Feasibility of an exercise intervention for women with postnatal depression: a pilot randomised controlled trial.
Daley A., Winter H., Grimmett C., McGuinness M., McManus R., MacArthur C.
BACKGROUND: Postnatal depression is a serious mental health problem that may be reduced by exercise. AIM: This study examined the feasibility of an exercise intervention for women with postnatal depression, and assessed which methods of recruitment are most effective. DESIGN OF STUDY: Randomised controlled trial. SETTING: General practice and the community. METHOD: Participants were recruited from various sources and randomised to an exercise intervention or usual care with follow-up at 12 weeks. As well as assessing feasibility, other trial outcomes included exercise participation and self-efficacy for exercise. Levels of depression were assessed but the study was not powered to show a difference in this. RESULTS: The recruitment rate of eligible patients was 23.1%. The highest recruitment rate was via referral from the psychiatric mother and baby unit (9/28; 32.1%), followed by invitation letters from GPs (24/93; 25.8%). Thirty-eight eligible participants were randomised. At follow-up there was no significant difference in exercise participation between groups. The intervention group reported significantly higher self-efficacy for exercise compared to usual care, but depression scores did not differ. CONCLUSION: Exercise participation over the 12-week period was not significantly increased, possibly because it is difficult to motivate women with postnatal depression to exercise, or the intervention was not sufficiently intensive. Eligible patients were recruited into this study but response rates were low. Optimum methods of recruitment in this difficult-to-reach population are required prior to a substantive trial. Further research is imperative given poorly-evidenced recommendations by the National Institute for Health and Clinical Excellence to consider this treatment.