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Exercise and Pregnancy

Exercise and Pregnancy. What are the common responses and adaptations we see in the pregnant exerciser?. Cardiovascular system:. Cardiac output rapid increase in 1st two trimesters levels off in 3rd 30-50% above normal increased stroke volume greater strain on heart during exercise.

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Exercise and Pregnancy

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  1. Exercise and Pregnancy What are the common responses and adaptations we see in the pregnant exerciser?

  2. Cardiovascular system: • Cardiac output • rapid increase in 1st two trimesters • levels off in 3rd • 30-50% above normal • increased stroke volume • greater strain on heart during exercise

  3. Cardiovascular system: • Blood flow distribution • increased flow to surface • increased renal, pulmonary, and uterine blood flow • decreased total peripheral resistance and increased peripheral blood flow • decreased venous return • exercise helps with venous return

  4. Cardiovascular system: • Blood pressure • decreased SBP and DBP during 1st two trimesters

  5. Cardiovascular system: • Blood volume • increases 50% by end of 2nd trimester • increased plasma volume

  6. Pulmonary System • Diaphragm elevates • FRC decreases by 25% due to decreased ERV and RV • hyperventilation occurs at rest due to increased progesterone levels and changes in the threshold of the respiratory centers.

  7. Metabolic System: • Slight increase in blood acidosis • Increase in resting VO2 and VCO2

  8. Metabolic System: • Metabolic rate is increased • Increased use of carbohydrates as fuel • result • increased VO2 at any given workload • increased O2 debt (EPOC)

  9. Musculoskeletal System: • Increased joint laxity (relaxin) • Stretching and thinning of abdominal wall

  10. Musculoskeletal System: • Forward shift in c of g and anterior rotation of pelvis • Proprioception and coordination are adversely effected

  11. Benefits of Exercise to the Pregnant Woman • 1. Facilitate a general feeling of well-being. • 2. Control of body composition. • 3. Maintenance or development of optimal posture. • 4. Decrease in the minor discomforts of pregnancy. • 5. Promotes pelvic floor strength.

  12. Benefits of Exercise to the Pregnant Woman • 6. Maintain or improve aerobic conditioning. • 7. Maintain or improve strength and/or flexibility. • 8. Facilitate general recovery after delivery. • Decrease by 1/2 post partum recovery days. • 9. Improved tolerance during delivery.

  13. Benefits of Exercise to the Pregnant Woman • 10. Improved physiologic adaptations to pregnancy. • 11. Improved ability to dissipate heat. • 12. Limits the pregnancy related increase in peripheral insulin resistance.

  14. Risks to the Mother: • 1. Risks of injury due to overuse. • 2. Increased potential for fatigue. • 3. Joint injury. • 4. Redistribution of cardiac output. • 5. Thermoregulatory problems.

  15. Latest Research • Most women increase body mass by 20% during pregnancy.

  16. Latest Research • Supine exercise doesn’t create abdominal hernias. • Abdominal recover within 6 weeks.

  17. Latest Research • Cardiac remodeling occurs. • VO2 Max higher 10-40 weeks post-partum.

  18. Latest Research • Birth occurs 5-7 days earlier. • No increased incidence of premature birth.

  19. Latest Research • Higher rate of normal delivery. • Quicker recovery post-partum.

  20. Latest Research • Decreased feelings of stress.

  21. Latest Research • Increased fitness and muscle tone.

  22. Latest Research • Improved bladder control.

  23. Risks to the Baby: A. Heat Stress: • 1. Heat stress and malformation (animal studies). • 2. Heat stress and malformation in saunas in humans during early pregnancy.

  24. Risks to the Baby: • 3. With exercise there is an increase in skin temperature with minor increases in core temperature. • 4. Exercising studies have not shown the correlation between heat stress and malformation.

  25. Risks to the Baby: B. Oxygen Delivery: • 1. Animal studies show conflicting results. • 2. Body can adapt to make-up for decreased blood flow - increase hemoconcentration and better extraction.

  26. Risks to the Baby: C. Fetal Heart Rate Changes: • 1. Conflicting results. • 2. Increased HR during start of exercise then it levels off.

  27. Risks to the Baby: • 3. No adverse effects. • 4. Trained women show less uterine blood flow.

  28. Risks to the Baby: D. Decreased Blood Flow: • 1. Animals suggest there is a relationship between exercise and low birth weight.

  29. Risks to the Baby: • 2. This does not seem to be a problem in rationally trained women. • 3. No relationship between exercise and miscarriage.

  30. Guidelines for Exercise • 1. Medical and exercise history of the individual. • 2. Questions or unusual symptoms • bleeding, dizziness, • cramping, joint pain • faintness, elevated blood pressure, • STOP exercising and consult physician.

  31. Guidelines for Exercise • 3. Listen to your body. • 4. Expect some discomfort.

  32. Guidelines for Exercise • 5. Exercise regularly. • 6. Do not exercise vigorously in hot humid weather.

  33. Guidelines for Exercise • 7. Do not exercise at all during an illness with fever.

  34. Guidelines for Exercise • 8. Avoid high impact activities. • 9. Drink plenty of fluids.

  35. Guidelines for Exercise • 10. Rise slowly from down positions. • 11. ACOG recommends that the HR not exceed 140 bpm.

  36. Guidelines for Exercise • 12. Avoid the valsalva maneuver.

  37. Guidelines for Exercise • 13. Do not begin a new fitness program. • 14. Follow basic fitness principles.

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