Certain Voicing Tasks Improve Balance in Postpartum Women Compared With Nulliparous Women

Background: Postpartum women are at an increased risk of falls. Maintaining standing balance is multifactorial, involving abdominal wall/pelvic floor muscle responsivity, quick generation of intra-abdominal pressure, and glottis position. Objective: To identify whether using voicing tasks improves balance in postpartum women. Study Design: Research report. Methods: Eleven postpartum women and 10 age-matched nulliparous controls stood on a force plate when balance was perturbed to the front or back of their bodies while performing 6 different breathing and voicing tasks. Tasks modified glottis position and lung volume. Primary outcome measure was maximal displacement of center of pressure immediately following perturbation. Results: When comparing the 2 groups' responses, postpartum women showed worse balance during the “Ah” sound and “normal exhale without breath hold” (P = .049 and P = .031, respectively). When comparing all responses to each task, participants in both groups showed no significantly different response to any tasks when they were perturbed anteriorly. The nulliparous group also had no significantly different responses when perturbed posteriorly. Postpartum women showed a significant difference in response to “normal exhale without breath hold” compared with “counting” (P = .01), with better balance for “counting.” Conclusion: Postpartum women showed improved balance during the “counting” task, which incorporates the glottis into the balance mechanism. Tasks that did not incorporate the glottis (exhalation) and relied more on the abdominal wall/pelvic floor produced worse balance in postpartum women. For recently postpartum women, counting may be a helpful strategy to improve balance and reduce fall risk.