Body image profiles and exercise behaviours in early motherhood. A latent profile analysis.

Early motherhood may impact body image, and its relationship to exercise, potentially affecting mother and infant wellbeing. This study examined whether duration of weekly exercise differed according to body image profile (BIP) based on relative levels of body dissatisfaction and body appreciation. Survey data from 262 women, 0-5 years postpartum, were analysed. Latent profile analysis identified "average", "dissatisfied" and "appreciative" BIPs. Significantly lower exercise was found in the dissatisfied compared to the appreciative BIP (p = 0.005), with marginally lower exercise in the dissatisfied compared to the average BIP (p = 0.029 with adjusted α = 0.02). This research has implications for designing targeted interventions supporting postpartum wellbeing.

Mothers' experiences of the relationship between body image and exercise, 0-5 years postpartum: A qualitative study.

The relationship between body image and exercise in early motherhood is an important yet understudied determinant of mother and infant wellbeing. To address this, we report on a qualitative study of early mothers' lived experiences of the relationship between body image and exercise in the first five years post-birth. Twenty-one mothers (0-5 years postpartum) completed individual, semi-structured online/phone interviews (M interview time =47.25 min), to elicit narratives about peripartum body image and its relationship with exercise. Thematic analysis was conducted according to the Braun and Clarke framework. Three key themes, and several subthemes, were identified: 1.body image in early motherhood is diverse, dynamic and individual, 2.postpartum exercise forms part of early motherhood adjustment, and 3.body image and exercise form an important, intricate relationship in early motherhood. Women's narratives indicated three body image/exercise patterns, each characterised by different behaviours and motivations. Mothers who reported exercising, or avoiding exercising, for reasons related to body dissatisfaction appeared at greatest risk of negative outcomes from body-related distress and maladaptive exercise patterns. Conversely, mothers reporting higher body appreciation described more adaptive exercise behaviours. This research provides important information for the development of interventions to support positive body image and healthful exercise in early motherhood.

The effect of different depths of medial heel skive on plantar pressures.

BACKGROUND: Foot orthoses are often used to treat lower limb injuries associated with excessive pronation. There are many orthotic modifications available for this purpose, with one being the medial heel skive. However, empirical evidence for the mechanical effects of the medial heel skive modification is limited. This study aimed to evaluate the effect that different depths of medial heel skive have on plantar pressures. METHODS: Thirty healthy adults (mean age 24 years, range 18-46) with a flat-arched or pronated foot posture and no current foot pain or deformity participated in this study. Using the in-shoe pedar-X® system, plantar pressure data were collected for the rearfoot, midfoot and forefoot while participants walked along an 8 metre walkway wearing a standardised shoe. Experimental conditions included a customised foot orthosis with the following 4 orthotic modifications: (i) no medial heel skive, (ii) a 2 mm medial heel skive, (iii) a 4 mm medial heel skive and (iv) a 6 mm medial heel skive. RESULTS: Compared to the foot orthosis with no medial heel skive, statistically significant increases in peak pressure were observed at the medial rearfoot - there was a 15% increase (p = 0.001) with the 4 mm skive and a 29% increase (p < 0.001) with the 6 mm skive. No significant change was observed with the 2 mm medial heel skive. With respect to the midfoot and forefoot, there were no significant differences between the orthoses. CONCLUSIONS: This study found that a medial heel skive of 4 mm or 6 mm increases peak pressure under the medial rearfoot in asymptomatic adults with a flat-arched or pronated foot posture. Plantar pressures at the midfoot and forefoot were not altered by a medial heel skive of 2, 4 or 6 mm. These findings provide some evidence for the effects of the medial heel skive orthotic modification.

Consensus for dry needling for plantar heel pain (plantar fasciitis): a modified Delphi study.

HYPOTHESIS: Plantar heel pain (plantar fasciitis) is a common and disabling condition. A variety of treatment options are available to patients with plantar heel, however the evidence for these treatments is generally weak and the best way to manage plantar heel pain remains unclear. Trigger point dry needling is increasingly used as an adjunct therapy for musculoskeletal pain. In patients with plantar heel pain this technique is thought to improve muscle activation patterns, increase joint range of motion and alleviate pain. However, there have been no randomised controlled trials that have evaluated the effectiveness of dry needling for plantar heel pain. METHODS: In order to develop a treatment protocol to evaluate the effectiveness of dry needling for plantar heel pain we conducted a three stage modified Delphi process using a web-based survey technique. Over a series of three iterations, 30 experts (participants) worldwide indicated their level of agreement on specific issues relating to the use of dry needling for plantar heel pain including their treatment rationale, needling details and treatment regimen. Consensus for a dry needling protocol for plantar heel pain was achieved when >60% of participants (IQR ≤ 1.0 category on 5-point Likert scale) agreed the protocol was adequate. RESULTS: The response rate was 75% (n=30), 100% (n=30) and 93% (n=28) in the first, second and third rounds respectively. Round 1 helped generate a list of 10 items that were deemed important for developing a dry needling protocol for plantar heel pain. These 10 items were subsequently presented in Round 2. Of these, 5 of the 10 items met the criteria to be included in a dry needling protocol for plantar heel pain that was presented in the final round, Round 3. Items that did not meet the criteria were either removed or amended and then presented in Round 3. In the final round, 93% of participants (IQR range = 1) agreed the proposed dry needling protocol for plantar heel pain was adequate. The protocol can now be used in future research projects designed to evaluate the effectiveness of dry needling for plantar heel pain.