.

        -  Procedures The investigators assessed the participants by an experienced
           physiotherapist, who was blind to the randomization, at the start of the study and after
           the 8-week training. The group on which they depended was not disclosed to the
           participants until the end of the baseline evaluation. The investigators used a computer
           program for randomization and randomly placed individuals who completed the initial
           assessment into the pilates group (PG) or control group (CG). The investigators
           performed the Pilates exercises under the supervision of a certified physiotherapist
           with ten years of experience. The investigators asked the individuals not to inform the
           evaluator of their involvement in the training during the last evaluation. Before the
           study, the investigators explained the purpose and content of the survey to the
           participants and obtained written informed consent from all pregnant women to
           participate in the study.

      Pilates training was done by an Australian Pilates and Physiotherapy Institute certified and
      experienced Ph.D. Physiotherapist Halil Ibrahim Bulguroglu lasted eight weeks, two days a
      week for one h. The investigators divided the individuals in the Pilates exercise group into
      two smaller groups of 12 or 13 to verify whether they correctly did the exercises. In this
      study, the investigators organized a program to include 15 min of warm-up, 30 min of Pilates
      exercises, and 15 min of cooling and stretching exercises. The exercises were done in 10
      repetitions. The exercise program recommended by the Australian Pilates and Physiotherapy
      Institute during postpartum was used in training. During the Pilates exercises, investigators
      described the activities with different visual simulation techniques, and exercises were done
      together with Pilates breathing. The intensity of the exercises was increased by using
      different positions and elastic bands. The resistance was increased by starting with the red
      Therabant and switching to the blue band after two weeks. If the new resistance amount was
      challenging for the patient, the exercises were continued with the same color band for one
      more week. Stretching exercises and posture exercises were used during the cooling period.
      The subjects in the online pilates group were informed about side effects such as shortness
      of breath, dizziness, headache, muscle pain, and weakness. They were asked to stop exercising
      when there were any side effects.

      -Statistical analysis The investigators will perform statistical analysis using SPSS
      software, version 21 (SPSS Inc. Chicago, IL, USA). The normal distribution of variables will
      be determined using histograms, probability plots, and a Shapiro-Wilk test. Because of an
      abnormal distribution, median and interquartile range (IQR) were used for descriptive
      statistics. Numerical variables showing normal distribution were shown as mean±standard
      deviation. The investigators will use a Mann-Whitney U test to compare baseline and change
      values between groups. The investigators will use Wilcoxon Test to compare baseline values
      within the group and values after eight weeks. The significance level will be set at p < 0.05
      for all analyses.
    

Intervention name(s): Pilates Training; breathing and relaxation exercises
Intervention type(s): Other; Other
Intervention description(s): The group that received pilates training.; The group who received breathing and relaxation exercises with a home program.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Using a computer program, the investigators randomly placed individuals who completed the initial assessment into the pilates group or control group.
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Pilates exercises; depression; sleep quality