The Physiotherapist Pocket Guide to Exercise Assessment Prescription and Training Physiotherapy Pocketbooks

142 The Physiotherapist's Pocket Guide to Exercise during their pregnancy will adversely affect their baby or themselves. I'hysiolhrr,lpists working in all kinds of fields may come across preg­ 11.1111 womcn and so require some knowledge about exercise during pregnancy to answer questions and prescribe exercise safely. PHYSIOLOGICAL DIFFERENCES AND RESPONSES TO EXERCISE DURING PREGNANCY In early pregnancy response to moderate activity is similar to that of normal healthy women. As pregnancy progresses blood volume, uterine size and metabolic rate start to increase. Fatigue is often a feature of early pregnancy and if the pregnant woman finds that fatigue is coming on more quickly than usual during exercise, she should moderate her level of activity accordingly. Early pregnancy is an important time for foetal development and so rest, hydration and nutrition are particularly important at this time. Ouring the later stages of pregnancy blood volume and weight increase significantly. A.s the weight gain is centred around the abdomen, posture and centre of gravity will alter, affecting balance. z Circulating hormones will relax ligaments around joints in prepara­ UJ I- tion for the birth, so some consideration should be given to joint 0:: UJ protection. It can take 4-6 weeks after giving birth for the physiol­ I­ «:trl:. ogy of the mother to return to normal. u roetal response to maternal exercise has been studied and an increase in foetal heart rate has been shown in response to short bOLits of maternal activity. BENEFITS OF EXERCISE DURING PREGNANCY Studies have shown that regular aerobic exercise during pregnancy can improve or maintain maternal fitness, prevent excess weight gain and speed recovery from giving birth. There is currently insllfficient information available to be certain aboLlt other risks or benefits to the mother or foetus. As the benefits of exercise in the management of hypertension have become recognized, consideration has been given to whether exercise during pregnancy could be useful in the prevention of pre-eclampsia. At present there is no clear evidence to support this suggestion. SPECIAL CONSIDERATIONS WHEN EXERCISING DURING PREGNANCY The main consideration for exercising during pregnancy is that no harm should come to the mother or foetus as a result of doing this.