EFFECTIVENESS OF RECOVERY OF THE PSYCHO-EMOTIONAL AND PHYSICAL STATUS OF WOMEN WHO HAVE SUFFERED A CAESAREAN SECTION BY MEANS OF PHYSICAL THERAPY
Purpose: to determine the influence of the developed program of physical therapy on the dynamics of the parameters of the psycho-emotional and physical status of women in the postpartum period after cesarean section.
Methods. 112 women were examined after childbirth. The comparison group consisted of 47 women who gave birth naturally. The main group 1 consisted of 32 women who were given general recommendations for self-care in the postpartum period after cesarean section (hygiene, restriction of motor activity due to postoperative scarring, etc.), as they found desire to recover on their own. The main group 2 consisted of 33 women after cesarean section who underwent postpartum physical therapy for 12 months (kinesitherapy, abdominal bandage, kinesiology taping, abdominal massage and general; health nutrition, psychological relaxation, women's education). The basis of kinesitherapy was functional training (to normalize the motor stereotype, restore the muscles of the torso and limbs, posture) with reference to household movements for child care. During the first weeks after the cesarean section, the movements that contributed to the tension of the postoperative suture were restricted, and the facilitated starting positions were chosen. Women were taught the optimal dynamic stereotype with the prevention of overload during habitual movements - lifting, feeding the baby, carrying a stroller, and the like.
Determination of psycho-emotional status (according to the Edinburgh Postnatal Depression Scale) and physical condition (according to the result of PWC170 and the value of VO2max) was carried out in the early and late postpartum periods; 6 and 12 months after birth.
Results. In women in the late postpartum period, regardless of the type of delivery, there were signs of psycho-emotional depression (according to Edinburgh Postnatal Depression Scale), a decrease in physical performance (according to the results of PWC170), a deterioration in cardio-respiratory reserves (according to the VO2max value). Within a year after childbirth, there was a gradual improvement in the physical performance of women and the normalization of their psycho-emotional state, regardless of delivery and the implementation of active restorative interventions. The use of a physical therapy program starting from the early postpartum period after cesarean section revealed the advantages of the state of the psycho-emotional and physical state relative to women who underwent natural delivery and recovered after cesarean section on their own, already in the late postpartum period. 1 year after delivery, women who underwent cesarean section and performed the developed physiotherapy intervention showed a statistically significantly better result according to Edinburgh Postnatal Depression Scale, PWC170, VO2max compared with women who underwent vaginal delivery and recovered from cesarean section on their own. Women who had cesarean section but recovered on their own with general advice failed to reach the levels of women who gave birth by vaginal birth and women who underwent a physical therapy program in physical performance tests 1 year postpartum.
Conclusions. Physical therapy means should be prescribed from the first day of postpartum rehabilitation to improve the psycho-emotional state and increase the physical performance of women.
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