Body Composition, Cardiometabolic Health, Physical Abilities, Postpartum Health, Quality of Life, Sleep
Conditions
Keywords
Postpartum health, Postpartum exercise, Pelvic floor muscle training, Cardiometabolic health, Pilot randomized controlled trial
Brief summary
The goal of this pilot clinical trial is to learn whether a 12-week home-based exercise programme is feasible, acceptable, and safe for postpartum women in Hong Kong who had hypertensive disorders of pregnancy. The exercise programme is called the Aerobic, Strength, and Kegel exercise programme, or ASK programme. The main questions this study aims to answer are: * Can postpartum women follow the ASK exercise programme at home? * Is the ASK exercise programme acceptable and safe? * Does the ASK exercise programme show early benefits for postpartum recovery and health? Researchers will compare women who receive the ASK exercise programme with women who receive standard postnatal care. Participants will be randomly assigned to one of the two groups. They will complete study assessments at the beginning of the study and after 12 weeks. Women in the ASK exercise programme group will complete three 60-minute exercise sessions per week for 12 weeks, supported by a mobile app and wearable device. Women in the standard postnatal care group will continue to receive usual postnatal care.
Detailed description
This is a parallel-group pilot randomized controlled trial designed to evaluate the feasibility, acceptability, safety, and preliminary effectiveness of the ASK Programme, a 12-week home-based postpartum exercise intervention for Asian women in Hong Kong. The ASK Programme combines aerobic training, strength training, and Kegel-based pelvic floor muscle training, and is delivered through a study app with wearable-supported monitoring. Eligible participants will be enrolled at 6 to 8 weeks postpartum and randomized in a 1:1 ratio to either the ASK Programme intervention group or the standard postnatal care control group. Participants in the intervention group will complete three home-based ASK exercise sessions per week for 12 weeks. Each session will include warm-up, aerobic training, strength training, pelvic floor muscle training, and cool-down. The control group will receive standard postnatal care. Assessments will be conducted at baseline and within 1 week after completion of the 12-week intervention. The study will collect feasibility, adherence, safety, acceptability, clinical, behavioral, psychosocial, physiological, cardiometabolic, and exploratory biological data to inform the design of a future full-scale randomized controlled trial.
Interventions
OTHERASK Exercise Programme
The ASK Exercise Programme is a 12-week home-based, app-guided exercise intervention supported by a wearable device. Participants will be asked to complete three sessions per week, with each session lasting approximately 60 minutes. The programme includes aerobic exercise, strength training, and Kegel-based pelvic floor muscle training. The mobile app and wearable device will be used to support exercise delivery, self-monitoring, and adherence tracking.
Sponsors
Chinese University of Hong Kong
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Female Asian postpartum women aged 18 to 45 years * Singleton pregnancy * 6 to 8 weeks postpartum at the time of enrolment * Medically stable after childbirth * Physically able to participate in low-to-moderate intensity exercise training * Able and willing to participate in the 12-week study programme * Able to use the study app and wearable device, or willing to receive instruction on their use * Able to provide written informed consent
Exclusion criteria
* Multiple pregnancy * Severe postpartum medical complications or conditions contraindicating exercise participation * Severe cardiovascular, respiratory, neurological, or major musculoskeletal conditions that may limit safe participation in exercise * Current use of medication likely to substantially affect cardiac function, including heart failure therapy * Antibiotic treatment within the preceding month * Severe mental illness or other condition affecting the ability to provide informed consent or comply with study procedures * Any medical, obstetric, or psychological condition judged by the research team or attending clinician to make participation unsafe or inappropriate * Inability or unwillingness to adhere to the 12-week ASK programme or study assessments
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Participant satisfaction rate | At 12 weeks | Participant satisfaction will be assessed using a study-specific acceptability questionnaire administered at 12 weeks. Satisfaction will be defined as reporting "satisfied" or "very satisfied" with the ASK Exercise Programme. The outcome will be reported as the percentage of participants who are satisfied or very satisfied. |
| Recruitment rate to the ASK Exercise Programme | From recruitment initiation to 12 weeks | Recruitment rate will be calculated as the number of participants enrolled divided by the number of eligible participants approached. The outcome will be reported as a percentage of eligible participants approached. |
| Retention rate in the ASK Exercise Programme | From baseline to 12 weeks | Retention rate will be calculated as the number of enrolled participants who complete the 12-week follow-up assessment divided by the total number of enrolled participants. The outcome will be reported as a percentage of enrolled participants. |
| Dropout rate from the ASK Exercise Programme | From baseline to 12 weeks | Dropout rate will be calculated as the number of participants who withdraw or are lost to follow-up before the 12-week assessment divided by the total number of enrolled participants. The outcome will be reported as a percentage of enrolled participants. |
| Assessment completion in the ASK Exercise Programme | From baseline to 12 weeks | Assessment completion rate will be calculated as the number of completed planned study assessments divided by the total number of planned study assessments. The outcome will be reported as a percentage of planned study assessments. |
| ASK session completion rate | Throughout the 12-week intervention period | ASK session completion rate will be calculated as the number of prescribed ASK exercise sessions completed divided by the total number of prescribed ASK exercise sessions during the 12-week intervention period. Session completion will be assessed using app-recorded exercise completion data. The outcome will be reported as a percentage of prescribed ASK exercise sessions. |
| Adverse events related to the ASK Exercise Programme | Throughout the 12-week intervention period | Safety will be assessed as the number of participants who experience one or more adverse events related to the ASK Exercise Programme during the 12-week intervention period. Adverse events and exercise-related symptoms will be collected using participant symptom reports and study adverse event records. The outcome will be reported as the number of participants with adverse events related to the ASK Exercise Programme. |
| Postpartum recovery score | Baseline and 12 weeks | Postpartum recovery will be assessed using the Obstetric Quality of Recovery-10. The change from baseline to 12 weeks in the total Obstetric Quality of Recovery-10 score will be calculated. Total scores range from 0 to 100, with higher scores indicating better postpartum recovery. |
| Postnatal depressive symptom score | Baseline and 12 weeks | Postnatal depressive symptoms will be assessed using the Edinburgh Postnatal Depression Scale. The change from baseline to 12 weeks in the total Edinburgh Postnatal Depression Scale score will be calculated. Total scores range from 0 to 30, with higher scores indicating more severe depressive symptoms. |
| Pelvic floor symptom distress score | Baseline and 12 weeks | Pelvic floor symptom distress will be assessed using the Pelvic Floor Distress Inventory-20. The change from baseline to 12 weeks in the total Pelvic Floor Distress Inventory-20 score will be calculated. Total scores range from 0 to 300, with higher scores indicating greater pelvic floor symptom distress. |
| Sleep quality score | Baseline and 12 weeks | Sleep quality will be assessed using the Pittsburgh Sleep Quality Index. The change from baseline to 12 weeks in the global Pittsburgh Sleep Quality Index score will be calculated. Global scores range from 0 to 21, with higher scores indicating poorer sleep quality. |
| Breastfeeding self-efficacy score | Baseline and 12 weeks | Breastfeeding self-efficacy will be assessed using the Breastfeeding Self-Efficacy Scale-Short Form. The change from baseline to 12 weeks in the total Breastfeeding Self-Efficacy Scale-Short Form score will be calculated. Total scores range from 14 to 70, with higher scores indicating greater breastfeeding self-efficacy. |
| Health-related quality of life score | Baseline and 12 weeks | Health-related quality of life will be assessed using the Short Form-12 Health Survey. The change from baseline to 12 weeks in the health-related quality of life score will be calculated. The outcome will be reported as a score on a scale, with higher scores indicating better health-related quality of life. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Post-exercise recovery heart rate | Baseline and 12 weeks | Cardiorespiratory fitness will be assessed using a 3-minute step test. Post-exercise recovery heart rate will be recorded after completion of the test. The change from baseline to 12 weeks in post-exercise recovery heart rate will be calculated. The outcome will be reported in beats per minute. |
| Daily step count | Throughout the 12-week intervention period | Daily step count will be recorded using wearable-derived activity data. Mean daily step count during the 12-week intervention period will be calculated. The outcome will be reported as steps per day. |
| Body mass index | Baseline and 12 weeks | Body mass index will be calculated as body weight in kilograms divided by height in meters squared. The change from baseline to 12 weeks in body mass index will be calculated. The outcome will be reported in kg/m². |
| Exploratory gut microbiome profile | Baseline and 12 weeks | Gut microbiome profiles will be assessed using stool samples collected at baseline and 12 weeks. Changes from baseline to 12 weeks in gut microbiome profiles will be explored, including microbial diversity and taxonomic composition, depending on sample availability and sequencing quality. |
| Waist-hip ratio | Baseline and 12 weeks | Waist-hip ratio will be calculated as waist circumference divided by hip circumference. The change from baseline to 12 weeks in waist-hip ratio will be calculated. The outcome will be reported as a ratio. |
| Resting heart rate | Baseline and 12 weeks | Resting heart rate will be measured at baseline and 12 weeks. The change from baseline to 12 weeks in resting heart rate will be calculated. The outcome will be reported in beats per minute. |
| Systolic blood pressure | Baseline and 12 weeks | Systolic blood pressure will be measured at baseline and 12 weeks where available through home or routine clinical measurement. The change from baseline to 12 weeks in systolic blood pressure will be calculated. The outcome will be reported in mmHg. |
| Diastolic blood pressure | Baseline and 12 weeks | Diastolic blood pressure will be measured at baseline and 12 weeks where available through home or routine clinical measurement. The change from baseline to 12 weeks in diastolic blood pressure will be calculated. The outcome will be reported in mmHg. |
| Daily active minutes | Throughout the 12-week intervention period | Daily active minutes will be recorded using wearable-derived activity data. Mean daily active minutes during the 12-week intervention period will be calculated. The outcome will be reported as minutes per day. |
| Fasting glucose concentration | Baseline and 12 weeks | Fasting glucose concentration will be measured using fasting blood samples at baseline and 12 weeks. The change from baseline to 12 weeks in fasting glucose concentration will be calculated. The outcome will be reported in mmol/L. |
| HbA1c | Baseline and 12 weeks | HbA1c will be measured using blood samples at baseline and 12 weeks. The change from baseline to 12 weeks in HbA1c will be calculated. The outcome will be reported as a percentage. |
| Triglyceride concentration | Baseline and 12 weeks | Triglyceride concentration will be measured using fasting blood samples at baseline and 12 weeks. The change from baseline to 12 weeks in triglyceride concentration will be calculated. The outcome will be reported in mmol/L. |
| Total cholesterol concentration | Baseline and 12 weeks | Total cholesterol concentration will be measured using fasting blood samples at baseline and 12 weeks. The change from baseline to 12 weeks in total cholesterol concentration will be calculated. The outcome will be reported in mmol/L. |
| High-density lipoprotein cholesterol concentration | Baseline and 12 weeks | High-density lipoprotein cholesterol concentration will be measured using fasting blood samples at baseline and 12 weeks. The change from baseline to 12 weeks in high-density lipoprotein cholesterol concentration will be calculated. The outcome will be reported in mmol/L. |
| Low-density lipoprotein cholesterol concentration | Baseline and 12 weeks | Low-density lipoprotein cholesterol concentration will be measured using fasting blood samples at baseline and 12 weeks. The change from baseline to 12 weeks in low-density lipoprotein cholesterol concentration will be calculated. The outcome will be reported in mmol/L. |
Countries
Hong Kong
Contacts
CONTACTLAI KWAN LAM, PhD
PRINCIPAL_INVESTIGATORYao Wang, PhD
Chinese University of Hong Kong
Outcome results
None listed