Orthopaedic Manual Physical Therapy as Part of the Postpartum Care Continuum

NCT06560190 | Recruiting

• 1 other identifier: PT4Postpartum
• Study Type: interventional
• Target: 58
• Locations: 1 country
• Sites: 1

Brief 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.

Conditions

Postpartum; Pregnancy Related

Keywords

Postpartum; Physical Activity; Pregnancy; Service Member; Physical Therapy

Outcome Measures

Primary Outcomes (1)

• 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 Outcomes (4)

• International Physical Activity Questionnaire- Short Form (IPAQ)

  Baseline, 4 weeks and 8 weeks

• Numeric Pain Rating Scale (NPRS)

  Baseline, 4 weeks and 8 weeks

• Cozean Pelvic Dysfunction Screening Protocol

  Baseline, 4 weeks and 8 weeks

• Edinburgh Postnatal Depression Scale (EPDS)

  Baseline

Study Arms (1)

Postpartum Study Participant

EXPERIMENTAL

Pragmatic Orthopaedic Physical Therapy

Other: Orthopaedic Manual Physical Therapy

Interventions

Orthopaedic Manual Physical Therapy OTHER

Individualized Treatment

Postpartum Study Participant

Eligibility Criteria

• Age: 18 Years - 44 Years
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Female Active-Duty Service Member
• Postpartum \>6 weeks and \<6 months
• Cleared by OBGYN at postpartum follow-up to initiate physical activity

You may not qualify if:

• Current or ongoing treatment by an orthopaedic physical therapist
• Separating from military service in the next 6 months
• Current permanent profile for a musculoskeletal condition
• Peripartum Hysterectomy

Sponsors & Collaborators

• Brooke Army Medical Center: lead

Study Sites (1)

Brooke Army Medical Center

San Antonio, Texas, 78234, United States

RECRUITING

Related Publications (9)

• Iobst SE, Smith DC, Best NI, Allard RJ, Trego LL. A Scoping Review of Pregnancy, Childbirth, and the Postpartum Period in Active Duty U.S. Military Women. Womens Health Issues. 2021 Aug 25;31 Suppl 1:S81-S92. doi: 10.1016/j.whi.2020.05.005.

  PMID: 34454706 BACKGROUND

• Miller MJ, Kutcher J, Adams KL. Effect of Pregnancy on Performance of a Standardized Physical Fitness Test. Mil Med. 2017 Nov;182(11):e1859-e1863. doi: 10.7205/MILMED-D-17-00093.

  PMID: 29087853 BACKGROUND

• Weina SU. Effects of pregnancy on the Army Physical Fitness Test. Mil Med. 2006 Jun;171(6):534-7. doi: 10.7205/milmed.171.6.534.

  PMID: 16808137 BACKGROUND

• DeGroot DW, Sitler CA, Lustik MB, Langan KL, Hauret KG, Gotschall MH, Gehrich AP. The effect of pregnancy and the duration of postpartum convalescence on the physical fitness of healthy women: A cohort study of active duty servicewomen receiving 6 weeks versus 12 weeks convalescence. PLoS One. 2021 Jul 28;16(7):e0255248. doi: 10.1371/journal.pone.0255248. eCollection 2021.

  PMID: 34320030 BACKGROUND

• Armitage NH, Smart DA. Changes in Air Force fitness measurements pre- and post-childbirth. Mil Med. 2012 Dec;177(12):1519-23. doi: 10.7205/milmed-d-12-00248.

  PMID: 23397699 BACKGROUND

• ACOG Committee Opinion No. 736: Optimizing Postpartum Care. Obstet Gynecol. 2018 May;131(5):e140-e150. doi: 10.1097/AOG.0000000000002633.

  PMID: 29683911 BACKGROUND

• Doran F, Davis K. Factors that influence physical activity for pregnant and postpartum women and implications for primary care. Aust J Prim Health. 2011;17(1):79-85. doi: 10.1071/PY10036.

  PMID: 21616029 BACKGROUND

• Selman R, Early K, Battles B, Seidenburg M, Wendel E, Westerlund S. Maximizing Recovery in the Postpartum Period: A Timeline for Rehabilitation from Pregnancy through Return to Sport. Int J Sports Phys Ther. 2022 Oct 1;17(6):1170-1183. doi: 10.26603/001c.37863. eCollection 2022.

  PMID: 36237644 BACKGROUND

• Christopher, S.M., et al., Rehabilitation of the Postpartum Runner: A 4-Phase Approach. Journal of Women's Health Physical Therapy, 2022. 46(2): p. 73-86.

  BACKGROUND

MeSH Terms

Conditions

Motor Activity

Condition Hierarchy (Ancestors)

Behavior

Study Officials

• Casey Shutt-Hoblet, DPT

  Brooke Army Medical Center

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Casey Shutt-Hoblet, DPT

CONTACT

210-808-2226; casey.e.shutt-hoblet.mil@health.mil

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: FED
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MAJ Casey Shutt-Hoblet, PT, DPT

Study Record Dates

• First Submitted: August 15, 2024
• First Posted: August 19, 2024
• Study Start: April 8, 2024
• Primary Completion: July 5, 2025
• Study Completion: July 5, 2025
• Last Updated: August 21, 2024

Record last verified: 2024-08

Locations

US (1)