Encouraging New Moms to Move More-Are We Missing the Mark? A Systematic Review With Meta-Analysis of the Effect of Exercise Interventions on Postpartum Physical Activity Levels and Cardiorespiratory Fitness.

Abstract

<b>OBJECTIVE:</b> To determine if current exercise interventions were effective at improving physical activity (PA) levels and/or cardiorespiratory fitness (CRF) in postpartum women. <b>DESIGN:</b> Intervention systematic review with meta-analysis. <b>LITERATURE SEARCH:</b> CINAHL, Embase, Medline, PsycINFO, and SPORTDiscus were searched from inception to March 2024. <b>STUDY SELECTION CRITERIA:</b> <i>Participants</i>: postpartum women; <i>intervention</i>: exercise; <i>control</i>: standard care; <i>outcomes</i>: PA levels and/or CRF. <b>DATA SYNTHESIS:</b> Random effects meta-analysis using standardized mean differences (SMDs). Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) and Risk of Bias in Non-Randomized Studies - Intervention (ROBINS-I). <b>RESULTS:</b> A total of 6041 studies were screened, and 29 were eligible for inclusion. Nineteen studies with adequate control data included outcomes related to PA levels (n = 12) or CRF (n = 7) and were pooled in meta-analyses. There was a small to moderate improvement in CRF (SMD, 0.65; 95% CI [confidence interval]: 0.20, 1.10; I² = 61%). There was no improvement in PA levels (SMD, -0.13; 95% CI: -0.53, 0.26; I² = 90%). Frequency, intensity, type, and time of the exercise interventions varied. Twenty-three studies were at high or serious risk of bias. <b>CONCLUSIONS:</b> Postpartum exercise interventions may improve CRF but have an unclear effect on PA levels. Despite numerous exercise interventions to improve health outcomes postpartum, parameters were inconsistent. <i>J Orthop Sports Phys Ther 2024;54(11):687-701. Epub 9 October 2024. doi:10.2519/jospt.2024.12666</i>.