Week 12: Physical Activity Guidelines & Special Populations 2 (Pregnancy)

Question 1

How is Gestational Age Calculated?

Answer 1

From the 1st day of the last menstrual period

Question 2

What are the effects of Pregnancy on the Repiratory system

Answer 2

Overall trend is an increase in respiration
- Increase in Tidal volume
- Increased respiration rate
- Increased alveolar ventialtion
- Decreased functional residual capacity

Oxygen consumption and carbon dioxide production are increased by 60%

Question 3

What are the effects of Pregnancy on the Cardiovascular system

Answer 3

General Trend of increased Heart rate and blood flow & Volume
- Increased CO
- Increased SV
- Increased RHR
- Increased Plasma volume
- Increased RBC mass
- Decreased Vascular resistance
- Increased blood flow to uterus

Question 4

What is Physiological Anemia?
Why is it important to consider for exercise?

Answer 4

Is caused a reduction in haemoglobin caused from haemodilation during pregnancy

Occurs as a result of increased plasma mass to support the growing fetus

Can cause exercise intolerance due to less haemoglobin
–> can result in dizziness or a greater increase in HR

Question 5

What metabolic effects occur due to pregnancy?

Answer 5

Increased demands for glucose by the fetus
- Increased protein content
- Increased fat deposits
- Increased blood lipds and salt accumlation
- Hormonal changes to promote water retention

Question 6

Musculoskeletal impacts of Pregnancy

Answer 6

Causes a shift in COG

Increases joint laxity (due to preparing for delivery)

These two factors combined increased the risk for strains/sprains during exercise

Question 7

Emotional changes during Pregnancy

Answer 7

Increased mood fluctuations
Increased emotional liability (mood swings)
Increase inestability

These occur due to the large number of physiological changes happening Not just due to hormonal changes

Question 8

What impact does Exercise have on delivery outcomes?

Answer 8

No evidence that exercise leads to many changes in delivery outcomes

Question 9

What impact does exercise have on the duration of labour?

Answer 9

No evidence for changes or harms to labour duration

Question 10

Effects of exercise on Maternal weight gain

Answer 10

Reduces weight gain –> only for people with a normal starting weight

Question 11

Impact of Exercise on Gestational diabetes

Answer 11

Reduces risk

Question 12

Impact of Exericse on Macrosomia

Answer 12

May potentially reduce the risk of macrosomia

Question 13

Pyschological impact of Exercise during pregnancy

Answer 13

Exercise may reduce the prevalence of antental and postnatal depression

Question 14

What intensity should be used for pregnany women?

Answer 14

Not recommended to perform vigorous activities (e.g. %VO2max or %HRMAX)

Use the simple talk test to determine intensity

Question 15

What are some pregnancy complications that would deter exercise prescription?

Answer 15

GENERAL TREND-Same as a normal person but has some degree of specificity for pregnancy

• Placenta previa
• Pre-eclampsia
• Evidence of intrauterine growth restriction
• Multiple gestation (triplets)

Always make sure they have clearance before performing exercise

Question 16

Safety Precautions/considerations during Exercise for Pregnancy

Answer 16

1. Drinking plenty of water
2. Avoid Heat stress / hypothermia
3. Avoid physical activities in high altitude
4. Always wear appropriate clothing –> non restrictive

Question 17

Warning signs to stop PA during Pregnancy

Answer 17

SAME AS A Non pregnant PERSON
Also include things such as:
- vaginal bleeding
- loss of fluid from the vagina
- Painful uterine contractions

Question 18

What activities should be avoided during pregnancy?

Answer 18

• Activities that have risk of falling (e.g. balancing)
• Heavy lifting
• Significant changes in pressure (e.g. scuba diving)
• After 28 weeks –> avoid supine activities (prop back to 45 degree angle

supine activities put pressure on the inferior vena cava that reduces BF

Question 19

How can pelvic girdle pain be reduced in pregnant individuals?

Answer 19

Performing exercises that have nice balance (not single leg squats)

Avoiding activities that have assymetric movements
–> when getting off a bed, roll to the side and stand up on both feet not single leg

Question 20

What is DRAM? What spacing is normal?

Answer 20

Diastasis Rectus Abdominus Muscle
Is the separation of the rectus muscle - expansion of the linea alba
Normal during pregnancy (>80%)

Normal spacing is 1-2 fingerwidths apart

Question 21

Activities to avoid for patients with DRAM?

Answer 21

AVOID anything that increases IAP

Question 22

Recommended exercises for patients with Rectus abdominus diastasis?

Answer 22

Exercises that strength deeper core muscles and provide pelvic stability –> stabilisation of the trunk