生產球運動對產後婦女下背痛感、腹肌耐力及核心肌群改變之成效

本研究旨在探討生產球運動對產後婦女下背痛感、腹肌耐力及核心肌群改變之成效。採類實驗性研究，收案場所為南部某區域教學醫院，收取足月產及陰道生產產婦，有意願者參與生產球運動為實驗組共25位；未參與運動但願意配合研究者為控制組共28位；實驗組提供生產球運動指導後給予視訊光碟加強，於坐月子期間每週3次、每次至少30分鐘為期六週的生產球運動；控制組於病房予一般產後運動指導；兩組資料包括：下背疼痛量表及超音波儀器測量腹直肌間距、肌肉與脂肪厚度；於六週後至產後門診再次接受相同測量。結果顯示生產球運動對產後婦女下背痛、日常生活功能限制、腹肌耐力、腹直肌間距改善皆無顯著成效；但經ANCONA控制後發現當產後天數增加、孕前體重減少、孕前身體質量數減少、有執行產後運動者、初產婦、年齡較小者、孕前一年有運動者，研究結果在肚臍上緣的腹直肌間距、肚臍下一吋腹直肌間距及肌肉平均厚度達顯著成效。整體而言，本研究結果雖然成效不明顯，但仍可提供臨床醫護人員對產婦在生產後的產後運動之重視，及鼓勵產婦在產後能夠執行生產球運動，以緩解由懷孕生產所造成的核心肌群改變與腹直肌分裂的問題，進而落實產婦於坐月子期間執行產後運動，以緩解生理不適情況。

關鍵字

生產球運動；下背痛；腹直肌間距；腹肌耐力；核心肌群

並列摘要

This study evaluated the efficacy of birth ball exercise on lower back pain, abdominal muscle endurance and core muscle recovery in postpartum women. Researchers used a non-randomised controlled experimental design and recruited as subjects women who gave births vaginally at a regional teaching hospital in southern Taiwan. All 53 enrolled participants were assigned into either the control group (CG) or experimental group (EG) by self-selection. The 28 EG subjects participated in a postnatal stability ball exercise intervention. After receiving verbal instructions on exercise routine basics, EG subjects received an instructional DVD video to further enhance learning and were asked to perform thirty minutes of birth ball exercise three times a week during the six-week ＂doing the month＂ period of confinement. The 25 CG subjects received standard post-natal ward health education instructions. Research instruments used included a questionnaire with basic information and Brief Pain Inventory (BPI-C) surveys and weight and waist circumference and ultrasound instruments used to measure inter-recti distance and muscle and fat thickness. Subjects answered the questionnaires and provided biophysical measurements twice - once at hospital discharge and once at six-weeks postnatal. Results showed no significant differences between the two groups in terms of pain intensity, limitations on activities of daily living, abdominal muscle endurance or improvement in core muscles / inter-recti distance. However, after using ANCOVA to adjust research-related confounding variables, we found significant improvement in inter-recti distance and average muscle thickness in subjects with the following attributes: more postpartum days, lower pre-conception weight, lower pre-conception body mass index (BMI), regular postpartum exercise habits, primipara, younger in age, and regular exercise during the year prior to pregnancy. While not identifying obvious benefits of the birth ball exercise program for postpartum women, this study can help increase clinical staff awareness of the importance of postnatal exercise and encourage new mothers to do birth ball exercises in order to alleviate lower-back and other pains resulting from pregnancy and post-pregnancy stressors and minimize postpartum physical discomfort.