Pilates Egzersizlerinin Doğum Sonu Dönemde Depresyon ve Uyku Kalitesine Etkisi: Randomize Kontrollü Bir Çalışma

Öz

Amaç: Doğum sonrası dönem kadınlar için en kritik süreçlerden biridir. Bu süreçte kadın vücudunda birçok değişiklik meydana gelir. Egzersiz, bu değişiklikleri yönetmenin en kolay yöntemidir. Çalışmamız, pilates egzersizi yapan kadınların doğum sonrası depresyon, uyku kalitesi ve fonksiyonel düzeylerinin nasıl etkilediğini anlamayı amaçlamaktadır. Gereç ve Yöntemler: Randomize kontrollü çalışmamızda, 25-38 yaş arası, tek bebeği olan 28 pilates ve 29 kontrol grubunda rastgele olacak şekilde 57 postpartum gönüllü kadın dahil edildi. Pilates grubuna 12 hafta boyunca haftada iki gün, günde bir saat fizyoterapist tarafından pilates egzersizleri verildi. Kontrol grubuna gevşeme ve nefes egzersizlerinden oluşan 12 haftalık ev programı verildi. Çalışma öncesi ve sonrasında doğum sonrası depresyon; Edinburgh Postpartum Depresyon Ölçeği ile (EPDÖ), uyku kalitesi; Postpartum Uyku Kalitesi Ölçeği (PUKÖ) ve fonksiyonel düzey; Doğum Sonrası Fonksiyonel Durum Envanteri (DSFDE) ile değerlendirildi. Bulgular: Pilates grubunda EPDÖ (8,71±1,42’ye karşı 7,06±1,21, p=0,001), PUKÖ (25,69±3,40’a karşı 22,91±3,04, p=0,001), DSFDE (2,47±0,41’e karşı 2,93±0,21, p=0,001) skorlarında istatistiksel olarak anlamlı iyileşmeler gözlendi. Kontrol grubu depresyon düzeylerinde anlamlı fark göstermezken (8,85±1,50’ye karşı 8,95±1,23, p=0,479), uyku kalitesi (26,17±3,41’e karşı 27,59±2,94, p=0,009) ve doğum sonrası fonksiyonel düzey parametrelerinde istatistiksel olarak bozulmalar gözlendi (2,65±0,42’ye karşı 2,48±0,46, p=0,016). Sonuç: Sonuçlar, doğum sonrası dönemde uygulanan 12 haftalık pilates egzersizlerinin kadınların postpartum fonksiyonel düzeylerini, depresyon düzeylerini ve uyku kalitelerini iyileştirebileceğini göstermiştir.

Anahtar Kelimeler

• Pilates egzersizleri
• Postpartum dönem
• Postpartum depresyon
• Uyku kalitesi

Effects of Pilates Exercises to Depression and Sleep Quality on the Postpartum Period: A Randomized Controlled Study

Öz

Aim: Postpartum is one of the most critical processes in women. Many changes occur in the female body during this process. Exercise is the easiest method to manage these changes. Our study aimed to understand how postpartum depression, sleep quality, and functional levels affect women who perform pilates exercises. Material and Methods: In this randomized controlled study, 57 postpartum volunteer women between six weeks and six months, aged 25-38, with a single baby, were randomly included in 28 pilates and 29 control groups. The pilates group was given pilates exercises for one hour a day, two days a week for 12 weeks, by a physical therapist. The control group was given a home program consisting of relaxation and breathing exercises. Before and after the study, depression was evaluated using the Edinburgh Postpartum Depression Scale (EPDS), sleep quality, the Postpartum Sleep Quality Scale (PSQS), and postnatal functional levels, the Inventory of Functional Status After Childbirth (IFSAC) was evaluated using the questionnaire form-filling method. Results: EPDS (8.71±1.42 versus 7.06±1.21, p=0.001), PSQS (25.69±3.40 versus 22.91±3.04, p=0.001), IFSAC (2.47±0.41 versus 2.93±0.21, p=0.001) scores statistically significant improvements were observed in pilates group. While the control group did not show a significant difference in depression levels (8.85±1.50 versus 8.95±1.23, p=0.479), statistically worsening of sleep quality (26.17±3.41 versus 27.59±2.94, p=0.009) and postpartum functional level parameters were observed (2.65±0.42 versus 2.48±0.46, p=0.016). Conclusion: The results showed that 12-week pilates exercises applied during the postpartum period could improve postpartum women’s functional levels, depression levels, and sleep quality.

Anahtar Kelimeler

• Pilates exercises
• postpartum period
• postpartum depression
• sleep quality

Kaynakça

1. 1. Asadi M, Noroozi M, Alavi M. Identifying women’s needs to adjust to postpartum changes: A qualitative study in Iran. BMC Pregnancy Childbirth 2022;22(1):115.
2. 2. Ghanbari-Homayi S, Fardiazar Z, Meedya S, Mohammad- Alizadeh-Charandabi S, Asghari-Jafarabadi M, Mohammadi E, Mirghafourvand M. Predictors of traumatic birth experience among a group of Iranian primipara women: A cross sectional study. BMC Pregnancy Childbirth 2019;19(1):1-9.
3. 3. Norhayati MN, Hazlina NH, Asrenee AR, Emilin WM. Magnitude and risk factors for postpartum symptoms: A literature review. J Affect Disord 2015;175:34-52.
4. 4. Ghaedrahmati M, Kazemi A, Kheirabadi G, Ebrahimi A, Bahrami M. Postpartum depression risk factors: A narrative review. J Educ Health Promot 2017;6:60.
5. 5. Posmontier B. Functional status outcomes in mothers with and without postpartum depression. J Midwifery Womens Health 2008;53(4):310-318.
6. 6. McBean AL, Kinsey SG, Montgomery-Downs HE. Effects of a single night of postpartum sleep on childless women’s daytime functioning. Physiol Behav 2016;156:137-147.
7. 7. Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, Hazen N, Herman J, Katz ES, Kheirandish-Gozal L, Neubauer DN, O’Donnell AE, Ohayon M, Peever J, Rawding R, Sachdeva RC, Setters B, Vitiello MV, Ware JC, Adams Hillard PJ. National Sleep Foundation’s sleep time duration recommendations: Methodology and results summary. Sleep Health 2015;1(1):40-43.
8. 8. Montgomery-Downs EH, Stremler R, Insana PS. Postpartum sleep in new mothers and fathers. Open Sleep J 2013;6(1):87- 97.

9. 9. Saxbe DE, Schetter CD, Guardino CM, Ramey SL, Shalowitz MU, Thorp J, Vance M. Sleep quality predicts persistence of parental postpartum depressive symptoms and transmission of depressive symptoms from mothers to fathers. Ann Behav Med 2016;50(6):862-875.
10. 10. Warren LP. First-time mothers: Social support and confidence in infant care. J Adv Nurs 2005;50(5):479-488.
11. 11. Fathi F, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Maternal self-efficacy, postpartum depression, and their relationship with functional status in Iranian mothers. Women Health 2018;58(2):188-203.
12. 12. Özkan S, Göral-Türkcü S, Kayhan Ö, Serçekuş-Ak P, Sevil Ü. Functional status of women and their partners after childbirth. Int J Assess Tools Educ 2018;5(3):510-523.
13. 13. Eck KM, Santiago E, Martin-Biggers J, Byrd-Bredbenner C. Maternal sleep quality is associated with personal and parenting weight-related behaviors. Int J Environ Res Public Health 2020;17(15):5312.
14. 14. Yogman MW, Eppel AM. The Role of Fathers in Child and Family Health. In: Grau Grau M, las Heras Maestro M, Riley Bowles H (editors). Engaged Fatherhood for Men, Families and Gender Equality; Contributions to Management Science, Springer, Cham:Switzerland, 2022: 279-295.
15. 15. Demissie Z, Siega-Riz AM, Evenson KR, Herring AH, Dole N, Gaynes BN. Associations between physical activity and postpartum depressive symptoms. J Womens Health (Larchmt) 2011;20(7):1025-1034.
16. 16. Basso JC, Suzuki WA. The effects of acute exercise on mood, cognition, neurophysiology, and neurochemical pathways: A review. Brain Plast 2017;2(2):127-152.
17. 17. Acar M, Yarımkaya NS, Tekindal MA. The effect of nordic walking exercise training on physical fitness, physical activity level, anxiety-depression and quality of life in smokers: A randomized controlled trial. Med J West Black Sea 2022;6(3):385-393.
18. 18. Kołomańska-Bogucka D, Mazur-Bialy AI. Physical activity and the occurrence of postnatal depression-A systematic review. Medicina (Kaunas) 2019;55(9):560.
19. 19. Okyay EK, Ucar T. The effect of physical activity level at postpartum period on quality of life and depression level. Med- Science 2018;7:587-593.
20. 20. Physical activity and exercise during pregnancy and the postpartum period: ACOG committee opinion, Number 804. Obstet Gynecol 2020;135(4);e178-e188.
21. 21. Hoffman J, Gabel CP. The origins of Western mind-body exercise methods. Phys Ther Rev 2015;20(5-6):315-324.
22. 22. Alkan E, Özçoban FA. Gebelik, doğum ve doğum sonu dönemde pilatesin etkileri. Smyrna Tıp Dergisi 2017; 7(2):2-30.
23. 23. Urer E. Gebelikte pilates egzersizi yapma durumunun doğum sonu dönemde stres inkontinans üzerine etkisi. İstinye Üniversitesi, Sağlık Bilimleri Enstitüsü. Yayınlanmamış Yüksek Lisans Tezi, İstanbul, 2019.
24. 24. Ko YL, Yang CL, Fang CL, Lee MY, Lin PC. Communitybased postpartum exercise program. J Clin Nurs 2013;22(15- 16):2122-2131.
25. 25. Ko YL, Lin PC, Yang CL, Chen CP, Shih HJ. Pilot study on an ıntegrated pilates and yoga program for decreasing postpartum depression in women. Open J Nurs 2015;5(10):885.
26. 26. Ashrafinia F, Mirmohammadali M, Rajabi H, Kazemnejad A, Sadeghniiathaghighi K, Amelvalizadeh M, Chen H. The effects of pilates exercise on sleep quality in postpartum women. J Bodyw Mov Ther 2014;18(2):190-199.
27. 27. Kim HB, Hyun AH. Psychological and biochemical effects of an online pilates ıntervention in pregnant women during COVID-19: A randomized pilot study. Int J Environ Res Public Health 2022;19(17):10931.
28. 28. Slomian J, Honvo G, Emonts P, Reginster JY, Bruyère O. Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Womens Health (Lond) 2019;15:1745506519844044.
29. 29. Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. BMJ 2010;340:c332.
30. 30. Kang H. Sample size determination and power analysis using the G*Power software. J Educ Eval Health Prof 2021;18:17.
31. 31. Klankhajhon S, Sthien A. A narrative review of physical activity and exercise during pregnancy: Nurse’s role. JPNS 2022;1(2):49-60.
32. 32. Aydin N, Inandi T, Yigit A, Hodoglugil NN. Validation of the Turkish version of the Edinburgh Postnatal Depression Scale among women within their first postpartum year. Soc Psychiatry Psychiatr Epidemiol 2004;39(6):483-486.
33. 33. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987;150:782-786.
34. 34. Yang CL, Yu CH, Chen CH. Development and validation of the postpartum sleep quality scale. J Nurs Res 2013;21(2):148-54.
35. 35. Fawcett J, Tulman L, Myers ST. Development of the inventory of functional status after childbirth. J Nurse Midwifery 1988;33(6):252-260.
36. 36. Boz I, Selvi N. Testing the psychometric properties of the postpartum sleep quality scale in Turkish women. J Nurs Res 2018;26(6):385-392.
37. 37. Ozkan S, Sevil U. Doğum sonrası fonksiyonel durum envanterinin geçerlilik güvenilirlik çalışması (in Turkish). [The study of validity and reliability of inventory of functional status after childbirth]. TSK Koruyucu Hekimlik Bülteni 2007;6(3):199- 208.
38. 38. Sharma V, Sharma P. Postpartum depression: Diagnostic and treatment issues. J Obstet Gynaecol Can 2012;34(5):436-442.
39. 39. Gurkan OC, Eksi Z. Effects of antenatal education program on postpartum functional status and depression. Clin Exp Health Sci 2017;7:133-138.
40. 40. Herbert C, Meixner F, Wiebking C, Gilg V. Regular physical activity, short-term exercise, mental health, and well-being among university students: The results of an online and a laboratory study. Front Psychol 2020;11:509.
41. 41. Wells C, Kolt GS, Bialocerkowski A. Defining pilates exercise: A systematic review. Complement Ther Med 2012;20(4):253- 262.
42. 42. Corrigan CP, Kwasky AN, Groh CJ. Social support, postpartum depression, and professional assistance: A survey of mothers in the midwestern united states. J Perinat Educ 2015;24(1):48- 60.
43. 43. Verma S, Quin N, Astbury L, Wellecke C, Wiley JF, Davey M, Rajaratnam SMW, Bei B. Treating postpartum insomnia: A three arm randomised controlled trial of cognitive behavioural therapy and light dark therapy. Psychol Med. 2022:1-11.
44. 44. Creti L, Libman E, Rizzo D, Fichten CS, Bailes S, Tran DL, Zelkowitz P. Sleep in the postpartum: Characteristics of firsttime, healthy mothers. Sleep Disord 2017;2017:8520358.
45. 45. Fleming KM, Herring MP. The effects of pilates on mental health outcomes: A meta-analysis of controlled trials. Complement Ther Med 2018;37:80-95.
46. 46. Chamgurdani FK, Barkin JL, Esmaeilpour K, Malakouti J, Buoli M, Mirghafourvand M. The effect of counseling with a skills training approach on maternal functioning: A randomized controlled clinical trial. BMC Womens Health 2020;20(1):51.
47. 47. Bagherinia M, Mirghafourvand M, Shafaie FS. The effect of educational package on functional status and maternal selfconfidence of primiparous women in postpartum period: A randomized controlled clinical trial. J Matern Fetal Neonatal Med 2017;30(20):2469-2475.
48. 48. Mirghafourvand M, Mohammad-Alizadeh-Charandabi, S, Jafarabadi MA, Soltanpour S, Aghamiri V, Bagherinia, M. Physical activity during pregnancy and its relationship with the functional status of primiparous women six weeks after childbirth: A cohort study. JCDR 2018;12(11):QC12-QC16.
49. 49. Mirghafourvand M, Bagherinia M. Relationship between maternal self-efficacy and functional status four months after delivery in Iranian primiparous women. J Psychosom Obstet Gynaecol 2018;39(4):1-8.
50. 50. Mazzarino M, Kerr D, Wajswelner H, Morris ME. Pilates method for women’s health: Systematic review of randomized controlled trials. Arch Phys Med Rehabil 2015;96(12):2231- 2242.