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Practice Topics Exam 5 > Pregnancy and Exercise > Flashcards

Pregnancy and Exercise Flashcards

1
Q

Goals of PT

A 
Inc/maintain aerobic ex
Improve cardiac reserve
Improve/maintain mm tone
Promote good posture
Improve sleep
Relieve pain
Prevent excess weight gain
Improve psych aspects
Easier delivery 
Faster recovery
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2
Q

Maternal response to exercise

A

Blood shunted from uterus but inc blood volume and dec vascular resistance
Max exercise capacity reached faster

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3
Q

Maternal response to exercise - exercises and hematocrit

A

10-15% increase

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4
Q

Maternal response to exercise - stroke volume

A

30-50% inc in fit pregnancy

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5
Q

Maternal response to exercise - energy needs

A

Additional 500 calories per day for exercise and pregnant

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6
Q

Maternal response to exercise - core temp

A

dec in fit preg during exercise

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7
Q

Maternal response to exercise - uterine contractions

A

inc strength and freq of uterine contractions

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8
Q

Maternal response to exercise - ballistic WB exercise

A

Can be cont throughout preg without the risk of pre term labor or pre term rupture of membranes
Be careful with FALL RISK INC

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9
Q

Fetal response to exercise

A

Animal studies show less than 50% dec uterine blood flow - not detrimental
Fetal HR inc in response to dec blood flow
Dec body fat at birth and at 5 years

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10
Q

Impact on labor and delivery

A

COnflicting info

More active someone is, the faster they recovery

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11
Q

ACOG recommendations

A

Min risk and benefits
Mod may be necessary
No med reason to avoid exercise needs to be ensured
Aerobic and strength before, during, and after preg
Bed rest rarely indicated (though is freq rx)

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12
Q

ACOG recommendations - regular PA

A

improves or maintains physical fitness, helps weight management, reduces risk of gestational diabetes and enhances well being

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13
Q

ACOG - ex in pregnancy - duration

A

Reg moderate intensity 30 min or more daily

Stay 12-14 on Borg

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14
Q

ACOG - ex in pregnancy - avoid what

A

Avoid more than 5 min in supine
Avoid activities with high fall risk
Avoid scuba diving
Be cautious with ex over 6000ft
Adjust ex level to prenatal fitness level
Stop when fatigued and never go to exhaustion

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15
Q

ACOG - contraindications

A 
Hemodynamically sig. heart disease
Restrictive lung disease
Incompentent cervix
Multiple gestation at risk
2nd or 3rd tri bleeding
Placenta previa
Premature labor 
Ruptured membranes
Preeclampsia
Severe anemia
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16
Q

ACOG - precautions

A 
Anemia
Cardiac arr
Obese
Poorly controlled DM
BMI less than 12
Sedentary life
Intrauterine growth restriction (below 10th perc)
Poor control HPTN
Ortho limitations
Seizures
Hyperthyroid
Heavy smoker
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17
Q

Warning signs to stop exercise

A 
Vaginal bleed
Dyspnea prior to exertion
Dizzy
HA
Chest pain
MM weakness
Calf pain/swelling
Preterm labor
Dec fetal mvmnt
Amniotic fluid leakage
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18
Q

ACOG - ex in postpartum for uncomplicated pregnancy

A

Physiological and morphological changes persist 4-6 weeks post partum
Gradual and as tolerated return to activity
No current lit showing adverse rxns
Mod weight reduction during nursing is safe
Returning to PA during post partum may assist in dev depression!

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19
Q

Meta analysis - ex for preg related lumbar and pelvic girdle pain

A

Better if supervised by exercise professional

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20
Q

Meta analysis - ex for prevention of LBP and PGP in preg

A

Ex reduced risk of LBP in preg by 9%

Prevented new episodes of sick leave of lumbopelvic pain

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21
Q

Flexibility

A

Remember joint are more mobile
Avoid forceful stretching
Emphasize - suboccipitals, pecs, hip flexors, adductors, hams, gastroc

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22
Q

Strengthening - emphasis on

A 
DNF
Thoracic paraspinals
Rhomboids, mid/low trap
Infraspinatus/teres
TA, internal oblique
Gluteals
Quads
Tib Ant
23
Q

Preg induced path (MSK)

A 
joint lax
DR
Postural back pain
Round ligament pain
PGP (SIJ, Pubic symphysis)
Nerve compression
Fall risk
24
Q

Joint laxity

A

Use caution when stretching (esp add)
Elevated levels of hormones have been found up to 5 months post partum
Encourage lower impact ex

25
Q

DRA

A

Separation of RA at linea alba
3rd trimesters has 66% incidence
7 wks post partum to years = 39%
Not only in pregnancy!

26
Q

DRA clinical significance

A 
Dec mechanical advantage
Dec protection of fetus
Potential for herniation
Continence contribution
Feelings of weakness
Aesthetics
27
Q

DRA causes

A 
Posture
Overactive EO
Large body
Excessive weight gain
Multiple gestation
28
Q

DRA - exam

A

Best evaluated with US or calipers

Finger width method is not reliable or valid!

29
Q

DRA - finger method

A

Hooklying. Patient lifts head slowly off the surface. Place fingers horizontally between the mm bellies of the rectus abdominus. Document number of fingers or centimeters

30
Q

DRA - treatment

A

Isometric TrA/PFM/diaphragm strengthening until lax CT is controlled
KT

31
Q

Postural back pain

A

50-70% of preg women

Worsens throughout day

32
Q

Postural back pain - causes

A

postural changes
lig laxity
Dec abd mm function

33
Q

Postural back pain - intervention

A 
Low back ex with TA contraction
Superficial thermal mod
STM/Manual therapy
Gait
Body mechanics
Support belt (very low)
34
Q

Posture - tips

A

Want shoulders on top of hips and ankles
Ribs down
Ears on top of shldrs
Adjust low back ccurve

Feet straight ahead
legs not too far apart
Avoid the waddle

Avoid shoulders WAY behind hips

35
Q

Pelvic girdle pain

A

Symphysis pubis, SIJ, gluteal region

36
Q

Pelvic girdle pain - location

A

From PSIS to gluteal folds

37
Q

Pelvic girdle pain - incidence

A

variable
33-50% before 20 wks
60-70% late preg

38
Q

Pelvic girdle pain - impairemnts

A 
Stairs
turning in bed
Not usually relieved with rest
SLS
Transfers (STS)
39
Q

pelvic girdle pain - risk factors

A 
Multiparous
Joint hypermob
Amenorrhea
High BMI
Hip and LE dysfunction including glut med and PFM
40
Q

Pubic symphysis dysfunction

A 
Changes to pubic symph begin at 8-10 wks
Widens to avg of 7mm prior to delivery
Tenderness
Radiation to groin
Pain with WB
Pain with LE abd
Pain with asymm mvmtns
41
Q

Pelvic girdle dysfunction tx

A 
Manual - MET, joint mobs, STM
External support belt
Stabilization!
AD for gait
Water exercise
Avoid exacerbating posture
Identify causative factor!
42
Q

Round ligament pain

A

Sharp, quick
Area of lateral low abdomen
OCcurs with movement
Often confused with psoas/hip flexor/add pain

43
Q

Nerve comp can be where

A

Thoracic outlet
Carpal tunnel
Sciatic

44
Q

Fall risk

A 
Comparable to geriatric pop
Incidence of 26.8% during preg
35.5% fallen more than twice during preg
Changes in gait noted with inc stance width
Changes in speed
Inc AP postural sway
45
Q

Physical agents in preg - contra/prec

A 
US over trunk
TENS
Mechanical traction
Diathermy
Ionto and phono
46
Q

Best activities

A 
ealking
Swimming
Biking
gentle yoga
strengthening pf postural mm
47
Q

Post partum considerations

A 
posture
skin care
nursing positions
body mechanics
continence
fatigue, exhaustion, baby blues, depression
sexual health
nutriton
48
Q

Posture post partum

A 
Forweard head
thoracic kyphosis and flared ribs
Scapular protraction
pelvis position
lumbar spine is flattened (or can be extra lordotic too)
49
Q

Skin care PP

A

Perineal or C section

  • US
  • Scar mob
  • Stretches
  • Education on expectations (pain, numbness, PA)
50
Q

Nursing positions

A

No righ tanswer
Use PT common sense
May be reclining on many pillows (esp during first 4-6 wks)
Pillows, pillows, pillows!

51
Q

Body mechanics

A 
Keep baby close to body
Limit use of car seat carriers
Use ring slings and front carriers with good support
Avoid carrying baby on hips asymm 
Traditional lifting mechancis
52
Q

Fatigue/exhaustion/baby blues/depression

A

Many causes nad very common
Post part dep can begin anytime up to a year post partum - 3x more likely if have LBP and pelvic pain
Acknowledgement is HUGE

53
Q

Sexual health

A

Consider perineal lacerations and healing
Consider body image
Consider fatigue and new demands on time
Nursing mothers hormones dec lubrication and libido

Practice Topics Exam 5 (13 decks)

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