M7: 3 Flashcards
General guidelines for safe exercise during low risk pregnancy?
- 3-5 days per week
- mod intensity (60-75% MHR)
- avoid ballistic, high velocity movements and straining
What happens in supine hypotension syndrome?
Aorta and inferior vena cava may be occluded by increased weight and size of the uterus
When does supine hypotension syndrome typically occur?
Usu after 4 months of pregnancy
Which positions can you get supine hypotension syndrome in?
- supine
- prolonged standing
S/s supine hypotension syndrome
- faint
- dizzy
- restless
- N/V
- chest/abd pain
- visual disturbances
- numbness/paresthesias
- HA
- cold legs
- weakness
- tinnitus
- fatigue
- desire to flex hips and knees
- anguish
What should you do if you suspect supine hypotension syndrome?
Modify positioning
- more upright or SL
- frequent position changes
- small wedge, pillow under R hip when supine
- prone
- quadruped
supine hypotension syndrome : why put a pillow under the right hip when supine?
Allows for max venous return in the LEFT lateral recumbant position
What are signs that exercise should be modified or d/c?
- pain
- vaginal bleeding
- contractions
- persistent dizziness, N/T
- faintness
- SOB
- palpitations
- N/V
- leaking amniotic fluid
- gen’l edema
- HA
- calf pain or swelling
Guidelines for exercise in postpartum period
- unilateral, no exercises in LE against gravity
- avoid abs and resistance
- progress gradually
- PFE
- gradual return to exercise
- avoid hips over heart exercises until bleeding stops postpartum, ballistic, extreme stretching, heavy lifting
When can PFE’s be performed postpartum?
Within 24 hrs. Postop
Important educational component postpartum (PFE)
- Contract pelvic floor prior to coughing, sneezing, laughing
- avoid valsalva
Safe exercise guidelines for pt on bedrest
- unilateral, no LE exercise against gravity, no abd contractions
- exhale with movement effort to prevent IAP
- ankle pumps for DVT prevention
- slow, gradual progress
- need medical clearance prior to exercise
What are the MSK and peripheral nerve problems often seen in a PT clinic during pregnancy?
- Intercostal neuralgia
- Thoracic outlet syndrome
- CTS
- Lateral femoral cutaneous nerve entrapment
- TTS
- Peroneal nerve compression
Intercostal neuralgia
pain in rib cage or chest due to flaring of ribcage
TOS
- may result from FHP and RSP with pregnancy
- may have pain, N/T in hand and forearm
Tx for TOS
- strengthening upper back and scapular mm
- lengthening pectorals
- good bra with support
CTS and pregnancy
- usually disappears after delivery, but may persist if breastfeeding
- usually bilateral
Tx for CTS with pregnancy
- decrease in hand and wrist flexion activities
- night splints
- exercises for finger mobility and fluid movement
Lateral femoral cutaneous nerve entrapment
nerve compressed as it emerges from the pelvis at the inguinal ligament adjacent to ASIS
Lateral femoral cutaneous nerve entrapment tx
Lay on unaffected side to draw uterus away from compressed area to reduce sx
Soft tissue techniques to reduce stiffness in ITB
TTS during pregnancy
- result of edema in tarsal tunnel
- N/T in medial aspect of foot
- weakness of toe flexors
Tx for TTS during pregnancy
- elevation
- AROM to help decrease edema and reduce compression
- night splinting
Peroneal nerve compression
- prolonged squatting may compress nerves and cause drop foot
- instruction on prevention
