Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 17 Resistance-Training Strategies During Pregnancy

Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Chapter 17

Resistance-Training Strategies During Pregnancy


Exercise and Pregnancy

• During low-risk pregnancy, moderate exercise for 30 minutes or more recommended

• American College of Obstetricians and Gynecologists (ACOG) does not distinguish between aerobic and resistance training


Exercise and Pregnancy

• Physical Activity Readiness Medical Examination (PARmed-X) for Pregnancy conversely has specific guidelines and precautions

• Effects of resistance training rarely examined


Contraindications of Resistance Training During Pregnancy

• Heavy lifting or straining

• Activities with static or isometric exercise component

• Changes in maternal blood pressure

• Heavy resistance training (> 80 percent of 1 RM) may reduce uterine blood flow and oxygen supply


Exercise During Pregnancy

• May prevent:– Excessive weight gain

– Postpartum weight retention

– Gestational diabetes

– Associated future risk of developing T2D


Other Benefits of Exercise

• Improves heart and lung health

• Reduces risk of hypertension and heart disease

• May increase stamina for labor and delivery

• May assist in faster postpartum recovery



• Improves self-esteem and mood

• Improves sleep-patterns

• Promotes healthy lifestyle

• Decreases postpartum anxiety and depression



• Improves muscle strength– May improve or prevent urinary incontinence and back

pain

• Improves upper-body strength– Supports breasts

– Assists in carrying infant


Research Supports Resistance Training

• Little research available due to concerns about possible contraindications

• Studies show healthy pregnant women lack hypertensive response to resistance exercise

• Supine position may cause transient changes in fetal heart rate


Research Supports Resistance Training

• Maintaining muscular fitness should be emphasized in light of general activity decline during pregnancy

• Beneficial for preventing muscle-related complications of pregnancy– Incontinence

• Kegel exercises

– Lower-back pain


Precautions

• Medical prescreening to ensure low-risk pregnancy– Physicians can use PARmed-X for Pregnancy as

screening tool

• Follow safety considerations duringwarm-up and cooldown

• Follow five resistance training precautions


First Precaution: Body Position

• Uterus may impinge abdominal aorta during exercise in supine position

• Beyond four months of pregnancy, do not perform exercises in supine position

• Modify supine exercises to sitting position


Avoid Supine Position


Second Precaution: Joint Laxity

• Hormone relaxin loosens ligaments and may makes joints more injury-prone

• Avoid rapid change of direction and bouncing ballistic movements

• Perform stretching and flexibility movements with caution


Third Precaution: Diastasis Recti

• Bulging or rippling of connective tissue along linea alba when abdominal exercise performed

• Contraindication for abdominal exercises– Could lead to tear in connective tissue


Diastasis Recti


Fourth Precaution: Breathing

• Maintain proper breathing technique– Prevents injury

– Ensures no change in blood pressure related to resistance training


Fourth Precaution: Breathing

• Emphasize continuous breathing during activity– Exhalation upon exertion

– Inhalation upon relaxation

• Avoid Valsalva maneuver


Fifth Precaution: Posture

• Emphasize correct posture and neutral pelvic alignment

• Incorrect posture may lead to back and pelvic pain

• Avoid extreme positions


Correct Posture forPregnant Woman


Warm-Up and Cooldown

• Warm-up may take longer

• 10- to 15-minute warm-up

• 10- to 15-minute cooldown

• Include lower intensity calisthenics, stretching, and relaxation during both


PARmed-X Absolute Contraindications

• Ruptured membranes

• Preterm labor

• Uncontrolled T1D or T2D

• Pregnancy-induced hypertension

• Incompetent cervix


PARmed-X Absolute Contraindications

• Intrauterine growth restriction

• High-order pregnancy– E.g., triplets

• Vaginal bleeding

• Relative contraindications– If risk to pregnancy exceeds exercise benefits


Program Design Considerations

• Gain medical clearance

• Follow guidelines

• Women with no experience may begin in second trimester– Approximately 12 to 13 weeks



• Maintain strength and endurance

• Follow safety precautions and guidelines on when to stop


Safety Considerations

• Avoid exercise in warm, humid environments

• Avoid isometric exercise or straining while holding breath

• Maintain adequate nutrition and hydration

• Avoid exercise in supine position past fourth month of pregnancy


Safety Considerations

• Avoid activities that involve physical contact or danger of falling

• Know limits

• Know reasons to stop

• Monitor temperature of heated pools


Reasons to Stop Exercise

• Persistent uterine contractions– More than six to eight per hour

• Bloody discharge from vagina

• Any “gush” of fluid from vagina

• Unexplained pain in abdomen



• Sudden swelling of extremities– E.g., ankles, hands, face

• Swelling, pain, and redness in calf of one leg

• Persistent headaches or disturbance of vision



• Unexplained dizziness or faintness

• Marked fatigue, heart palpitations, or chest pain

• Failure to gain weight

• Absence of usual fetal movement



• Incorporate low-impact warm-up

• Use weight that allows 12 to 15 repetitions per set without fatigue

• May need to decrease intensity during third trimester

• Incorporate with aerobic exercise, if desired



• Perform ideal number of sessions– Three to four times per week

• Do not exceed five times per week

• Use one to two exercises for each major muscle group– Including pelvic floor muscles



• Use target heart rate zones provided in PARmed-X for Pregnancy

• Begin with 15 minutes of exercise– Adding two minutes each week to maximum of 30

minutes

• Refer to Table 17.4 for exercises

• Review sample 24-Week Program

Documents

Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 17 Resistance-Training Strategies During Pregnancy