\n\u2022 Post Partum Depression (PPD) 10-16% with symptoms lasting up to 1 year.
\n\u2022 Often goes undiagnosed or untreated.
\n\u2022 Adverse effects of pharmacological therapy with breast feeding and the stigma associated with taking antidepressants.<\/p>\n
Clinical Scenario:<\/strong> PICO Question:<\/strong> Search Strategy:<\/strong> Results:<\/strong><\/p>\n Evidence Summary:<\/strong> Clinical Bottom Line:<\/strong> Limitations:<\/strong> Application to Case:<\/strong> The Future:<\/strong> References:<\/strong> Gabrielle Abate, SPT Background: \u2022 Post Partum Depression (PPD) 10-16% with symptoms lasting up to 1 year. \u2022 Often goes undiagnosed or untreated. \u2022 Adverse effects of pharmacological therapy with breast feeding and the stigma associated with taking antidepressants. Clinical Scenario: \u2022 30 year-old female with complaints of low back and hip pain since having […]<\/p>\n","protected":false},"author":0,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-771","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/sites.temple.edu\/dptebp2016\/wp-json\/wp\/v2\/posts\/771","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sites.temple.edu\/dptebp2016\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sites.temple.edu\/dptebp2016\/wp-json\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/sites.temple.edu\/dptebp2016\/wp-json\/wp\/v2\/comments?post=771"}],"version-history":[{"count":0,"href":"https:\/\/sites.temple.edu\/dptebp2016\/wp-json\/wp\/v2\/posts\/771\/revisions"}],"wp:attachment":[{"href":"https:\/\/sites.temple.edu\/dptebp2016\/wp-json\/wp\/v2\/media?parent=771"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sites.temple.edu\/dptebp2016\/wp-json\/wp\/v2\/categories?post=771"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sites.temple.edu\/dptebp2016\/wp-json\/wp\/v2\/tags?post=771"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\n\u2022 30 year-old female with complaints of low back and hip pain since having her first baby 4 months ago.
\n\u2022 She is worried her pain affects her ability to take care her daughter \u201cthe way a mother should\u201d.
\n\u2022 She is taking antidepressant medication, but would rather not because she heard it may be harmful while breastfeeding
\n\u2022 She cannot sleep even if her baby sleeps. She cries daily and worries constantly. She does not feel hungry and is not eating regularly. Making decisions is overwhelming. She says she is not herself.
\n\u2022 Experiences urinary incontinence.
\n\u2022 She has not exercised in years.<\/p>\n
\nIn women diagnosed with post partum depression (PPD) is exercise (including yoga and\/or Pilates) a more effective treatment than standard care or no intervention for decreasing depressive symptoms?<\/em><\/p>\n
\nSearch Terms: \u201cExercise\u201d AND \u201cPost partum depression\u201c AND \u201cStandard care\u201d or \u201cUsual care\u201d.
\nInclusion criteria:
\n\u2022 English language
\n\u2022 Dates 2000-2016
\n\u2022 Women diagnosed with PPD
\n\u2022 Exercise (one article including yoga or Pilates intervention)
\n\u2022 Control group consisting of usual care or no treatment
\n\u2022 Outcome measures
\n\u2022 Edinburg Postnatal Depression Scale (EPDS) score of greater or equal to 10
\n\u2022 Hamilton Depression Scale (HAM-D) score of greater or equal to 10<\/p>\n![\"img_2781\"](\"https:\/\/sites.temple.edu\/dptebp2016\/files\/2016\/11\/IMG_2781.jpg\")
<\/p>\n![\"img_2779-1\"](\"https:\/\/sites.temple.edu\/dptebp2016\/files\/2016\/11\/IMG_2779-1.jpg\")
<\/p>\n
\n\u2022 Exercise interventions are statistically significant and clinically meaningful for mild to moderate PPD.
\n\u2022 The experimental group may decrease symptoms quicker than the control group.<\/p>\n
\n\u2022 Exercise interventions are statistically significant and clinically meaningful for mild to moderate PPD versus trial medicine especially given the adverse events to the infant.
\n\u2022 CEBM Level 2 recommendation that women diagnosed with mild to moderate PPD could benefit from receiving an exercise program to decrease depressive symptoms compared to usual care or no intervention.
\n\u2022 At long term follow up both groups had similar decrease in depressive symptoms.<\/p>\n
\n\u2022 Poor generalizability due to lack of diversity in participant demographics and small sample sizes.
\n\u2022 No blinding of participants.
\n\u2022 Participants in the intervention group were not excluded if taking pharmacological therapies<\/p>\n
\nEvaluate and treat low back and hip pain while providing education on the benefits of exercise in treating PPD. Additionally, patient is provided with a home exercise program to increase endurance, strength, and flexibility. The program should consist of a walking program and strengthening and stretching exercises which could include a yoga video. Patient will attend therapy twice per week for two weeks and once per week for the next two weeks. Patient is referred to a pelvic floor therapist to treat urinary incontinence.<\/p>\n
\n\u2022 Exercise is an emerging treatment to treat post partum depression.
\n\u2022 What is our role in treating post partum depression in physical therapy?
\no Thorough history-taking<\/em>
\n o Adequate time spent with patients throughout care<\/em>
\n o Administering a depression scale\u00a0when applicable\u00a0<\/em>
\n o Tailor treatment plan to our patients’ needs<\/em><\/p>\n
\n1. Armstrong and Edwards. The effectiveness of a pram-walking exercise programme in reducing depressive symptomatology for postnatal women.<\/em> International journal of nursing practice. 2004. 10.4: 177-194.
\n2. Buttner. Brock. O’Hara, et al. Efficacy of yoga for depressed postpartum women: A randomized controlled trial.<\/em> Complementary Therapies in Clinical Practice, 2015; 21, 94e100.
\n3. Da Costa, Lowensteyn, Abrahamowicz, et al. A Randomized clinical trial of exercise to alleviate postpartum depressed mood.<\/em> Journal of Psychosomatic Obstetrics & Gynecology. 2009. 30(3): 191-200.
\n4. Daley, Blamey, Jolly, et al. A pragmatic randomized controlled trial to evaluate the effectiveness of a facilitated exercise intervention as a treatment for postnatal depression: the PAM- PeRS trial.<\/em> Psychological Medicine, 45(11), pp. 2413\u20132425. doi: 10.1017\/S0033291715000409.
\n5. Shu-Shya Heh, RN, MPhil, Lian-Hua Huang, RN, PhD, Shiao-Ming Ho, EdD, et al. Effectiveness of an Exercise Support Programin Reducing the Severity of Postnatal Depression in Taiwanese Women.<\/em> BIRTH 35:1 March 2008.<\/p>\n","protected":false},"excerpt":{"rendered":"