ANALYSIS OF THE QUALITY OF LIFE DYNAMICS OF WOMEN AFTER ABDOMINAL ACCOUCHEMENT IN THE POSTPARTUM PERIOD UNDER THE INFLUENCE OF THE PHYSICAL THERAPY PROGRAM
Purpose: to determine the impact of the developed program of physical therapy on the dynamics of the quality of life after abdominal accouchement (caesarean section - CS) in the postpartum period.
Methods. A comparative assessment of the components of the quality of life in 112 women after childbirth was carried out. The comparison group consisted of 47 women who had a natural childbirth. The main group consisted of 65 women after CS. The main group 1 consisted of 32 women who did not want to carry out the proposed program of physical therapy; they were provided with general recommendations for self-observation in the postpartum period after cesarean section. The main group 2 consisted of 33 women who underwent postpartum rehabilitation, the effectiveness of which is presented in this study. The program lasted 12 months, during which the following means were used: kinesiotherapy, abdominal wall bandage, kinesiotaping, general and abdominal massage; wellness nutrition, psychological relaxation, education for women. Physical therapy has been used to improve mood and psychological well-being; reducing anxiety and the risk of developing depression; improving the function of internal organs and general fitness; weight loss; prevention of adhesions of the abdominal cavity; reducing the risk of chronic diseases; normalization of the function of the pelvic muscles; prevention and correction of postpartum diastasis of the abdominal muscles, normalization of posture, altered as a result of the redistribution of the center of gravity during pregnancy; improving sexual health; improving the quality of life, taking into account the physiological and pathological changes in the body of a woman after childbirth and lactation, lifestyle changes taking into account contextual factors; return to the usual everyday and professional activity with a high level of performance and psycho-emotional state. A feature of the program was the performance of motor tasks with binding or in the process of motor activity associated with caring for a child - feeding, walking, etc., which caused a high compliance of women.
The quality of life was determined using the “Medical outcomes study short form” (SF-36) questionnaire 4 times: in the early postpartum period (up to 24 hours after delivery) in the late postpartum period (6-8 weeks after delivery); 6 and 12 months after childbirth
Research results. In women after childbirth, there was a decrease in the indicators of physical and mental components of the quality of life. In the early postpartum period, women after CS had the worst indicators of physical functioning, role functioning, general health, vitality according to SF-36 compared to women after natural childbirth (p<0.05). By the end of the late postpartum period, the use of physical therapy allowed women after CS to achieve the quality of life in all studied parameters, who gave birth naturally (p> 0.05). Women who underwent CS, but recovered on their own with the help of general recommendations, according to most criteria of quality of life (except for social functioning) were able to reach the levels of women who gave birth naturally only after a year.
Conclusions. It is advisable to prescribe physical therapy means from the first day of postpartum rehabilitation in order to improve the quality of life and, accordingly, postpartum recovery of women and their quick return to full functioning.
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