Orthopaedic Manual Physical Therapy as Part of the Postpartum Care Continuum
NCT Number: NCT06560190
Status: RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Postpartum|Pregnancy Related
Interventions: OTHER: Orthopaedic Manual Physical Therapy
Sponsor: Brooke Army Medical Center
Sex: FEMALE
Age: ADULT
Enrollment: 58
Study Design: Allocation: NA|Intervention Model: SINGLE_GROUP|Masking: NONE|Primary Purpose: TREATMENT
Start Date: 2024-04-08
Completion Date: 2025-07-05
Locations: Brooke Army Medical Center, San Antonio, Texas, 78234, United States

Summary:
Data shows us that injury risk increases in the first year postpartum. There is a paucity of literature regarding MSK injuries in postpartum military women. A unique challenge that postpartum service members face is the increased stress of training for and having to pass a physical fitness test directly tied to their career advancement.

While there is epidemiological data across multiple branches of service, there is a gap in the literature in terms of how to appropriately address these decreased fitness levels and better understand the root causes. American College of Gynecology (ACOG) recommends that the postpartum visit include actionable information on return to physical activity. However, a large majority of women report receiving no guidance on how to engage in physical activity during pregnancy and in the postpartum period.

Physical therapy is commonly used to help individuals return to physical activity following orthopaedic surgeries, but it is not frequently utilized to assist the postpartum population in progressing back to physical activity. Orthopaedic Manual Physical Therapists (OMPTs) are uniquely trained to address musculoskeletal symptoms and progress physical activity. An OMPT evaluation and treatment could facilitate increased physical activity and improve health-related quality of life, supporting the ACOG recommendation to make postpartum care an ongoing multidisciplinary process.

Primary Outcome Measures: 36-Item Short Form Survey Instrument (SF36), The 36-Item Short Form Survey Instrument (SF 36) is the most widely used quality of life tool in the postpartum population. The lowest score on each subscale is zero and the highest score on each subscale is 100. A higher score is better., Baseline, 4 weeks and 8 weeks
Secondary Outcome Measures: International Physical Activity Questionnaire- Short Form (IPAQ), We will use the International physical activity questionnaire short form to assess physical activity level. The lowest score is zero and the highest score is not identified although scores over 16 hours of physical activity per day should be excluded as an outlier. A higher score is better., Baseline, 4 weeks and 8 weeks|Numeric Pain Rating Scale (NPRS), The Numeric Pain Rating Scale (NPRS) will be used to measure pain.The lowest score is 0 and the highest score is 10. A lower score is better., Baseline, 4 weeks and 8 weeks|Cozean Pelvic Dysfunction Screening Protocol, Orthopaedic physical therapists should utilize the Cozean protocol to screen which patients need a pelvic floor rehab referral following the DHA practice recommendation for Pelvic Health and Postpartum Rehabilitation Services. The lowest score is zero and highest score is 10. A higher score does not indicate more dysfunction. A cutoff of 3 is applied to indicate a referral is needed for pelvic floor physical therapy., Baseline, 4 weeks and 8 weeks|Edinburgh Postnatal Depression Scale (EPDS), This tool will be used in accordance with the DHA Practice Recommendation for Behavioral Health Screening and Referral in Pregnancy and Postpartum at the initial evaluation to screen for depression in postpartum patients. The lowest score is zero and highest score is thirty. A higher score is worse and indicates need for behavioral health referral., Baseline