Psychophysiological rehabilitation for postpartum depression: A physiotherapy-led, nurse-collaborative model from calabar metropolis

Vollständiger Abstract

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Background: Postpartum depression (PPD) profoundly disrupts maternal well-being, yet conventional care in many low-resource settings remains narrowly focused on psychosocial counseling. Integrating physiotherapy, delivered in collaboration with nursing support, offers a novel psychophysiological approach to recovery by enhancing autonomic regulation, self-efficacy, and functional capacity. Objective: This study examined the effectiveness of a physiotherapy-led, nurse-collaborative psychophysiological intervention in reducing the severity of PPD among postpartum women, with secondary effects on perceived stress, autonomic function, and quality of life, in Calabar Metropolis, Nigeria. Materials and Methods: A single-blind randomized controlled trial recruited 148 women (6–12 weeks postpartum) randomized to intervention ( n = 74) or control ( n = 74). The intervention group received physiotherapy-led, nurse-collaborative psychophysiological intervention, which integrated aerobic exercise, progressive muscle relaxation, mindfulness breathing, and heart rate variability (HRV) biofeedback over 12 weeks under nurse supervision. Controls received structured maternal education, emotional support, and wellness sessions reflecting enhanced standard care. Outcomes (depressive symptoms, perceived stress, autonomic function, and quality of life) were assessed using the Edinburgh Postnatal Depression Scale, Perceived Stress Scale, HRV analysis, and the Maternal Postpartum Quality of Life Questionnaire, respectively, at baseline, 6, and 12 weeks. Results: By week 12, the intervention group demonstrated a 37% reduction in depressive scores, 32% reduction in stress, 14% increase in HRV, and 9-point gain in quality-of-life indices (all P < 0.001). Collaborative nursing support enhanced adherence (91%) and emotional engagement. Conclusion: A physiotherapy-led, nurse-collaborative model significantly optimized psychophysiological recovery and maternal quality of life. This integrative, nonpharmacological approach represents a transformative pathway for holistic postpartum mental health care.