Preparation and implementation of an individual physical exercise program for mothers 6 weeks after childbirth

Ženske se v poporodnem obdobju srečujejo z različnimi zdravstvenimi težavami, kot so urinska inkontinenca, bolečine v medenično-ledvenem, prsnem in vratnem delu hrbtenice, povezane z razmikom preme trebušne mišice in disfunkcijo mišic medeničnega dna. Razmik preme trebušne mišice je povezan s šibkimi mišicami medeničnega dna. V pričujočem magistrskem delu smo zato želeli raziskati stopnjo ozaveščenosti in znanje pravilne aktivacije mamic o mišicah medeničnega dna in ostalih mišicah notranje enote. Vzorec je predstavljal naključne prostovoljke, mamice, približno šest tednov po porodu, ki niso rodile s carskim rezom. Eksperimentalna skupina je dva meseca trikrat tedensko obiskovala individualno strokovno telesno vadbo pod stalnim strokovnim nadzorom kineziologinje. Razlike smo opazovali pri analizi specialnega ginekološkega pregleda, fizioterapevtskega pregleda, kineziološkega pregleda, anketnega vprašalnika ter testov gibalnih sposobnosti. Ugotovili smo, da mamice po porodu ne dosegajo stopnje dejavnosti v skladu s smernicami. Potrdili smo hipotezo, da je na koncu eksperimenta eksperimentalna skupina bolje ozaveščena in bolj telesno dejavna kot kontrolna skupina. Prav tako smo potrdili boljše poznavanje in izvedbo pravilne aktivacije mišic medeničnega dna in ostalih mišic notranje enote pri eksperimentalni skupini. Potrdili smo tudi tretjo hipotezo, da bo imela eksperimentalna skupina manj zdravstvenih težav in boljše rezultate testov gibalnih sposobnosti. Z izvedenim eksperimentom smo pokazali, da je potrebno spodbujanje sodelovanja strokovnih delavcev na tem področju (ginekolog, fizioterapevt in kineziolog) za doseganje dobrega telesnega in psihičnega stanja mamic po porodu. Predstavili smo, da je za ranljivo skupino mamic po porodu pomembna strokovna telesna vadba individualno prilagojena vsaki posameznici. Na podlagi izsledkov eksperimenta ugotavljamo, da je potrebno okrepiti ozaveščanje mamic o pomenu rehabilitacije mišic medeničnega dna po porodu in podajamo predloge rešitev.In the postpartum period women face various health problems such as urinary incontinence, pain in the pelvic-lumbar, thoracic and cervical spine, associated with diastasis recti abdominis and pelvic floor muscles dysfunction. Diastasis recti abdominis is associated with weak pelvic floor muscles. In this master\u27s thesis, we therefore wanted to investigate the level of awareness and knowledge of correct activation of mothers regarding the muscles of the pelvic floor and other muscles of the internal unit. The sample consisted of random volunteers, mothers, approximately six weeks postpartum, who did not give birth by caesarean section. The experimental group attended individual professional physical training three times a week for two months under the constant professional supervision of a kinesiologist. Differences were observed in the analysis of a special gynecological examination, physiotherapy examination, kinesiological examination, survey questionnaire and tests of movement abilities. We found that mothers do not reach the level of activity in accordance with the guidelines after giving birth. We confirmed the hypothesis that at the end of the experiment, the experimental group will be more aware and more physically active than the control group. We also confirmed better knowledge and execution of correct activation of the pelvic floor muscles and other muscles of the internal unit in the experimental group. We also confirmed the third hypothesis, that the experimental group will have fewer health problems and better results in motor skills tests. Through the experiment we have shown that it is necessary to encourage the cooperation of professionals in this field (gynecologist, physiotherapist and kinesiologist) in order to achieve a good physical and psychological state of mothers after childbirth. We presented that for the vulnerable group of mothers after childbirth, professional physical exercise, individually adapted to each individual, is important. Based on the results of the experiment, we conclude that it is necessary to raise the awareness of mothers about the importance of rehabilitation of the pelvic floor muscles after childbirth, and we provide suggestions for solutions