{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T20:16:56Z","timestamp":1780085816709,"version":"3.54.0"},"reference-count":49,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Mental health problems among expectant and nursing mothers also affect their infants, partners, and families. While physical activity is a potential method for preventing postpartum depression (PPD), it is difficult for postpartum women to find the time for physical exercise. A recent study reported that improving communication between expectant couples can be used as a preventive intervention for PPD, and a systematic review and meta-analysis recently reported decreased facial emotional expressivity in individuals with different non-psychotic disorders. Therefore, we focused on facial muscle training and its potential as prevention for PPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We evaluated the effectiveness of online facial muscle training with resonance vocalization using real-time video conferencing programs on the PPD of postpartum women at 2\u20133\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>We recruited 20 postpartum women and used a single-arm, prospective, pre-post design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>All subjects participated in 30\u2009min of online facial muscle training with resonance vocalization once a week for 4\u2009weeks. The first and final sessions were performed using a real-time remote chat application, and the second and third sessions were performed on demand. Scores on the Edinburgh Postnatal Depression Scale (EPDS) as an indicator of PPD were used as the primary outcome. Secondary outcomes included the appearance ratio of a happy facial expression, analyzed using FaceReader\u2122; mood, which was measured using a visual analog scale; and stress level, which was measured using a smartwatch.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The training had a significant effect on EPDS, appearance ratio of a happy facial expression, and mood; however, it did not affect physical stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In the future, intervention studies with a higher evidence level, such as a crossover randomized controlled trial, are required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057241286201","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T14:53:25Z","timestamp":1729090405000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The effects of online facial muscle training with resonance vocalization on mental health in postpartum women: A single-arm pilot study"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2060-603X","authenticated-orcid":false,"given":"Rumiko","family":"Okamoto","sequence":"first","affiliation":[{"name":"Institute of Health and Sport Sciences, University of Tsukuba, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eriko","family":"Terasawa","sequence":"additional","affiliation":[{"name":"Master\u2019s and Doctoral Programs in Nursing Science, University of Tsukuba, Tsukuba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsumi","family":"Usui","sequence":"additional","affiliation":[{"name":"Master\u2019s and Doctoral Programs in Nursing Science, University of Tsukuba, Tsukuba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Midori","family":"Matsushima","sequence":"additional","affiliation":[{"name":"Faculty of Humanities and Social Sciences, University of Tsukuba, Tsukuba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisayo","family":"Okayama","sequence":"additional","affiliation":[{"name":"Master\u2019s and Doctoral Programs in Nursing Science, University of Tsukuba, Tsukuba, Japan"},{"name":"Institute of Medicine, University of Tsukuba, Tsukuba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,10,15]]},"reference":[{"key":"bibr1-17455057241286201","unstructured":"World Health Organization. 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