Physical activity in postpartum women and its relationship to postnatal depression

Background. For most women in the postpartum period, six to 52 weeks after childbirth, participation in physical activity is limited. New mothers often report inability to exercise, due in part to feeling isolated and exhausted. The literature offers contradictory arguments regarding the influence of exercise on Postnatal Depression (PND). Therefore, this study aimed to: (1) determine the variables associated with physical activity during the postpartum period; (2) investigate the relationship between physical activity and PND; and (3) explore the enablers and barriers to physical activity in a sample of postpartum women.Method. This multi-method study employed a cross-sectional correlational design in Stage One and a qualitative design in Stage Two. In Stage One 150 postpartum women recruited from the Western Australian metropolitan Child Health Clinics were sent a questionnaire. In Stage Two 14 postpartum women who participated in the survey were also interviewed. Survey data were analysed using SPSS to conduct multiple regression analysis and the interviews were thematically coded.Results. The study did not demonstrate an association between physical activity participation (PAP) and PND. However, psychosocial factors, parental confidence, partner support and social support were significantly associated with PND. The predictors of the mother’s PAP were the age of her baby, her education level, number of children, family income, parental confidence, partner support and lack of time. Lack of information, lack of confidence, lack of knowledge and poor access to public transport were the barriers to the living domain of PAP. Lack of money was associated with reduced exercise. Results from Stage Two supported the findings from Stage One and illustrated that mothers were more likely to participate in physical activity if they had greater social support, particularly partner support, and if they were confident in their parenting ability.Conclusion. The study was unable to determine a direct effect of exercise on PND. However, other factors such as partner support do affect mothers at risk of PND and influence their participation in physical activity. Further study is required which firstly employs a longitudinal design and secondly uses a clinically depressed sample to more fully understand the role of PAP in mediating the effects of PND. Specifically tailored exercise programs may help to address barriers to PAP and enable postpartum women to access the physiological and psychological benefits of exercise

Perceived barriers and enablers of physical activity in postpartum women: A qualitative approach

© 2016 Saligheh et al.Background: Postpartum women's recovery from birth can be assisted through increased physical activity (PA). However, women face substantial barriers to participating in exercise and require support to enable them to benefit from increased PA. Methods: This study sought to explore women's beliefs about and experiences of PA and exercise during the 6 weeks to 12 months postpartum period. A cohort of 14 postpartum women from a survey study of the barriers and enablers to exercise participation agreed to take part in interview sessions to provide an in-depth understanding of the women's perceptions of the postpartum period and their physical activity during this time. Results: Findings are presented with reference to the social ecological framework and indicate postpartum women face substantial personal and environmental barriers to PA and exercise participation: fatigue, a lack of motivation and confidence, substantial time constraints, lack of access to affordable and appropriate activities and poor access to public transport. In contrast, enablers such as possessing greater social support, in particular partner support, improved PA and exercise participation. Conclusions: The findings encourage facilitation of exercise through mothers' groups, mothers' exercise clubs or postnatal classes suggesting behavioral and social change is needed. Interaction between individuals, community, organizations and policy makers is required. In addition, the provision of specifically tailored and appropriate exercise programs could potentially enable increased PA in postpartum women, thereby improving their health

Can exercise or physical activity benefit women’s mental health? An examination of post and antenatal depression

Depression during the childbearing years affects between 10-15% of women, and amongst the detrimental effects to health is lowered Physical Activity (PA) behaviour. While modalities of exercise and PA behaviour have been identified as having a positive effect on the depression condition as well as other heath indices (e.g., weight and adiposity), its effectiveness remains uncertain during the postnatal and antenatal stages. Postnatal Depression (PND) and Antenatal Depression (AND) are predominantly treated with antidepressants and counselling; and even while acknowledging potential movement associated with pregnancy, emerging evidence suggests exercise/PA could be a potentially feasible and cost-effective, adjunct, treatment behaviour. Thesis findings suggest that exercise/PA interventions could have specific preventative and symptom treatment roles. Thus, exercise/PA guidelines can be recommended

Additional file 2: of Perceived barriers and enablers of physical activity in postpartum women: a qualitative approach

Consolidated criteria for reporting qualitative studies (COREQ): 32-item checklist. (DOCX 17 kb

Additional file 1: of Perceived barriers and enablers of physical activity in postpartum women: a qualitative approach

Interview Guide - contains interview questions. (DOCX 13 kb

Effective Connectivity Evaluation of Resting-State Brain Networks in Alzheimer’s Disease, Amnestic Mild Cognitive Impairment, and Normal Aging: An Exploratory Study

(1) Background: Alzheimer’s disease (AD) is a neurodegenerative disease with a high prevalence. Despite the cognitive tests to diagnose AD, there are pitfalls in early diagnosis. Brain deposition of pathological markers of AD can affect the direction and intensity of the signaling. The study of effective connectivity allows the evaluation of intensity flow and signaling pathways in functional regions, even in the early stage, known as amnestic mild cognitive impairment (aMCI). (2) Methods: 16 aMCI, 13 AD, and 14 normal subjects were scanned using resting-state fMRI and T1-weighted protocols. After data pre-processing, the signal of the predefined nodes was extracted, and spectral dynamic causal modeling analysis (spDCM) was constructed. Afterward, the mean and standard deviation of the Jacobin matrix of each subject describing effective connectivity was calculated and compared. (3) Results: The maps of effective connectivity in the brain networks of the three groups were different, and the direction and strength of the causal effect with the progression of the disease showed substantial changes. (4) Conclusions: Impaired information flow in the resting-state networks of the aMCI and AD groups was found versus normal groups. Effective connectivity can serve as a potential marker of Alzheimer’s pathophysiology, even in the early stages of the disease

Quantitative Assessment of Resting-State Functional Connectivity MRI to Differentiate Amnestic Mild Cognitive Impairment, Late-Onset Alzheimer's Disease From Normal Subjects

BACKGROUND: Alzheimer disease (AD) is a neurological disorder with brain network dysfunction. Investigation of the brain network functional connectivity (FC) alterations using resting-state functional MRI (rs-fMRI) can provide valuable information about the brain network pattern in early AD diagnosis. PURPOSE: To quantitatively assess FC patterns of resting-state brain networks and graph theory metrics (GTMs) to identify potential features for differentiation of amnestic mild cognitive impairment (aMCI) and late-onset AD from normal. STUDY TYPE: Prospective. SUBJECTS: A total of 14 normal, 16 aMCI, and 13 late-onset AD. FIELD STRENGTH/SEQUENCE: A 3.0 T; rs-fMRI: single-shot 2D-EPI and T1-weighted structure: MPRAGE. ASSESSMENT: By applying bivariate correlation coefficient and Fisher transformation on the time series of predefined ROIs' pairs, correlation coefficient matrixes and ROI-to-ROI connectivity (RRC) were extracted. By thresholding the RRC matrix (with a threshold of 0.15), a graph adjacency matrix was created to compute GTMs. STATISTICAL TESTS: Region of interest (ROI)-based analysis: parametric multivariable statistical analysis (PMSA) with a false discovery rate using (FDR)-corrected P  24.05) and clustering-coefficient (25 > 20.18) were found in aMCI compared to normal. DATA CONCLUSION: This study demonstrated resting-state FC potential as an indicator to differentiate AD, aMCI, and normal. GTA revealed brain integration and breakdown by providing concise and comprehensible statistics. EVIDENCE LEVEL: 1. TECHNICAL EFFICACY: Stage 2