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Effects of a Home-based Exercise Intervention on Fatigue in Postpartum Depressed Women: Results of a Randomized Controlled Trial

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Fatigue is prevalent during the postpartum period and may be heightened in postpartum depressed women.

Purpose

To evaluate the efficacy of a home-based exercise intervention in reducing physical and mental fatigue scores in postpartum depressed women.

Methods

Eighty-eight women in the postpartum (4–38 weeks) obtaining a score ≥10 on the Edinburgh Postnatal Depression Scale (EPDS) were randomly assigned to a 12-week individualized home-based intervention (n = 46) or a control group (n = 42).

All participants completed a cardiovascular fitness test at baseline. Outcomes were physical and mental fatigue scores and were measured at baseline, posttreatment and 3 months posttreatment.

Results

On the basis of intent-to-treat analyses, compared to the control group, women in the exercise group showed significantly greater reduction in physical fatigue at posttreatment [mean change =  −4.07, (95% CI, (−5.15, −2.98)] and 3 months posttreatment [mean change = −4.24, (95% CI, (−5.36, −3.12)]. Significant reductions in mental fatigue with exercise were observed at posttreatment for women reporting lower physical fatigue at baseline.

Conclusions

Fatigue is a common symptom experienced in the postpartum that can be heightened by depression. The findings show that home-based exercise can reduce physical and mental fatigue in postpartum depressed women.

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References

  1. McGovern D, Dowd B, Gjerdingen D, et al. Postpartum health of employed mothers 5 weeks after childbirth. Annals of Family Medicine. 2006; 4: 159–167.

    Article  PubMed  Google Scholar 

  2. Saurel-Cubizolles MJ, Romito P, Lelong N, Ancel PY. Women’s health after childbirth: a longitudinal study in France and Italy. Br. J. Obstet. Gynaecol. 2000; 107: 1202–1209.

    CAS  Google Scholar 

  3. Cathébras PJ, Robbins JM, Kirmayer L, Haton BC. Fatigue in primary care: prevalence, psychiatric comorbidity, illness behavior, and outcome. J. Gen. Intern. Med. 1992; 7: 276–286.

    Article  PubMed  Google Scholar 

  4. Troy NW. A comparison of fatigue and energy levels at 6 weeks and 14 and 19 months postpartum. Clin. Nurs. Res. 1999; 8: 135–152.

    Article  PubMed  CAS  Google Scholar 

  5. Tylee A, Gastpar M, Lepine JP, Mendelwicz J. DEPRES II (Depression Research in European Society II): A patient survey of the symptoms, disability and current management of depression in the community. DEPRES Steering Committee. Int. Clin. Psychopharmacol. 1999; 14: 139–151.

    Article  PubMed  CAS  Google Scholar 

  6. Kroenke K, Wood DR, Mangelsdorff AD, Meier NJ, Powell JB. Chronic fatigue in primary care: prevalence, patient characteristics and outcome. J Am. Med. Assoc. 1988; 260: 929–934.

    Article  CAS  Google Scholar 

  7. Manu P, Lane TJ, Matthews DA. The frequency of chronic fatigue syndrome in patients with symptoms of persistent fatigue. Arch. Intern. Med. 1988; 109: 554–556.

    CAS  Google Scholar 

  8. Stowe ZN, Nemeroff CB. Women at risk for postpartum-onset major depression. Am. J. Obstet. Gynecol. 1995; 173: 639–645.

    Article  PubMed  CAS  Google Scholar 

  9. Righetti-Veltema M, Conne-Perréard E, Bousquet A, Manzano J. Postpartum depression and mother–infant relationship at 3 months old. J. Affect. Disord. 2002; 70: 291–306.

    Article  PubMed  Google Scholar 

  10. Smets EMA, Garssen B, Bonke B, de Haes JC. The Multidimensional Fatigue Inventory (MFI): psychometrics qualities of an instrument to assess fatigue. J. Psychosom. Res. 1995; 39: 315–325.

    Article  PubMed  CAS  Google Scholar 

  11. Mohr DC, Hart SL, Goldenberg A. Effects of treatment for depression on fatigue in multiple sclerosis. Psychosom. Med. 2003; 65: 542– 547.

    Article  PubMed  Google Scholar 

  12. Kirk KM, Hickie IB, Martin NG. Fatigue as related to anxiety and depression in a community-based sample of twins aged over 50. Soc. Psychiatry Psychiatr. Epidemiol. 1999; 34: 85–90.

    Article  PubMed  CAS  Google Scholar 

  13. Koschera A, Hickie I, Hadzi-Pavlovic D, Wilson A, Loyd A. Prolonged fatigue, anxiety and depression: exploring relationships in a primary care sample. Aust. N. Z. J. Psychiatry. 1999; 33: 545–552.

    Article  PubMed  CAS  Google Scholar 

  14. Schneider RA. Concurrent validity of the Beck depression inventory and the Multidimensional Fatigue Inventory-20 in assessing fatigue among cancer patients. Psychol. Rep. 1998; 82: 883–886.

    PubMed  CAS  Google Scholar 

  15. Hickie IB, Koschera A, Hadzi-Pavlovic D, Bennett B, Loyd A. The temporal stability and co-morbidity of prolonged fatigue: a longitudinal study in primary care. Psychol. Med. 1999; 29: 855–861.

    Article  PubMed  CAS  Google Scholar 

  16. Dennis CL, Ross L. Relationships among infant sleep patterns, maternal fatigue, and development of depressive symptomatology. Birth. 2005; 32: 187–193.

    Article  PubMed  Google Scholar 

  17. Corwin EJ, Brownstead J, Barton N, Heckard S, Morin K. The impact of fatigue on the development of postpartum depression. J. Obstet. Gynecol. Neonatal Nurs. 2005; 34: 577–586.

    Article  PubMed  Google Scholar 

  18. Troy NW, Dalgas-Pelish P. The effectiveness of a self-care intervention for the management of postpartum fatigue. Appl. Nurs. Res. 2003; 16: 38–45.

    Article  PubMed  Google Scholar 

  19. Thome M, Adler BA. Telephone intervention to reduce fatigue and symptom distress in mothers with difficult infants in the community. J. Adv. Nurs. 1999; 29: 128–137.

    Article  PubMed  CAS  Google Scholar 

  20. Leermakers EA, Anglin K, Wing RR. Reducing postpartum weight retention through a correspondence intervention. Int. J. Obes. 1998; 22: 1103–1109.

    Article  CAS  Google Scholar 

  21. Ohlin A, Rossner S. Factors related to body weight changes during and after pregnancy: the Stockholm Pregnancy and Weight Development Study. Obes. Res. 1996; 4: 271–276.

    PubMed  CAS  Google Scholar 

  22. Harris HE, Ellison GT, Clement S. Do the psychosocial and behavioural changes that accompany motherhood influence the impact of pregnancy on long-term weight gain. J. Psychosom. Obstet. Gynaecol. 1999; 20: 65–79.

    Article  PubMed  CAS  Google Scholar 

  23. Larson-Meyer DE. Effect of postpartum exercise on mothers and their offspring: a review of the literature. Obes. Res. 2002; 10: 841–853.

    PubMed  Google Scholar 

  24. Koltyn KF, Schultes SS. Psychological effects of an aerobic exercise session and a rest session following pregnancy. J. Sports Med. Phys. Fitness. 1997; 37: 287–291.

    PubMed  CAS  Google Scholar 

  25. Annesi JJ. Relation of rated fatigue and changes in energy after exercise and over 14 weeks in previously sedentary exercisers. Percept. Mot. Skills. 2002; 95: 719–727.

    Article  PubMed  Google Scholar 

  26. Dimeo FC, Stieglitz RD, Noveli-Fischer U, Fetscher S, Keul J. Effects of physical activity on the fatigue and psychologic status of cancer patients during chemotherapy. Cancer. 1999; 85: 2273–2277.

    Article  PubMed  CAS  Google Scholar 

  27. Fulcher KY, White PD. Randomised controlled trial of graded exercise in patients with the chronic fatigue syndrome. Br. Med. J. 1997; 314: 1647–1652.

    CAS  Google Scholar 

  28. Mock V, Hassey-Dow K, Meares CJ, et al. Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Oncol. Nurs. Forum. 1997; 24: 991–1000.

    PubMed  CAS  Google Scholar 

  29. Pinto B, Frierson GM, Rabin C, Trunzo JJ, Marcus BH. Home-based physical activity intervention for breast cancer patients. J. Clin. Oncol. 2005; 23: 3577–3587.

    Article  PubMed  Google Scholar 

  30. Puetz T, O’Connor P, Dishman RK. Effects of chronic exercise on feelings of energy and fatigue: A quantitative synthesis. Psychol. Bull. 2006; 132: 866–876.

    Article  PubMed  Google Scholar 

  31. Da Costa D, Lowensteyn I, Abrahamowicz M, et al. A randomized clinical trial of exercise to alleviate postpartum depression. Psychosomatic Medicine (Under review).

  32. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: Development of the 10-item Edinburgh postnatal depression scale. Br. J. Psychiatry. 1987; 150: 782–786.

    PubMed  CAS  Google Scholar 

  33. Smets EM, Garssen B, Cull A, de Haes JC. Application of the multidimensional fatigue inventory (MFI-20) in cancer patients receiving radiotherapy. Br. J. Cancer. 1996; 73: 241–245.

    PubMed  CAS  Google Scholar 

  34. Harris B, Huckle P, Thomas R, Johns S, Fung H. The use of rating scales to identify post-natal depression. Br. J. Psychiatry. 1989; 154: 813–817.

    PubMed  CAS  Google Scholar 

  35. Murray L, Carothers AD. The validation of the Edinburgh Post-natal Depression Scale on a community sample. Br. J. Psychiatry. 1990; 157: 288–290.

    Article  PubMed  CAS  Google Scholar 

  36. Zelkowitz P, Milet TH. Screening for postpartum depression: a community sample. Can. J. Psychiatry. 1995; 40: 80–86.

    PubMed  CAS  Google Scholar 

  37. Da Costa D, Larouche J, Dritsa M, Brender W. Psychosocial correlated of prepartum and postpartum depressed mood. J. Affect. Disord. 2000; 59: 31–40.

    Article  PubMed  Google Scholar 

  38. Hamilton MA. Development of a rating scale for primary depressive illness. Br. J. Soc. Clin. Psychol. 1967; 6: 278–296.

    PubMed  CAS  Google Scholar 

  39. Hamilton MA. The Hamilton rating scale for depression. In: Sortorius N, Ban TA, eds. Assessment of Depression. Berlin: Springer-Verlag; 1986: 143–152.

    Google Scholar 

  40. O’Hara MW, Stuart S, Gorman LL, Wenzel A. Efficacy of interpersonal psychotherapy for postpartum depression. Arch. Gen. Psychiatry. 2000; 57: 1039–1045.

    Article  PubMed  CAS  Google Scholar 

  41. Blumenthal JA, Babyak MA, Moore KA, et al. Effects of exercise training on older patients with major depression. Arch. Intern. Med. 1999; 159: 2349–2356.

    Article  PubMed  CAS  Google Scholar 

  42. Simon GE, Revicki D, VonKorff M. Telephone assessment of depression severity. J. Psychiatry Res. 1993; 27: 247–252.

    Article  CAS  Google Scholar 

  43. Bruce RA, Kusumi F, Hosmer D. Maximal oxygen uptake and nomographic assessment of functional aerobic impairment in cardiovascular disease. Am. Heart J. 1973; 85: 546–562.

    Article  PubMed  CAS  Google Scholar 

  44. American College of Sports Medicine: American College of Sports Medicine’s guidelines for exercise testing and prescription (5th ed.). Philadelphia: Williams & Wilkins, 1995.

  45. American College of Sports Medicine: American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc. 1998, 30: 975–91.

  46. Aiken LS, West SG. Multiple Regression: Testing and interpreting interactions. Thousand Oaks: Sage; 1991.

    Google Scholar 

  47. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale, NJ: Elbraum.

  48. Oken BS, Kishiyama S, Zajdel D, et al. Randomized controlled trial of yoga and exercise in multiple sclerosis. Neurology. 2004; 62: 2058–2064.

    PubMed  CAS  Google Scholar 

  49. Courneya KS, Roanne JS, Reid RD, et al. Three independent factors predicted adherence in randomized trial of resistance exercise training among prostate cancer survivors. J. Clin. Epidemiol. 2004; 57: 571–579.

    Article  PubMed  Google Scholar 

  50. Annesi JJ. Mood alterations following an indoor and outdoor exercise program in healthy elderly women. Percept. Mot. Skills. 2005; 100: 707–715.

    Article  Google Scholar 

  51. Porock D, Kristjanson LJ, Tinnelly K, Duke T, Blight J. An exercise intervention for advanced cancer patients experiencing fatigue: a pilot study. J. Palliat. Care. 2000; 16: 30–36.

    PubMed  CAS  Google Scholar 

  52. Mock V, Frangakis C, Davidson NE, et al. Exercise manages fatigue during breast cancer treatment: a randomized controlled trial. Psychooncology. 2005; 14: 464–477.

    Article  PubMed  Google Scholar 

  53. Lim W, Hong S, Nelesen R, Dimsdale JE. The association of obesity, cytokine levels, and depressive symptoms with diverse measures of fatigue in healthy subjects. Arch. Intern. Med. 2005; 25: 910–915.

    Article  Google Scholar 

  54. Maloni JA, Park S. Postpartum symptoms after antepartum bed rest. J. Obstet. Gynecol. Neonatal Nurs. 2005; 34: 163–171.

    Article  PubMed  Google Scholar 

  55. Stark MA, Cimprich B. Promoting attentional health: Importance to women's lives. Health Care Women Int. 2003; 24: 93–102.

    PubMed  Google Scholar 

  56. Marin H, Menza MA. The management of fatigue in depressed patients. Essent. Psychopharmacol. 2005; 6: 15–192.

    Google Scholar 

  57. Hrobjartsson A. What are the main methodological problems in the estimation of placebo effects. J. Clin. Epidemiol. 2002; 55: 430–435.

    Article  PubMed  Google Scholar 

  58. Murray L, Cooper P, ed. Postpartum Depression and Child Development. London: The Guilford Press; 1997.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Psychology, Université du Québec à Montréal, Montreal, Canada

    Maria Dritsa Ph.D. & Gilles Dupuis Ph.D.

  2. Division of Clinical Epidemiology, McGill University Health Centre (MUHC), 687 Pine Avenue West, V Building, Montreal, QC, Canada, H3A-1A1

    Maria Dritsa Ph.D., Deborah Da Costa Ph.D. & Ilka Lowensteyn Ph.D.

  3. Department of Obstetrics & Gynecology, Royal Victoria Hospital MUHC, Montreal, Canada

    Samir Khalifé M.D.

Authors
  1. Maria Dritsa Ph.D.
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  2. Deborah Da Costa Ph.D.
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  3. Gilles Dupuis Ph.D.
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  4. Ilka Lowensteyn Ph.D.
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  5. Samir Khalifé M.D.
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Corresponding author

Correspondence to Maria Dritsa Ph.D..

Additional information

This study was funded by an operating grant from the Fonds de recherche en santé du Québec (#024018).

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Dritsa, M., Da Costa, D., Dupuis, G. et al. Effects of a Home-based Exercise Intervention on Fatigue in Postpartum Depressed Women: Results of a Randomized Controlled Trial. ann. behav. med. 35, 179–187 (2008). https://doi.org/10.1007/s12160-008-9020-4

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  • DOI: https://doi.org/10.1007/s12160-008-9020-4

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