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Physical Activity After Delivery: A Pilot Feasibility Study
Abstract Number: F3B-6
Abstract Type: Original Research
Introduction: Enhanced Recovery after Surgery, focuses on decreasing factors associated with prolonged hospital stay. These factors are: pain control, ileus, and immobilization.1 Although ambulation is a recognized key element for recovery, and a known method of mechanical prophylaxis against deep venous thrombosis (DVT)2, this variable is rarely objectively measured immediately post-partum.
Methods: In this pilot study, we evaluated the physical activity after vaginal (VD), and Cesarean delivery (CD), of 24 and 10 parturients respectively, by using a research validated accelerometer (Actigraph GT3X).3 We examined the effects of age, gestational age, BMI, race, ethnicity, mode of delivery, pain score at rest and with movement, and satisfaction with analgesia over steps taken. The noted variables and number of steps were assessed at 6, 12, 24, 36 and 48 hours after delivery. 2-tailed-t-tests or chi-square were used to analyze the univariable differences, and a multivariate mixed model was used, with p < 0.05 considered significant.
Results: Demographic data analysis is summarized in Table 1. Based on unadjusted, univariable analysis, statistical difference in steps taken between CD and VD patients was noted at 12, 24 and 36 hrs with p = 0.049, 0.017 and 0.02 respectively (Figure 1). Satisfaction with pain management was higher for VD at all times after 6 hrs; CD patients were significantly less satisfied with their pain management starting at 24 hrs post-delivery. After adjusting for pain satisfaction, static maternal age, BMI and race, mode of delivery remained associated with number of steps taken, averaged across time points (p = 0.03). On average, after adjustment of covariates, CD and each additional year of maternal age were associated with 2198 (95% CI 237-4159), p = 0.03 and 159 (95% CI 23-295), p = 0.024 fewer steps respectively.
Conclusion: Monitoring patients postpartum with an accelerometer was easily accomplished. Fewer steps were taken with advancing maternal age and after CD. Accelerometer data should be further studied to assess outcomes, and to evaluate the efficacy of educational efforts and multimodal pain management strategies.
1. Anesth Analg 2014; 118:1052-61.
2. Anesth Analg 2016;123:942-9.
3. Int J Behav Nutr Phys Act 2011;8:19.