Dr. James LeCheminant, Department of Exercise Sciences

Evaluation of how well the academic objectives of the proposal were met

The purpose of this study, as submitted to the IRB, was to determine the effects of flexibility or resistance training on body composition, strength, spontaneous physical activity, cardiovascular disease risk factors, bone density, and body satisfaction, depression, health-related quality of life, and self-efficacy in postpartum women.

We successfully recruited 60 postpartum women and randomized them to either resistance or flexibility training. The study design included four months of training with a subsequent eight- month follow-up after completion of the training. Forty-four participants completed all aspects of the initial training and were measured for each of the outcomes listed above. To date, all participants completed the training portion, half of the participants have completed the eight month follow-up, and the other half will complete their follow-up in January of 2011.

Recruitment for this study was very difficult as the targeted population was fairly small. It took nearly a year to recruit and complete the first phase of the study. This is perhaps why we were one of the very first to do such a study in postpartum women. A great deal of student effort and time was required. Nevertheless, we completed the main objectives of this study and met the objectives of the proposal.

Evaluation of the mentoring environment

The original proposal suggested that the mentoring environment would include two components: 1) training/preparation; 2) weekly follow-up. As intended, each student received training and became competent technicians for the following tests: body composition and anthropometric assessments, strength and flexibility testing, bone mineral testing, physical activity assessment via accelerometry, various psychosocial tests, and each learned how to interpret assessment results to provide to participants. Each student also was trained in the resistance and flexibility exercises participants were asked to complete. As a result, the students are better able to communicate and teach these principles. In addition, each student met or reported to Dr. LeCheminant virtually every week in which the intervention was occurring.

In sum, I believe the students now better understand scientific research, its challenges and rewards, and are better able to appreciate the attention to detail and work level required to produce good human subject research. I think this will help them going forward to turn to the science for answers and to detect robust study design vs. poor quality studies and results.

List of students who participated and what academic deliverables they have produced or it is anticipated they will produce

Graduate students that participated included:
Tiffany Hinman, Katherine Bishop-Pratt, Nathan Earl.

Undergraduate students that participated included:
Kimberlee Ray, Emily Lund, Ben LeCheminant, Steve Crowe, Kylie McLennan.

Academic Deliverables:

• Tiffany and Katherine were able to use a portion of the data for the successful completion of their Master’s Thesis.
• In October of 2010, two international presentations were given in San Diego at the Obesity Society annual conference with several of the students above as either the primary author or as a co-author. The titles of the presentations include:
  • The effect of resistance or flexibility training on total physical activity in lactating postpartum women.
  • The relationship between body image and adiposity in postpartum women.
• The following manuscripts are in-process with anticipated submission for publication as noted below. It is anticipated that there will be 3-4 student co-authors on each submission below.
  • Body satisfaction and appearance evaluation in lactating postpartum women: the influence and relationship with adiposity. (Anticipated submission to Body Image by December 1, 2010)
  • The relationship between four-months of resistance exercise training and physical activity in postpartum women. (Anticipated submission to Obesity or Medicine and Science in Sports and Exercise by December 1, 2010)
  • A randomized trial of four-months of resistance or flexibility training and eight-months of follow-up on body composition in postpartum women. (Anticipated submission to Obesity or Medicine and Science in Sports and Exercise by March 1, 2010)

Description of the results/findings of the project

First, this is the first study solely examining the effect of resistance training in postpartum women. There is one other study published during our data collection period describing the effects of weight training/aerobic exercise on body composition in postpartum women, making it a bit different than ours. Based upon the paucity of data, we fell this study is somewhat “cutting- edge” and will be quite publishable. Summary of main findings are below.

• A cross-section analysis revealed a significant relationship between adiposity and body image satisfaction in these postpartum women. Weight retention following childbirth and length of time postpartum modified this relationship. This result indicates that the postpartum period represents an opportune time for interventions that help women return to pre-pregnancy weight and to improve body image. This will be the focus one of the manuscripts.
• Strength significantly and astronomically improved in the weight training group compared to
  the flexibility group. There was no difference in low back flexibility between groups over time.
• There were significant group*time interactions for sedentary time and light-intensity activity time. The resistance training group showed significantly less sedentary activity and more light- intensity activity over time than the flexibility group. This did not quite result in better body weight changes (P=0.09); but a definite trend was apparent. This will be the focus one of the manuscripts.
• Though most other outcomes improved in both groups, there were no group*period interactions for CVD risk factors, body composition, or psychosocial outcomes.
• We are near completion of the final follow-up in which we will be able to determine the effectiveness or longer-term implications of the study; including, if the women were able to maintain their training without constant supervision and accountability. This will be the focus one of the manuscripts.

Description of how the budget was spent

Originally, there were eight components of the budget including: gym memberships for participants to train, blood analyses, DXA certifications, compensation for participants, payment of student workers, advertising/recruiting, dietary analysis, and miscellaneous.

We closely followed the originally proposed budget with only minor modifications and one primary modification. The major modification was that we did not measure diet and thus did not spend money for dietary analysis. The primary percent expenditures, in order from most to least expensive included: payment of undergraduate student workers, compensation of participants, gym memberships for participants to train, blood analyses, miscellaneous expenditures, and advertising expenditures. As the follow-up portion of this study will be entirely completed in January, the remaining budget will go to paying undergraduates and compensating participants for their final testing at eight-month follow-up in January.