Journal of Obstetric, Gynecologic & Neonatal Nursing

Effectiveness of video assisted Kegel exercise and abdominal muscle exercises on 

involution of uterus and perineal pain among postnatal mothers

--Manuscript Draft--

Manuscript Number:

Full Title: Effectiveness of video assisted Kegel exercise and abdominal muscle exercises on 

involution of uterus and perineal pain among postnatal mothers

Article Type: Research

Keywords: Kegel exercise abdominal muscle exercise, Involution of uterus, perineal pain postnatal
mother

Corresponding Author: Neha Singh

Lucknow, ID INDIA

Corresponding Author Secondary

Information:

Corresponding Author's Institution:

Corresponding Author's Secondary

Institution:

First Author: Neha Singh

First Author Secondary Information:

Order of Authors: Neha Singh

TANIMA VERMA

Order of Authors Secondary Information:

Abstract: Objectives
 To assess the effectiveness of video assisted Kegel exercise and abdominal muscle
exercises on involution of uterus and perineal pain among postnatal mothers in
experimental.
Design
Quasi-experimental research design
Setting
Postnatal wards at Queen Mary Hospital, KGMU, Lucknow.
Participants
Postnatal mothers with normal vaginal delivery
           Methods                                                                    
Involution of uterus assessed by measurement of fundal height twice during the study.
For experimental group firstly assess the fundal height at 24 hours from the delivery
and after that implementation of video assisted kegel and abdominal muscle exercise
and then after 5 days again assessd the fundal height in order to see the effect of
kegel and abdominal muscle exercises on involution of uterus. In control group assess
the fundal height at 24 hours from the delivery, then monitor the condition
simultaneously and after 5 days assessd the fundal height of postnatal mothers without
implementing the exercise. On 6th day of purperium categories in good involution, fair
involution, slow involution. To find out the level of pain, visual analogue pain scale was
used and was given score from 0-10 the following score indicates the level of pain.
Mild pain, moderate pain, severe pain.
Result
Video assisted kegel exercise and abdominal muscle exercises were associated with
the involution of uterus (p=<0.001) and perineal pain score (visual analogue scale
p=<0.001). 
Conclusion  
Kegel exercise and abdominal exercises are having good impact on involution of

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COVERING LETTER FOR SUBMISSION

Dated: 28-10-2021

To,

The Editor

Subject: Submission of Manuscript for the JOGNN

Dear Sir/Madam

Please find my submission of manuscript titled ‘Effectiveness of video assisted kegel exercise
and abdominal muscle exercises on involution of uterus and perineal pain among postnatal
mothers.’ for possible publication in your journal.

I hereby affirm that the contents of this manuscript are original. Furthermore it has neither been
published elsewhere in any language fully or partly, nor is it under review for publication
anywhere.

I affirm that all author (s) have seen and agreed to the submitted version of the manuscript and
their inclusion of name (s) as co-author (s).Also, if our/my manuscript is accepted, I/We agree to
comply with the formalities as given on the website of journal & you are free to publish our
contribution to any of your journals.

Yours sincerely

Ms. Neha Singh

M.Sc (nursing) Obstetrics and gynecology

King George’s Medical University
College of Nursing, Lucknow, UP
8874535249
nsneha1001@gmail.com
Name of corresponding Author:

Mrs. Tanima Verma

Clinical Instructor
KGMU, College of Nursing, Lucknow, UP
8601676259
tanimaverma9@gmail.com

All Author’s Name-

1- Ms. Neha Singh

M.Sc (nursing) Obstetrics and gynecology
KGMU, College of Nursing, Lucknow, UP
8874535249
nsneha1001@gmail.com

2- Mrs. Rashmi P. John

Acting Principal, HOD MSN,

KGMU College of Nursing, Lucknow, UP

9628180095
rashmijohn@kgmcindia.edu

This is to certify that Ms. Neha Singh has prepared her manuscript for the award of
Master of Science in Nursing Degree of King George’s Medical University. She has
carried out the work at the King George’s Medical University at department of obstetrics
and Gynecology, KGMU College of Nursing, Lucknow, U.P.
3- Dr. Monika Agrawal
MS, Associate Professor, Obstetrics and gynaecology
Queen Mary Hospital, KGMU, Lucknow, UP
9628667755
dr.monikagrawal@gmail.com
 This is to certify that Ms. Neha Singh has prepared her manuscript for the award of
Master of Science in Nursing Degree of King George’s Medical University. She has
carried out the work at the King George’s Medical University at department of obstetrics
and Gynecology, KGMU College of Nursing, Lucknow, U.P.

4- Mrs. Tanima Verma

Clinical Instructor
KGMU, College of Nursing, Lucknow, UP
8601676259
tanimaverma9@gmail.com
This is to certify that Ms. Neha Singh has prepared her manuscript for the award of
Master of Science in Nursing Degree of King George’s Medical University. She has
carried out the work at the King George’s Medical University at department of obstetrics
and Gynecology, KGMU College of Nursing, Lucknow, U.P.

Type of article- Original article

Page count for manuscript- 15

Word count for abstract- 250 words

Number of tables- 2 table

Funding- The author receive no financial support for the research authership or publication
Manuscript Click here to access/download;Manuscript;manuscript neha
singh.pdf
Click here to view linked References

VIDEO ASSISTED KEGEL EXERCISE AND ABDOMINAL MUSCLE

EXERCISES ON INVOLUTION OF UTERUS AND PERINEAL PAIN

Objectives

To assess the effectiveness of video assisted Kegel exercise and abdominal muscle

exercises on involution of uterus and perineal pain among postnatal mothers in

experimental.

Design

Quasi-experimental research design

Setting

Postnatal wards at Queen Mary Hospital, KGMU, Lucknow.

Participants

Postnatal mothers with normal vaginal delivery

Methods

Involution of uterus assessed by measurement of fundal height twice during the study.

For experimental group firstly assess the fundal height at 24 hours from the delivery

and after that implementation of video assisted kegel and abdominal muscle exercise

and then after 5 days again assessd the fundal height in order to see the effect of

kegel and abdominal muscle exercises on involution of uterus. In control group

assess the fundal height at 24 hours from the delivery, then monitor the condition

simultaneously and after 5 days assessd the fundal height of postnatal mothers

without implementing the exercise. On 6th day of purperium categories in good

involution, fair involution, slow involution. To find out the level of pain, visual
analogue pain scale was used and was given score from 0-10 the following score

indicates the level of pain. Mild pain, moderate pain, severe pain.

Result

Video assisted kegel exercise and abdominal muscle exercises were associated with

the involution of uterus (p=<0.001) and perineal pain score (visual analogue scale

p=<0.001).

Conclusion

Kegel exercise and abdominal exercises are having good impact on involution of

uterus and reduction in perineal pain.

KEY WORDS

KEGEL EXERCISE, ABDOMINAL MUSCLE EXERCISE, INVOLUTION OF UTERUS , PERINEAL PAIN, POSTNATAL
MOTHERS
 INTRODUCTION

Background of the study

Motherhood is the most joyful journey which is experienced by the women after giving the child

birth. She is the one who not only give the birth of the child but she also nourishes the child and

give quality of care throughout life as well. Mother experiences various important events that

occur throughout the journey in her reproductive life like prenatal, antenatal, intranatal and

postnatal. Postpartum period is the period in which all the organ of postnatal women will revert

back into pre-pregnant state. In pregnancy, uterus of a mother undergo in various changes and it

is most affecting part because the fetus grows inside. When uterus get contracted after child birth

so due to contraction mother may feel pain especially at perineum.

Immediately following delivery, the uterus becomes firm and retract with alternate hardening

and softening. The uterus measures about 20 × 12 × 7.5 cm3 (length, breadth and thickness) and

weighs about 1,000g. At the end of 6 weeks, its measurement is almost similar to that of the non-

pregnant state and weighs about 60 g. The decrease in size of the uterus and cervix has been

shown with serial MRI. The placental site contracts rapidly presenting a raised surface which

measures about 7.5 cm and remains elevated even at 6 weeks when it measures about 1.5 cm.¹

After delivery there is a continuation of uterine activity and for about the first twelve hours the

mother may experience regular, strong, well-coordinated contractions.

These contractions will decrease gradually with their intensity and frequency.It will help to

retract the uterine muscles and causes involution. If it will not revert back properly it can cause

delayed involution, factors can associate with nutrition, anemia, breastfeeding, exercises,
lifestyle changes, lack of education, other factors like any disease factor associated with high risk

pregnancy etc.

Postpartum exercises is one of most preventive measures which may affect the size of the uterus

and perineal pain after pregnancy due to contractions of muscle for regular basis. If women will

adopt the exercise it will help to strengthen the pelvic floor muscle, reduce perineal pain and help

the uterus revert back into pre-pregnant state.

To assess the effectiveness of kegel exercise on disorder of pelvic floor muscle. Pregnant women

in the third trimester will be invited to participate in the study. Through the screening of 435

pregnant women with pelvic floor disorders. P value <0.05 will be considered statistically

significant. The study was effective on disorders of pelvic floor. It will also help implementation

of interventions regarding pelvic floor muscle disorders.²

Kegel exercises and abdominal muscle exercise strengthen the pelvic floor muscles, which

support the uterus, bladder, small intestine and rectum. It will also help is reduction of pain after

child birth. Postnatal mother can do exercises, also known as pelvic and abdominal floor muscle

training, just about any time. For this there will be no expenses, no technology, no need of higher

education, time consuming, and can be perform at any place.

Need of the study

The postnatal period is a time of maternal changes that are both retrogressive(involution of

uterus and vagina) and progressive (production of milk for lactation, restoration of the normal

menstrual cycle, and beginning of a parenting role). The physical care a woman receives during

the postnatal period can influence her health for rest of her life. Most women experience some

degree of discomfort during the postnatal period. Common causes of discomfort include pain
from uterine contractions (afterpains), perineal lacerations, episiotomy, haemorrhoids, sore

nipples, and breast engorgement.

During my clinical posting, I observe that, many postnatal mothers were unaware regarding

kegel exercises and its effect. Some mothers had knowledge regading postnatal exercises but

they were not able to perform due lack of supervision and proper guidance. Kegel exercise and

abdominal muscle exercises works on the pelvis floor muscles in postnatal mothers, it helps to

treat the urinary incontinence and helps in contract the uterine muscles. It help to avoid

complications like abnormal lochial discharge, either excessive or prolonged, irregular or at

times excessive uterine bleeding, irregular cramp-like pain in case of retained products and

uterine sepsis and Sub involution of the uterus and persistence of pain is one of the important

factor in post-partum period if mother will not take proper initiate for self-care.

A study was conducted to assess the effectiveness of kegel exercise and prone position on

involution of uterus and after pain among postnatal mothers. In control group monitoring of pain

level and involution of uterus will be assessed every day for three days. Data was analysed by

descriptive and inferential statistics using chi-square and student’s independent t test. The study

revealed that kegel exercise and prone position have significant reduction of afterpains and

improvement of involution of uterus.

Objectives of the study-

• To assess the pre-test and post-test scores of involution of uterus and perineal pain

among postnatal mothers in experimental and control group.

• To compare the effectiveness of video assisted kegel exercise and abdominal muscle

exercises on involution of uterus and perineal pain among postnatal mothers in

experimental and control group.

 • To find an association between post-test impact score of involution of uterus and

perineal pain among postnatal mothers with their selected demographic variables.

Ethical consideration

The ethical aspects is considered by ethical committee when presented them and committee had

given clearance at institutional level. Department permission from the concerned authority will

be obtained from Queen Mary Hospital, Lucknow.Informed consent will be obtained from

postnatal mothers who selected for the study. The participants have full freedom to withdraw

from the study. The participants is assured for the confidentiality. Care was taken for no

exploitation of human rights, humanity and indiscrimination of any type. Ethical clearance from

ethical committee of university is also granted before study design. No potential harm or

intervention is applied to the control group.

Research design

In this study the investigator selected quasi experimental research design, with two group pre-

test and post-test research design.

Setting of the study

In this study the data were collected from postnatal ward, KMC ward at Queen Mary hospital,

KGMU Lucknow.

Population

In this study population consist of postnatal mothers admitted in Queen Mary Hospital, KGMU

Lucknow.

Sample
In this study sample consist of both primi and multi parous mothers who are admitted in Queen

Mary Hospital, KGMU Lucknow, who are willing to participate in the study and fulfill the

inclusive criteria of the study.

Sampling technique

A Purposive sampling technique was adopted by researcher to select the subjects.

Sample size

In this study there were two groups one is experimental group and second is control group. Total

sample size was 60 and out of which 30 were assigned for experimental group and 30 were

assigned for control group.

Data collection tools and techniques

Data collection is one of the most important part of research it refers to gathering of information

to address a research problem.

It has 3 section as follows

Section I: Consists of 6 demographic profile.

Section II: Scoring of uterine fundal height for the assessment of involution of uterus.

Section III- Visual analogue scale of the assessment of perineal pain.

Development of the tools

Tool is develop after a thorough review of literature related to the topic from various textbook,

journals, and considering the suggestions of experts in field of nursing, department of obstetrics

and gynecology.
Section I: Demographic profile

The demographic profile was self-structured tool. It consist of 6 points such as age, occupation,

food habits, type of family, religion, parity and Source of information.

Section II:Scoring of uterine fundal height for the assessment of involution of uterus

To find out the effect on involution of uterus by assessed measurement of fundal height twice

during the study. For experimental group firstly assess the fundal height at 24 hours from the

delivery and after that implementation of video assisted kegel and abdominal muscle exercise

and then after 5 days again assess the fundal height in order to see the effect of exercise on

involution of uterus. In control group assess the fundal height at 24 hours from the delivery, then

monitor the condition simultaneously and after 5 days again assess the fundal height of postnatal

mothers without implementing the exercise.

On 6th day of purperium

Fundal height Expected outcome

Less than 8cm. Good involution

8cm.-10cm. Fair involution

10cm.-12cm. Slow involution

Section III- Visual analogue scale of the assessment of perineal pain

To find out the level of pain, visual analogue pain scale was used and was given score from 0-10

the following score indicates the level of pain

Pain rating Scale

Mild pain 0-2

Moderate pain 4-6

Severe pain 8-10

Table 1- Comparison of mean, SD, of pre and post-test score of involution of uterus and

perineal pain in experimental group

Pre-test Post-test T

Std
Experim Sig.
.
Std.
ental (2-
Mea De
Mean Deviat
group tailed)
n via
ion
tio

Fundal 14.3 0.9 8.30 1.59 18.1 0.001

height 9 3 25

Table reveals that

The data shows that in experimental group the mean of the pretest score of involution of

uterus 14.39 and 8.30 in the posttest. The standard deviation in the pretest 0.93 and 1.59 in

the posttest. The calculated‘t’ value is 18.125.

Table 2 Comparison of mean, SD, of pre and post-test score of involution of uterus in

control group

Pre-test Post-test t
Sig.

Contro (2-
M Std. Std.
Me
l group taile
ea Deviati Deviati
an
d)
n on on

Fundal 14. 0.98 9.63 1.17 17.7 0.00

height 58 05 1

Table reveals that

The data shows that in control group the mean of the pretest score of involution of uterus

14.58 and 9.63 in the posttest. The standard deviation in the pretest 0.98 and 1.17 in the

posttest. The calculated‘t’ value is 17.705.

Finding of the study

Effectiveness of video assisted kegel exercise an abdominal muscles exercises

The data shows that the mean of the pretest score of involution of uterus 14.39 and 8.30 in

the posttest. The standard deviation in the pretest 0.93 and 1.59 in the posttest. The

calculated‘t’ value is 18.125. Then the researcher compared the calculated ‘t’ value with

the tabulated‘t’ value. Then the researcher compared the calculated‘t’ value with the
tabulated‘t’ value. Since the calculated greater than the tabulated value the researcher

accepted the hypothesis. It means that there is a significant change in fundal height of

postnatal mothers in posttest.

Association between the posttest and selected demographic variables

The researcher compared the chi square value of each variable with tabulated value.

Association between fundal height score and mother’s demographic variables in

experimental group. There is a statistical significance between age of the mother and

reduction of fundal height specifically in mothers between 19-25 years, and also there is a

marked reduction of fundal height among postnatal mothers who are government employee.

There is a significance between primipara mothers and reduction of fundal height.

Discussion

The discussion of the findings of the study to assess the effectiveness of video assisted

kegel exercise and abdominal muscle exercise on involution of uterus among postnatal

mothers admitted in Queen Mary Hospital, KGMU, Lucknow.

The sample was 60 postnatal mothers. Out of which, 30 will be experimental group and 30

in control group. Samples were selected by using purposive sampling technique. In

experimental group level of involution of uterus will be assessed after the implementation

of video assisted kegel and abdominal muscle exercise for five days (excluding the day of

delivery) followed by three times in a day. Involution of uterus will be assessed among

postnatal mothers in experimental group and in control group. Process to making the

subjects to do video assisted kegel exercise for 10 seconds for 3 times a day, 10 repetitions

each time for five days then after finishing the 10 repetition of kegel exercise in each time
same post natal mothers perform video assisted three abdominal muscle exercises that are

abdominal breathing exercise for 10 repetition each time, abdominal tightening exercise 20

repetitions at a time, bridging exercise 10 repetition at a time for 5 days. The post

intervention pain score and involution of uterus will be assessed by the 6th day of

postpartum day.

The data consists of three sections, first section contains the demographic profile, the

second section contains the fundal height to assess the involution of uterus. Data analysis

and interpretation were done by using frequencies, percentage, mean and standard

deviation, chi square test, student’s t-test.

Conclusion

The present study suggested that vedio assisted kegel exercise and abdominal exercises

have good impact on involusion of uterus. Delyed involusion is a major problem remains

in mothers after delivery. Since nurses have a key role in preventive, curative,

rehabilitative aspects of healthcare. Nursing personnel should educate and administer the

kegel and abdominal muscle exercises so that the quality of life will be improved. The

intervention was found to be very effective in prevention of subinvolusion in mothers.

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ononmybehal f. ✓
Acknowl eed Icannotacknowl
edgedandagr edgeor
agr
ee

I
fyouchecked"
IcannotAgr
eeorAcknowl
edgei
ne.
),pl
easeexpl
ain:

Empl
oyee(
s)oft
hef
eder
algov
ernment
.Ify
ouar
eaf
eder
alempl
oyeeandy
ourcont
ri
but
ionwascr
eat
edbyy
ouwi
thi
nthescope
ofyouremploymentwi
ththefeder
algover
nmentorabranchoft
hefeder
algover
nment
,pl
easeacknowledgeherethatyourwor
kisi
nthe
publi
cdomainbycert
if
yingassuch.Onl
yfil
loutt
hispar
tify
ouareanemployeeoft
hef
ederal
government.Thisdoesnotappl
yto
employeesofstat
eorl
ocal
governmet.  Icertif
y ✓ Icannotcer t i
fy;doesnotappl ytome

3.FI
NANCI
ALDI
SCLOSURE&AFFI
LIATI
ONS
Thismanuscripti
ncl
udesdiscussionofproductsorser
vicesofpersons, companies,or
ganizati
ons,orot
herenti
ties(“
Enti
ti
es”)
,or
signi
fi
cantcompetit
orsofsuchEnt i
ti
es,f
rom whichIhaverecei
ved, dir
ectl
yorindir
ectl
y,compensat i
onforser
vices,
reimbur
sementofexpensesorot herremunerati
onorthi
ngsofsi gni
ficantvaluet
hathavepai dmef ormyservi
cesdur i
ngthe
pastthreeyearsi
nthefoll
owingcapaciti
es.Ifur
therwar
rantthatthesear etheonlysuchrelat
ionshi
pswithsuchEntit
iesofmeor
myspouse( checkallt
hatapply
):
  Ihavenor
elev
antf
inanci
ali
nter
est
stor
epor
trel
atedt
othi
smanuscr
ipt

OR,
rel
atedt
othi
smanuscr
iptIhav
ehadt
hef
oll
owi
ngr
elat
ionshi
pwi
tht
heEnt
it
yment
ionedoramaj
orcompet
it
or(
checkal
lthatappl
y):

 actedasaconsult
antforaf
ee
 beenpaidorsponsor
edbytheor
gani
zat
iont
ospeakt
oapr
ofessi
onal
orl
aygr
oup
  beenpai dtowrit
ethismanuscr iptorf orapublicati
onr elatedtot hismanuscr i
pt
 servedasanunpai dorpaidadv isortot heorganizati
onoronanadv i
sorypanel paidfor
 byitbeenoram nowaf ul
l orpar t
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 receivedormyempl oyi
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edtothet
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cofthe
 manuscr i
ptheldorholdstocki ntheor gani
zat i
onment i
onedi nt hispaper(othert hanlessthan1%ofapubl
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c
 company )
 providedtest
imonyfortheor ganizationinrelat
iontot hepr oductorser vicediscussedi nthe
 manuscr i
ptheldornowhol dapat entforapr oductdiscussedi nthemanuscr ipt
receivedorconti
nuetoreceiver oyalti
esforapr oductdi scussedi nt hemanuscr ipt

Ify
oucheckedanyoftheboxesabov e,
exceptf
orthever
yfir
stone,
pleaseprov
idethespeci
fi
csofthearr
angement(
e.g.“
Iwaspaid
anhonor
ari
um andtr
av elexpensest
oserveontheadv
isorycommitt
eefortheBigDrugCompanyInc.t
hatmakesSuperCapsul
e.”
):

Ent
it
y Rel
ati
onshi
p

4.OFF-
LABELUSEOFMEDI
CALDEVI
CES&DRUGSSTATEMENT
SomeFDA- approvedorclearedmedicaldevicesordrugsar eatti
mesbeusedof f
-l
abel(
i.
e.,
ausenotFDAappr oved, cl
ear edor
descri
bedont heproduct’
slabel)i
f,i
nthejudgmentoft het r
eati
ngcli
nici
an,suchuseismedicall
yindicat
edt otreatapat ient’
s
condit
ion.TheFDAdoesnotr egul
atethepracti
ceofmedi cinebutdoesregulat
ehowcompani espr omotet hei
rclearedorappr oved
products;“
off-l
abel”usemaybedescr i
bedinthemanuscr iptsolongasthelackofFDAappr ovalorclear
ancef orsuchusesi s
di
sclosed.Tocheckt hecl
earancestatusofapar t
icul
arusef oradeviceordrug,r
efert
othecur r
entlyapproved/clear
edl abeli
ngat
www. fda.
gov .Checkoneoft hefol
lowing:

✓ Sect
ion4doesnotappl
ytot
hismanuscr
ipt
.

 TheFDAhascl
ear
edal
lphar
maceut
ical
sand/
ormedi
cal
dev
icesf
ort
heusedescr
ibedi
nthi
spaper
.

 TheFDAhasnotcl
earedthef
oll
owingphar
maceutical
sand/ormedical
devicesf
ortheusedescr
ibedi
nthi
spaper
.The
f
oll
owi
ngpharmaceuti
cal
sand/ormedi
caldev
icesarebei
ngdiscussedforanoff
-l
abeluse:

Manuf
act
urerName Dr
ugorDev
ice

Bysigni
ngthi
sstat
ement,Iher
ebyattesttotheaccur
acyofthi
sCopyri
ghtTransfer&Aut
horDiscl
osureandagreeast othe
obl
igati
onssetf
ort
hherei
nandt hati
nr el
ati
ontothesubmissi
onoftheafor
ement i
onedmanuscri
pt,Iwi
llcomplywit
ht hej
ournal
’s
pol
i esofCopy
ci ri
ghtTr
ansfer(
AppendixA) Ful
, lDi
scl
osur
eofRelat
ionshi
pswi t
hCommer ci
alEnti
ti
es,andAuthorshi
pVer i
fi
cat
ion.

NAME.NehaSi
ngh DATE.10/
11/
2021

SI
GNATURE Nehasi
ngh
 JOGNN
Appendi
xA:Copy
rightTr
ansf
er

TheJournalofObstetr
ic,Gynecol
ogic&Neonat alNur
singisownedbyt heAssociat
ionofWomen’ sHeal
th,Obst
etri
candNeonatal
Nurses(AWHONN)andpubl ishedbyElsevi
erInc.(
Publi
sher).AWHONNi spl
easedt oconsidert
heContr
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onforpubl
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ionin
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.Ifandwhent heContri
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ionintheJournal,
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msandconditi
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l
becomeef f
ectiv
easoft hedateof
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butor
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ionofthisAuthorDiscl
osureandCopy r
ightTransfer:

Transf erofCopy ri
ght :Cont r
ibut ortransf ersandassi gnst o b) TheEdi tormaycopy edi
ttheCont r
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ionasnecessar yi
n
AWHONNal lr i
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titl
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eitforproducti
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ghti ntheCont ribut i
onf ort hef ul
l ter
m ofcopy r
ight Journal.TheCor r
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edmanuscr iptand,iff
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on.

AWHONNmakesnoguar anteet hattheContri

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ibutionis
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Licenset oCont ribut or:AWHONNgr antsbackt oCont ributor

thenonexcl usi velicenset o:
a) useal lorpar toft heCont ri
bution(afterpubl i
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nanybookorar t
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and
b) makephot ocopi esofal lorpar toftheCont ribut i
on
forusebyt heAut hor (
s)inclassroom t eachi ng.
Cont ri
but ormaynotpostt heas-publishedPDF
v ersionoft heCont ri
butiononline,orthei rfinal
manuscr iptf i
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Asacondi ti
onf ort hislicenset oCont ri
butor,allsuchbooks
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nwhi cht heCont ributi
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followingcr edi tstat ement : “
From (orAdapt edf rom: )Ful l
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Cont
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but
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a) IftheCont r
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togetherwithdel i
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 Ifcorrectedproof sarenotti
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AWHONNandPubl i
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c) ThisTr ansfermustbesi gnedbyeachAut hor(and
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asacondi ti
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nt heJour nal.

Credit
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onwheni tis
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theform andpl acementoft he
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Consi der
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naddit
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AWHONNwi ll
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War
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original wor koft heAut hor (s)( exceptf or
excer pt sf rom copy right edmat er i
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b) Cont ribut ori stheownerofal lright ,ti
tle,and
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aut hor ityt otransf erandassi gnt hecopy ri
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Contribut orshal lindemni fyAWHONNandPubl isher,
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