What is physical activity?

Physical activity is a collective term that encompasses all energy-based physical movements. Physical activity is described as energy-consuming tasks that involve the use of our muscles and joints in daily life, resulting in increased heart and respiratory rates and greater or lesser levels of fatigue. Physical activity includes things like sports, play, and everyday activities. Sports are a type of physical activity that is done on a regular basis.

What is the definition of sport?

Sport is a planned, structured, and voluntary physical activity designed to improve one or more elements of physical fitness. Light to moderate physical activity is beneficial in the early stages of pregnancy. Women who exercised before pregnancy may continue to exercise during pregnancy under certain conditions. Women who have never exercised before pregnancy, such as hiking or swimming, should not exert themselves excessively, should activate their entire body musculature evenly, and exercise carefully.

Pregnancy Posture:

What is the correct standing position for a pregnant woman?

• Keep your chin tucked in and your head upright. Do not look forward, backward, downward, or to the side with your head.
• Make sure your earlobes and the middle of your shoulders are in line.
• Keep your chest forward and your shoulder blades back.
• Keep your knees in a straight but not locked position.
• Raise your eyebrows toward the ceiling.
• Pull your abdomen inward and upward as far as possible. Do not tilt your pelvis forward or backward. Keep your buttocks in a bent position.
• Your weight should be properly distributed on both feet while placing your feet in the same direction. Wear shoes with low heels (but not flats) to support your arches and take pressure off your back.
• It is not recommended to stand in the same position for a long period of time.

Due to hormone production, weight gain, and changes in posture, numerous aches and pains, numbness, and weakness are typical of pregnancy. This change in posture can lead to problems such as neck discomfort and irritability. In the early stages of pregnancy, thoracic crisis, which is felt in the back, can cause discomfort and difficulty breathing. The rise of the lumbar, one of the postural changes, is one of the most typical difficulties of pregnancy. Back discomfort, leg pain, and pelvic pain are also common due to the forward tilt of the pelvis. Hyperextension of the knees and flattening of the foot can cause discomfort in the feet and heels. If numerous exams and treatments to protect the fetus are not performed, complications can occur. However, many of these problems can be quickly resolved if appropriate suggestions and treatments are followed.

Regular pregnancy exercises have the following benefits:
– Helps control weight
– Increases metabolic rate
– Increases endurance and strength
– Minimizes back and lower back pain
– Stimulates muscle activity needed for childbirth
– Regulates the digestive system, prevents constipation
– Reduces the risk of gestational diabetes
– Provides a more comfortable sleep
– Less edema

Evaluation of the level of physical activity during pregnancy

Before beginning any exercise program during pregnancy, the clinical condition of the pregnancy must be thoroughly assessed and any conditions that limit or hinder activity must be thoroughly investigated. The following methods were used in this assessment:

Subjective approaches: Physical activity surveys and activity records are common examples of subjective methods.
Objective methods: Accelerometers, pedometers, and heart rate monitors are examples of objective methods.

Pregnant women who should not exercise

• Individuals with severe heart disease.
• Individuals with severe lung disease such as COPD.
• Pregnant women with cervical insufficiency and sutures.
• Pregnant women with more than one risk of preterm delivery.
• Recurrent bleeding over 16 weeks.
• Women with placenta previa (lower placenta) over 26 weeks.
• Women who have had preterm labor in their current pregnancy.
• Pregnant women whose water breaks.
• Pregnant women with preeclampsia (pregnancy toxicity) or pregnancy-related blood pressure disease.
• Severe anemia.

Pregnant women with partial limitation of physical activity

• Anemia,
• Cardiac arrhythmias,
• Chronic bronchitis,
• Uncontrolled type 1 diabetes,
• Severe morbid obesity,
• Severe underweight (BMI less than 12),
• Previous severe inpatient lifestyle,
• In the current pregnancy, associated with the lack of growth of the baby,
• Uncontrolled hypertension,
• Orthopedic limitations,
• Inadequate control of stroke disease,
• Under-controlled hyperthyroidism,
• Heavy smoking.

What you should pay attention to during pregnancy?

1. 20-30 minutes of exercise per day is required.
2. It is important to pay attention to how much water you drink.
3. Long-term postures on the back must be avoided at all costs.
4. Heavy sports that last longer than 45 minutes must not be chosen.

You should stop exercising if you have vaginal bleeding, regular painful contractions, water retention or shortness of breath before exercising.
Headaches, chest discomfort, leg cramps, or edema are possible symptoms.

PREGNANCY EXERCISE RECIPE

A training session is composed of three phases. The first warm-up phase. The purpose of the warm-up phase is to ensure that the person is aware of the physiological processes that must take place before the activity. The warm-up phase should last between 5 and 10 minutes. The loading phase is the second step. The cool-down phase is the third step. The cool-down phase avoids muscular discomfort after exercise and reduces cardiovascular problems by preventing the person from stopping the exercise too soon. A cool-down period of 5-10 minutes must also be observed.

Warm-up exercises

Warming up is an important element of any prenatal activity… no matter what you do. You can not expect your body to respond immediately when you start exercising. Proper warming up gradually increases your heart rate, improves blood flow to your muscles, ligaments, and tendons, increases your body temperature, and reduces the risk of injury. It also helps you psychologically prepare for exercise by putting you in the right frame of mind. During pregnancy, exercise is even more important because a quick burst of movement could even wake up your baby!

1st Ankle Twists: Stand on one leg (hold onto something if you feel wobbly); lift the other foot off the floor and twist the ankle, pointing and flexing the foot.

2. knee extensions: Remain in a one-legged position. Raise your knee higher in the air and bend it back and forth.

3. Hip and body rotations: Turn one way, then the other, with your feet hip-width apart and your hands resting on your hips. Rotate your body from side to side with your hands at your temples. Get the bumps going, mammas (but only lightly!).

4. Warm up your arms by bending your wrists up and down and rotating your arms forward and backward with your arms extended. Cross your arms in front of your body inward and outward. Raise your arms and extend them toward the ceiling (or sky if you are exercising outdoors!). Stretch your arms straight and bend them.

5. Do a decent shoulder shrug by raising and lowering your shoulders to relieve your back, neck, and shoulders. Then roll your shoulders back and forth.

6. raise and lower your arms across your body. Reach one arm up and lean to the side with one hand on your hip – or reach toward the ceiling (or sky!) with one hand on your hip and bend forward while the other arm slides down your thigh. Make sure you do this on both sides.

 

 

Exercise Examples

Colling Down

Cooling down is the process by which your heart rate and breathing gradually return to normal. If you simply stop exercising and go home or sit down, blood backs up in your muscles and decreases blood flow to other parts of your body, including your baby. Like warming up, cooling down reduces the risk of post-workout injury and soreness.

 

Aerobic exercise is indicated to prevent chronic disease, maintain cardiovascular fitness, and reduce excessive weight gain during pregnancy. Walking, stationary cycling, swimming, exercising in water, and aerobic dance are some of the activities that can be included in an aerobic fitness program. When choosing the best aerobic workout for a pregnant woman, you should also make sure that large muscle groups are used and that the activity is continuous, rhythmic, and intentional.

For aerobic exercise, it is recommended to do moderate-intensity every day or at least three days a week.

Strengthening Exercises: A strength training program should consist of exercises that target more than one muscle group. Exercises for individual joints that work large muscle groups can also be included in the program. Since an imbalance in muscle strength can lead to injury, training agonist and antagonist muscle groups together should be included in the program. Each set should consist of 8-2 repetitions of the exercise. There should be 60-90 seconds rest between sets. Frequent repetitions of the movement should be performed with light weights. Do not hold your breath during the exercise. Breathing should be synchronized with the movement. Exercises can be performed with free weights, weight machines, and with your own body weight.

Research has shown that low-intensity strength training performed during the second and third trimesters of pregnancy has positive effects on overall health and does not harm the baby’s body weight. According to evidence from systematic reviews, a single aerobic exercise program is reported to have more positive effects on maternal and infant health compared to a program in which aerobic and strengthening exercises are used together.

Pelvic floor muscle training: Pelvic floor training should be performed at the beginning of pregnancy to prevent incontinence later in pregnancy and in the postpartum period, and to treat incontinence in women.

Although the most appropriate protocol for pelvic floor training has not yet been determined, it is recommended that pelvic floor training be started before pregnancy and that 3 sets of 8-12 repetitions of continuous and rapid contractions be performed daily during pregnancy. It should be emphasized that during pelvic floor contractions, no muscles or muscle groups (especially abdominal, adductor, and hip muscles) other than those of the pelvic floor should be contracted and the breath should not be held.

Stretching and flexibility exercises: These exercises stretch muscles and tendons, increase flexibility and protect joints and muscles. Before stretching, as with other exercises, the muscles must be prepared. First, you should warm-up and then perform the stretching exercises. It is recommended to wait 10-30 seconds at the point where the feeling of discomfort or tension begins.

Relaxation techniques and breathing exercises: Pregnancy is an important process that should be continued and increases the psychological well-being of women. Anxiety and tension during pregnancy and childbirth also trigger pain. As long as the fears do not disappear, the natural process of childbirth will also be severely affected. The body sees the anxiety as a danger, causing a vicious cycle called anxiety-tension-pain. To break this vicious circle, it is necessary to provide information about childbirth during pregnancy and teach relaxation and breathing techniques.

Relaxation techniques recommended for use during pregnancy include Mitchell’s physiological relaxation method, the progressive relaxation method, visual imagination techniques, touch and massage, breathing, and the mindfulness approach.
Breathing control is necessary to meet the increased metabolic demands during labor and to manage labor. The most beneficial breathing technique for both mother and baby at the time of delivery is slow and controlled breathing. Therefore, pregnant women should be encouraged to practice abdominal breathing, chest breathing, and complete breathing techniques (abdominal and chest breathing together) with 10-15 repetitions three times a day until delivery.

Clinical Pilates exercises: These are movements that create concentration, tension, balance, and relaxation in the body through conscious movement and breathing.

Yoga: It is a method that helps to release tension during pregnancy and strengthen the mind. It should be applied while adapting to pregnancy. Positions, even of pregnant women who practice yoga before pregnancy, should be applied if the physiotherapist considers it appropriate. Yoga practiced during pregnancy also helps to relax during childbirth and helps to facilitate and speed up the birth.

Exercise Intensity

There are many methods to determine exercise intensity. One of them is the speaking test. The person should be able to sing while exercising at light intensity. While doing moderate-intensity exercise, the person should be able to maintain a conversation. During vigorous exercise, he should be able to hold his breath while chatting.
Exercise intensity can also be determined using the Borg Scale. A range of 12-14 is recommended for pregnant women on the Borg scale.

It is recommended that women who were sedentary before pregnancy start exercising with 15 minutes three days a week during pregnancy and increase the exercise time to 30 minutes overtime. Women who were active before pregnancy can continue their moderate-to-high-intensity activities 4-5 days a week. An adequate and appropriate warm-up should be done before each exercise, and then stretching exercises should be done. New guidelines also recommend adding light strength training to the exercise prescription of pregnant women. It has been shown that light strength training in the second and third trimesters does not harm birth weight or newborn health. It is appropriate to perform resistance training two days a week, on non-consecutive days. However, women should be warned against overexertion or excessive stretching during pregnancy. It is recommended that they continue the types of activities they are accustomed to before pregnancy.

 

References :

1. ACOG Committee Obstetric Practice: ACOG Committee opinion, Number 267, January 2002: exercise during pregnancy and the postpartum period. Obstet Gynecol 99: 171-3, 2002.
2. Pennick VE, Young G: Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Syst Rev 2: CD001139, 2007
3. American Pregnancy Association. Exercise during pregnancy. (http://americanpregnancy.org/pregnancy-health/exercise-during-pregnancy/) Accessed 8/14/2018.
4. American Congress of Obstetricians and Gynecologists. Exercise during pregnancy. (http://www.acog.org/Patients/FAQs/Exercise-During-Pregnancy) Accessed 8/14/2018.