REF-1781 · Elliott-Sale et al., 2026 · Scientific Reports · Paper · PubMed

An 18-week supervised programme started 6 weeks after birth

Core and pelvic-floor rehabilitation plus resistance training and HIIT — improved mid-thigh pull, vertical jump and 2-km run time more than standard postpartum care, with no adverse events reported, in a non-randomised controlled trial of UK servicewomen with 11 and 9 completers; from the abstract

Main caveat: Design: not randomised, so the groups may have differed in motivation, fitness or circumstances at the start; how women were assigned is not in the abstract.
limited, mixed evidenceMeasured on non-athletes to trained athletesRead from the abstract only

Elliott-Sale and colleagues tested whether a structured programme helps servicewomen return to occupational fitness after birth.

At 6 weeks postpartum, UK servicewomen were assigned, without randomisation, to standard postpartum care (n = 14) or to standard care plus an 18-week programme combining core and pelvic-floor rehabilitation with supervised resistance and high-intensity interval training (n = 17).

Occupational performance was the primary outcome; pelvic health, psychological well-being and musculoskeletal health were secondary, with assessments between 6 and 24 weeks postpartum. Eleven women in the programme and nine controls completed every visit. Adherence to the core reconnection and physical development training was 96% and no adverse events were reported.

The programme group improved more than controls in mid-thigh pull, vertical jump and 2-km run time (group × time interactions, all p ≤ 0.05; improvements of 12.7-14.5%), but not in the medicine-ball throw (p = 0.643), and showed larger gains than controls in pelvic health, body composition and psychological well-being (each p < 0.05).

The authors conclude that the combined programme was well adhered to, produced no adverse events and was more effective than standard care.

Participants

UK-based servicewomen, 6 weeks postpartum at allocation: programme 17, control 14; completers 11 and 9.
Age, parity, mode of delivery, complications, pre-pregnancy fitness, breastfeeding and the reasons for dropout: not in the abstract.

Protocol

Control: standard postpartum care.
Programme: standard care plus 18 weeks combining core and pelvic-floor rehabilitation with supervised resistance training and HIIT. Session frequency, loads, interval structure, the timing of each phase and when running began: not in the abstract.
Outcomes: occupational performance (primary: mid-thigh pull, vertical jump, 2-km run time trial, medicine-ball throw); pelvic health, psychological well-being, musculoskeletal health and body composition (secondary). The instruments for pelvic health and well-being are not named in the abstract.
Assessments: between 6 and 24 weeks postpartum (the exact time points are not in the abstract).
Allocation: non-randomised; how women were assigned is not in the abstract.

Key Results

OutcomeProgramme vs standard care
Mid-thigh pull, vertical jump, 2-km run time trialsignificant group × time interactions favouring the programme (all p ≤ 0.05); improvements of 12.7-14.5% (the abstract does not say which figure belongs to which test, or whether these are within-group or between-group)
Medicine-ball throwno significant interaction (p = 0.643)
Body composition, pelvic health, psychological well-beinggreater improvement with the programme (all p < 0.05); no magnitudes in the abstract
Adherence96% to core reconnection and physical development training
Adverse eventsnone reported in the programme group
Musculoskeletal health was a secondary outcome; its result is not stated separately in the abstract.
No confidence intervals or effect sizes are given.

Practical Application

A supervised return combining pelvic-floor and core work with lifting and intervals, from 6 weeks after birth was tolerated and improved strength, jump and 2-km run performance more than usual care — in one small, non-randomised study of servicewomen. Adherence was 96% and the programme group reported no adverse events (whether this covers all 17 starters or the 11 completers is not in the abstract).
Consistent with [SYNTH-95]: the guide sets no running before 3 weeks and a screened, person-specific return with the pelvic floor and strength first; this programme began at 6 weeks with rehabilitation alongside resistance training and HIIT, and pelvic health improved more than with usual care (instrument and size not in the abstract). It gives no date to promise: the start was fixed by the study, not tested against earlier or later starts.
Inference, not tested here: supervised strength and interval work begun at a fixed 6 weeks after birth showed no adverse events in this small group; it does not show that an earlier start is safe or that 6 weeks suits every woman, and the order, loads and when running began are not in the abstract, so the programme cannot be copied from it.
Not treatment advice. When to start after birth, and whether pelvic or abdominal symptoms allow impact work, is decided with the obstetric provider and a pelvic-health physiotherapist; leaking, heaviness or pain go to them (SYNTH-95).

Limitations

Design: not randomised, so the groups may have differed in motivation, fitness or circumstances at the start; how women were assigned is not in the abstract.
Size and attrition: 31 allocated, 20 completed all visits (6 of 17 and 5 of 14 lost); whether the analysis used completers only is not in the abstract.
Unclear figures: the 12.7-14.5% improvements are not tied to specific tests or to a between-group difference in the abstract; secondary outcomes carry p values only; the pelvic-health and well-being measures are not named.
Control: standard care with no exercise programme, so extra attention and supervision cannot be separated from the training itself.
Not in the abstract: participant characteristics, delivery mode, complications, breastfeeding, programme dose and progression, when running resumed, blinding of assessors, adverse-event definitions, funding and conflicts of interest.
Transfer: military occupational tests, not sport performance; follow-up ends at 24 weeks postpartum.
How this entry was checked and changed
Why this level

a controlled trial without randomisation and with about ten completers per arm (11 and 9, about a third lost), held one step below its B design because it is a small study read from the abstract with key methods missing (rubric B-), which gives the primary performance results but not how participants were assigned or how pelvic health was measured