Influence of a supervised postpartum exercise program on maternal physical activity levels and musculoskeletal health

Carroll University, Inc. (doing business as Carroll College) received a $343,320 project grant award dated September 22, 2025, from the National Institute of Child Health and Human Development under the Child Health and Human Development Extramural Research program (CFDA 93.865). The award supports an eight-week supervised postpartum exercise intervention designed to evaluate the influence of structured physical activity on maternal neuromuscular function, habitual activity levels, and overall wellbeing. The research will employ a randomized controlled trial (RCT) design to assess outcomes including lower extremity and pelvic floor muscle strength and endurance, self-reported pelvic floor dysfunction symptoms, kinesiophobia levels, sleep quality, and quality of life in postpartum females through August 31, 2028.

The intervention addresses documented gaps in standard postpartum care by providing comprehensive neuromuscular assessment and exercise education while mitigating participation barriers through the provision of childcare services and opportunities for participants to incorporate their children into exercise sessions. The study will utilize objective strength measurements via load cells combined with standard clinical pelvic floor assessments to generate evidence-based guidance on safe and effective exercise resumption following childbirth, addressing conflicting information currently available to postpartum women.

Abstract

Physical activity (PA)/exercise is crucial for maternal health and wellbeing but several barriers to PA/exercise participation exist in the postpartum period. Musculoskeletal impairments-such as weakness, increased fatigability, pelvic floor dysfunction (e.g., incontinence, pelvic organ prolapse, etc.), and pain-are common in the postpartum period. While these impairments provide strong rationale for participation in PA/exercise, they can also act as barriers to participation. Several psychosocial barriers also exist, including fear of movement and lack of childcare. Despite the importance of PA/exercise for health and wellness, and the documented musculoskeletal impairments that are associated with the postpartum period, assessment of neuromuscular function and education on resuming exercise is lacking in the standard postpartum care model in the united states. In addition, conflicting information can be found on social media and among clinical experts on when and how to best resume PA/exercise after childbirth. This proposal will evaluate the influence of an eight-week exercise intervention on neuromuscular function (i.e., lower extremity strength & endurance, pelvic floor muscle strength & endurance, self-reported pelvic floor dysfunction symptoms), habitual physical activity levels, and overall wellbeing (i.e., levels of kinesiophobia, sleep quality, self-reported quality of life) in postpartum females. In an effort to decrease barriers to exercise, childcare will be offered, and participants will have the opportunity to incorporate their child(REN) into exercise sessions if they so desire. This proposal will utilize a randomized control trial (RCT) design and objective measures of strength (i.e., load cells) along with standard clinical assessments of pelvic floor muscle function (i.e., internal vaginal assessment of strength and endurance, self-reported symptoms using validated questionnaires). Findings will be used to perform power analyses for future grant proposals to support a large, appropriately powered RCT. This proposal has potential to significantly influence guidelines for postpartum physical activity/exercise, thus facilitating a change in current standard postpartum care.