Aerobic, Strength, Kegel (ASK) Exercise Intervention Perceptions for Postpartum Health

Recruitment rate will be calculated as the number of participants enrolled divided by the number of eligible participants approached. The outcome will be reported as a percentage of eligible participants approached.

Retention rate will be calculated as the number of enrolled participants who complete the 12-week follow-up assessment divided by the total number of enrolled participants. The outcome will be reported as a percentage of enrolled participants.

Dropout rate will be calculated as the number of participants who withdraw or are lost to follow-up before the 12-week assessment divided by the total number of enrolled participants. The outcome will be reported as a percentage of enrolled participants.

Assessment completion rate will be calculated as the number of completed planned study assessments divided by the total number of planned study assessments. The outcome will be reported as a percentage of planned study assessments.

Participant satisfaction will be assessed using a study-specific acceptability questionnaire administered at 12 weeks. Satisfaction will be defined as reporting "satisfied" or "very satisfied" with the ASK Exercise Programme. The outcome will be reported as the percentage of participants who are satisfied or very satisfied.

ASK session completion rate will be calculated as the number of prescribed ASK exercise sessions completed divided by the total number of prescribed ASK exercise sessions during the 12-week intervention period. Session completion will be assessed using app-recorded exercise completion data. The outcome will be reported as a percentage of prescribed ASK exercise sessions.

Safety will be assessed as the number of participants who experience one or more adverse events related to the ASK Exercise Programme during the 12-week intervention period. Adverse events and exercise-related symptoms will be collected using participant symptom reports and study adverse event records. The outcome will be reported as the number of participants with adverse events related to the ASK Exercise Programme.

Postpartum recovery will be assessed using the Obstetric Quality of Recovery-10. The change from baseline to 12 weeks in the total Obstetric Quality of Recovery-10 score will be calculated. Total scores range from 0 to 100, with higher scores indicating better postpartum recovery.

Postnatal depressive symptoms will be assessed using the Edinburgh Postnatal Depression Scale. The change from baseline to 12 weeks in the total Edinburgh Postnatal Depression Scale score will be calculated. Total scores range from 0 to 30, with higher scores indicating more severe depressive symptoms.

Pelvic floor symptom distress will be assessed using the Pelvic Floor Distress Inventory-20. The change from baseline to 12 weeks in the total Pelvic Floor Distress Inventory-20 score will be calculated. Total scores range from 0 to 300, with higher scores indicating greater pelvic floor symptom distress.

Sleep quality will be assessed using the Pittsburgh Sleep Quality Index. The change from baseline to 12 weeks in the global Pittsburgh Sleep Quality Index score will be calculated. Global scores range from 0 to 21, with higher scores indicating poorer sleep quality.

Breastfeeding self-efficacy will be assessed using the Breastfeeding Self-Efficacy Scale-Short Form. The change from baseline to 12 weeks in the total Breastfeeding Self-Efficacy Scale-Short Form score will be calculated. Total scores range from 14 to 70, with higher scores indicating greater breastfeeding self-efficacy.

Health-related quality of life will be assessed using the Short Form-12 Health Survey. The change from baseline to 12 weeks in the health-related quality of life score will be calculated. The outcome will be reported as a score on a scale, with higher scores indicating better health-related quality of life.

Body mass index will be calculated as body weight in kilograms divided by height in meters squared. The change from baseline to 12 weeks in body mass index will be calculated. The outcome will be reported in kg/m².

Waist-hip ratio will be calculated as waist circumference divided by hip circumference. The change from baseline to 12 weeks in waist-hip ratio will be calculated. The outcome will be reported as a ratio.

Resting heart rate will be measured at baseline and 12 weeks. The change from baseline to 12 weeks in resting heart rate will be calculated. The outcome will be reported in beats per minute.

Systolic blood pressure will be measured at baseline and 12 weeks where available through home or routine clinical measurement. The change from baseline to 12 weeks in systolic blood pressure will be calculated. The outcome will be reported in mmHg.

Diastolic blood pressure will be measured at baseline and 12 weeks where available through home or routine clinical measurement. The change from baseline to 12 weeks in diastolic blood pressure will be calculated. The outcome will be reported in mmHg.

Fasting glucose concentration will be measured using fasting blood samples at baseline and 12 weeks. The change from baseline to 12 weeks in fasting glucose concentration will be calculated. The outcome will be reported in mmol/L.

HbA1c will be measured using blood samples at baseline and 12 weeks. The change from baseline to 12 weeks in HbA1c will be calculated. The outcome will be reported as a percentage.

Triglyceride concentration will be measured using fasting blood samples at baseline and 12 weeks. The change from baseline to 12 weeks in triglyceride concentration will be calculated. The outcome will be reported in mmol/L.

Total cholesterol concentration will be measured using fasting blood samples at baseline and 12 weeks. The change from baseline to 12 weeks in total cholesterol concentration will be calculated. The outcome will be reported in mmol/L.

High-density lipoprotein cholesterol concentration will be measured using fasting blood samples at baseline and 12 weeks. The change from baseline to 12 weeks in high-density lipoprotein cholesterol concentration will be calculated. The outcome will be reported in mmol/L.

Low-density lipoprotein cholesterol concentration will be measured using fasting blood samples at baseline and 12 weeks. The change from baseline to 12 weeks in low-density lipoprotein cholesterol concentration will be calculated. The outcome will be reported in mmol/L.

Cardiorespiratory fitness will be assessed using a 3-minute step test. Post-exercise recovery heart rate will be recorded after completion of the test. The change from baseline to 12 weeks in post-exercise recovery heart rate will be calculated. The outcome will be reported in beats per minute.

Daily step count will be recorded using wearable-derived activity data. Mean daily step count during the 12-week intervention period will be calculated. The outcome will be reported as steps per day.

Daily active minutes will be recorded using wearable-derived activity data. Mean daily active minutes during the 12-week intervention period will be calculated. The outcome will be reported as minutes per day.

Gut microbiome profiles will be assessed using stool samples collected at baseline and 12 weeks. Changes from baseline to 12 weeks in gut microbiome profiles will be explored, including microbial diversity and taxonomic composition, depending on sample availability and sequencing quality.