JWHPT Special Issue Highlights | The Fourth Trimester: Optimizing Health

Journal of Women’s Health Physical Therapy | Special Issue Highlights
The Fourth Trimester: Optimizing Health

In the first ever Clinical Practice Guidelines for Pelvic Girdle Pain in the Postpartum Population, Simonds and colleagues map out graded recommendations across 6 practice domains to support clinical decision-making. Notably, the synthesized evidence aligns well with the evolving pain science literature base, which has long been lacking where perinatal pelvic pain is concerned. These guidelines grade risk factors, prognostic factors, systems screening, evaluation, and interventions, all highlighting the fact that a pathoantomical care lens does not facilitate evidence-based care.

The chosen clinical commentary Beyond the musculoskeletal system: considering whole-systems readiness for running postpartum by Donnelly and colleagues mounts a strong argument for the consideration of multiple factors outside of the biomechanical and structural domains pertaining to running in the postpartum periods. This article complements the cohort study Biomechanical and musculoskeletal differences between postpartum runners and nulliparous controls by Christopher and colleagues investigating differences in running kinetics, strength, and flexibility in postpartum runners (PPRs) and age-matched nulliparous controls. The between-group differences highlight possible deficits present among PPRs.

Havens and colleagues analyzed survey responses from almost 4,000 “babywearing enthusiasts.” The results of Infant Carrying in the United States: A Survey of Current Practices, Physical and Mental Health Benefits and Challenges of Babywearing shed light on various health domains relevant to the fourth trimester from a biopsychosocial perspective, pointing to where physical therapists can level up care.

In a retrospective review of 70 data sets of individuals who sustained third- or fourth-degree birth-related perineum tears, Kim and colleagues explore how Pelvic Health Physical Therapy improves Pelvic Floor Symptoms in women with Obstetric Anal Sphincter Injury.

The issue also includes a welcomed addition to the diastasis rectus abdominis (DRA) literature. Berg-Poppe and colleagues systematically reviewed the current body of conservative care interventions for DRA and included 14 studies (9 of which were randomized controlled trials) in their analysis. Results of Use of Exercise in the Management of Postpartum Diastasis Recti: A Systematic Review favored abdominal and associated deep system motor control exercises in addition to using electrical muscle stimulation as an adjunct therapy. 

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