[[alternative]]Efficacy of the Prenatal Birth Ball Exercise on Pregnancy Discomfort and Low Back Pain During the Second and Third Trimester

[[abstract]]本研究旨在探討懷孕第二、三孕期執行生產球運動對孕期不適及下背痛之成效探討，主要分為發展與執行兩階段，於發展階段，乃聘請具有國際運動有氧體適能聯盟（Federation of International Sports, Aerobies and Fitness Inc, FISAF）之國際委員、FISAF Taiwan教育訓練總監與專業講師暨檢定官及衛生署國民健康局孕產婦運動自學教材研發人、產前身體柔軟度訓練運動專家洪雅琦老師研擬一套孕期生產球運動，在執行階段，主要目的在於測試產前生產球運動對孕婦孕期不適及下背痛之成效，採類實驗性（qusai experimental design）雙組前後測研究設計，收案對象為懷孕20週至26週之初產婦、產檢正常之婦女，收案場所為北區某地區婦產科專科醫院婦女為研究對象，以方便取樣將收案對象分為實驗組與控制組，共計95位個案，排除因早產及無法追蹤之個案，最後完成研究之個案數為89人。實驗組(n=45)除一般產前照護指導外，於收案後以「視訊化孕期生產球運動護理指導光碟」教導個案在家練習，每週至少三次，每次30分鐘，每週回院練習，評估實驗組個案實際運用孕期生產球運動，一直使用到生產；控制組(n=44)則僅接受一般的孕期常規照護活動。研究工具包括：基本人口學及產科學資料、孕期不適量表、下背痛簡明疼痛量表及運動支持量表。研究資料以SPSS 17.0統計軟體進行資料處理及分析，研究結果顯示：懷孕20週開始至36週期間，有從事相關運動約佔50.6％～55.1％；懷孕36週至40週期間，則下降至43.4％，兩組個案在懷孕末期運動皆有下降的情形。兩組前測（懷孕20～26週）評估指標之比較，發現實驗組和控制組在孕期不適、過去一週下背不適影響程度，並無統計上之差異性(p>.05)，但在孕期運動支持上，實驗組高於控制組（t=-2.129, p.05），然而經過時間與組別交叉比對之結果顯示：實驗組在36～40週時的運動支持較懷孕20～26週高7.280分（p.05). Support for prenatal exercise was higher in the experimental than in the control group (t=-2.129, p.05). After accounting for the group-time interaction effect, the researcher found a significant 7.280 rise (p<01) in exercise support scores between earlier (weeks 20~26) and later (weeks 36~40) weeks for the experimental group and a gradual decrease in exercise support scores for the control group.Significant factors of influence identified in terms of lower back pain impact on daily life included group, time, and previous exercise habit. Experimental group scores averaged 3.611 points lower than control group scores (p=.043). Lower back pain impact on daily life scores correlated positively with weeks pregnant (p<.01). After accounting for the group-time interaction effect, the researcher found a moderating effect over time on the impact of lower back pain on daily life for the experimental group and a gradually rising trend over time for the control group (p<.001). Subjects reporting a previous exercise habit scored an average 3.854 points less for impact of lower back pain on daily life than those who did not (p=.05).Easy for expectant mothers to do at home, birth ball exercises can help alleviate prenatal discomfort and should be promoted as part of prenatal education. Expectant mothers should consult with their physician prior to beginning any exercise program and an outpatient assessment system should be created to provide appropriate exercise information, ensure safety, and promote effective and enjoyable exercise. The author recommends incorporating prenatal exercise formally into the health education curricula as well as providing appropriate settings and trained nurses to deliver proper clinical guidance. Spouses should be encouraged to participate in the exercise learning and practice process in order to give essential support and encouragement