Active Pregnancy: A Physical Exercise Program Promoting Fitness and Health during Pregnancy—Development and Validation of a Complex Intervention (original) (raw)
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ACTIVE PREGNANCY: Workshop on Promotion of Physical Activity in Pregnancy for Exercise Professionals
Journal of Multidisciplinary Healthcare
A one-day workshop on promotion of physical activity in pregnancy for exercise professionals was delivered during 2021, to 137 participants. The main aim of this workshop was to motivate and prepare exercise professionals for promoting physical activity and implementing prenatal exercise programs, in their respective private or public fitness centers or other physical activity settings. Methods: The contents of the workshop were focused on six topics based on the "Pregnancy and Postpartum Exercise Specialist" educational standards by EuropeActive and the "Exercise and Physical Activity during Pregnancy and Postpartum" textbook published by Springer. Participants provided feedback on the effectiveness and satisfaction with the workshop. Results: Overall evaluations from the feedback forms showed that majority of the participants agreed that the workshop achieved its objectives with a major recommendation as to the organization of more short duration workshops, the inclusion of practical sessions, and the separation of the contents addressing the postpartum period. Discussion: The workshop on promotion of physical activity in pregnancy for exercise professionals was successfully organized and the participants are looking forward for future ones.
2018
Extensive scientific evidence has shown that prenatal physical activity is a prerequisite for the proper course of pregnancy, fetal development, labour and delivery, and the postpartum period. In 2015, the American College of Obstetricians and Gynecologists published a breakthrough statement that inactivity in pregnancy is risky behaviour. The aim of this paper is to provide answers to the questions concerning who and how should prescribe and conduct exercise programs for pregnant women. Close cooperation between the woman, her obstetric care provider and exercise specialists is necessary to promote exercise in pregnancy. Obstetricians should carefully evaluate women with medical or obstetric complications before starting the exercises. They should also provide women with general information about the benefits of prenatal exercise and the risks of physical inactivity. On the other hand, the design and implementation of the exercise program are tasks for exercise professionals, prefe...
Research Square (Research Square), 2023
Postnatal physical activity is a public health issue. Reporting on the quality of exercise interventions designs must be ensured in view of the reproducibility and successful implementation of such studies. The objective was to develop and validate a physical exercise program for postpartum recovery, aiming to promoting physical tness and health of the new mothers. A qualitative pilot study was carried out through the three stages of development, piloting, and evaluation. The Consensus on Exercise Reporting Template (CERT) was used to describe the postpartum exercise program. The Criteria for Reporting the Development and Evaluation of Complex Interventions in Healthcare (CReDECI2) was followed to validate the program. A tailored postpartum exercise program was designed and validated based on evidence-based international recommendations to be implemented by quali ed exercise professionals. A pilot intervention of 16 weeks was carried out, engaging a group of postpartum women. The viability of the program was subsequently evaluated by all participants. The presented intervention can assist exercise specialists, health professionals and researchers in the planning, promoting, and implementation of an exercise program for postpartum recovery. Background Regarding the effects of physical activity on maternal health during pregnancy and postpartum, the public health importance of increasing physical activity in women of childbearing age before, during, and after pregnancy is substantial [1]. In 2020, the World Health Organization (WHO) issued, for the rst time, guidelines on physical activity and sedentary behavior for women during pregnancy and the postpartum period, reinforcing the need for national policies to include and monitor these subpopulations [2]. Exercise is a simple, low-cost intervention that can play an important role in health and well-being during the postpartum period [3]. Speci c programs for this stage of life can increase physical activity and consequently, potentially improve women's health and tness, as shown in the umbrella review by Dipietro et al. [1]. Since 2019, updated international guidelines for exercise during pregnancy and postpartum from Canada [4], USA [5], Brazil [6], and Australia [7] have been published. However, these guidelines lack speci c postpartum contents, and only one consensus paper supported by the International Olympic Committee (IOC) addresses exercise and postpartum in recreational and elite athletes [8]. Clear guidance and reporting of exercise interventions is critical for interpreting and translating research into clinical practice. Nevertheless, the available o cial guidelines lack structured methodologies to design and implement effective and safe exercise programs [9, 10]. Therefore, it is important to know more precise information about the type of exercise, intensity and frequency, in order to fully understand the intervention and how to replicate it. The Consensus on Exercise Reporting Template (CERT) by Slade et al. [11] is a tool used to describe the components of interventions based on exercise programs. The Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare (CReDECI2) by Möhler et al. [12], allows describing all the relevant methodological aspects related to the process of research and development, piloting and evaluation of a complex intervention, which can be applied to exercise programs. Therefore, the objective of this study was to develop and validate a physical exercise program "ACTIVE MUMS", speci c for postpartum recovery that aims to promote maternal health and physical tness, helping women to resume an active and healthy lifestyle after giving birth. Methods Study Design Qualitative study for the development and validation of an exercise program for postpartum recovery as a complex intervention. Participants Seventeen participants were involved in the validation process, six specialists in physical exercise with a doctorate, master's or degree in exercise/sports science and 11 women who were in the postpartum period, who participated in the pilot intervention. Instruments The Consensus on Exercise Reporting Template (CERT) was followed to describe the postpartum exercise program [11], and the Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare (CReDECI 2) was followed to develop and validate it [12]. Procedures regarding the development of the postpartum exercise program The exercise program was designed through three stages proposed by the CERT and the CReDECI guidelines: development, piloting and evaluation. The postpartum physical exercise program was developed by exercise specialists. The periodized training plan includes a variety of exercises to promote cardiorespiratory tness, posture, strength, exibility, balance, abdominal recovery, and pelvic oor muscle training. Procedures regarding the piloting and evaluation of the postpartum exercise program The dissemination process, recruitment of the target population and implementation of the pilot study in a training studio were planned. An in-person or online pilot intervention of 48 sessions over 16 weeks was developed between October 2021 and June 2022, in Leiria, Portugal. The pilot exercise intervention was delivered by an exercise physiologist. All women in the postpartum period (4-12 weeks) received a medical consultation by a gynecologist before being included in the pilot intervention. The inclusion criteria were: women in the (4-12 weeks) postpartum period, aged between 18 and 45 years old, without medical contraindications for the practice of physical exercise. Exclusion criteria were: any medical contraindications for physical exercise.
Current Women s Health Reviews, 2015
Background: Regular physical activity during pregnancy has a positive effect on the psychophysical condition of the pregnant woman, pregnancy and fetal development, parturition and the postpartum period. However, its level in pregnant women is insufficient in most countries. For an exercise program to be effective it must take into account four training components: intensity, frequency, duration and its content - through a proper selection of the type of exercises and their technique. In this work we aimed to answer the question what information on the contents of prenatal exercises is provided in the current guidelines for exercise during pregnancy in different countries. Methods and Results: We have analyzed 11 documents, that were the official position of national obstetrics, gynecology, or sports medicine institutions from 7 countries. The guidelines provide little information on the contents of prenatal exercise and on the adaptation of sports activities to pregnancy. Conclusio...
Physical Activity Assessment During Gestation and Its Outcomes: A Review
Background: Physical activity recommendations emphasize a positive influence of exercise on health. It is particularly recognized during pregnancy for both the mother and fetus. Aim: This review aims to identify the main trends of activity undertaken by women during gestation and to find out how it affects the expecting mother and her child. Methods: Review of the literature comprising the following databases: PubMed, Academic Search Complete, Health Source—Consumer Edition, Health Source: Nursing/Academic Edition, EMBASE (2000 to May 2013), used detailed search strategies. The review was restricted to experimental studies. Trials were excluded if they met any of the following criteria: reviews, letters, commentaries or editorials, only abstracts available, and any kind of pathology during pregnancy. Three assessors reviewed the titles, abstracts, and full articles using standardized data abstraction forms, and they assessed the study quality. A total of 474 potential articles remained for analyses. Findings: Twenty-eight articles were eligible for inclusion in the present review: randomized controlled trials and observational studies that evaluated maternal and offspring outcomes as a result of physical activity during pregnancy. Quasi-randomized trials were excluded. The activities that were most frequently assessed included occupational activity, housework/caregiving, sport/exercise, and active living, as well as habits. The authors evaluated different types of physical activity in the loading conditions. The aerobic activities most frequently used for assessment included treadmill walking program; step aerobics or stair stepper; aerobics; bicycle ergometer; combination of rowing, stationary cycling, and walk jogging; rhythmic calisthenics class and step class; brisk walks; stretching; and relaxation. The benefits following being active during pregnancy are associated with improved maternal psychological well-being, a reduced risk of preterm birth and excessive gestational weight gain, and lower risk of birth-related complications. Conclusions: Patterns of activity change during pregnancy. Although exercise is safe for both the mother and fetus, most women reduce their activity level during the first weeks of gestation. Specifically, physical activity tends to be of lower duration, frequency, and intensity. Therefore, women should be encouraged by professionals to initiate or continue exercising during a healthy pregnancy. Target Audience: Obstetricians and gynecologists, family physicians. Learning Objectives: After completing this activity, the learner should be better able to identify the main trends among pregnant women in terms of physical activity, investigate the main benefits following exercising during pregnancy, recognize the most popular forms of physical activity in pregnant population, and realize health professionals to make women more aware of the importance of exercise.
Sustainability
Background: Regular physical activity (PA) practice during pregnancy offers health and fitness benefits for both mother and baby. Therefore, healthy pregnant women with no contraindications to exercise should be encouraged to perform PA. Nevertheless, their levels of PA are generally low. The aim of the WELL-DONE! Study is to co-design an adapted physical activity intervention (APAI) for pregnant women to include in childbirth preparation classes (CPCs) evaluating its feasibility and efficacy on quality of life (QoL), PA levels and other outcomes. Methods: A quasi-experimental study was divided in two progressive stages. First, APAI was developed in collaboration with pregnant women and midwives using focus groups; second, APAI’s efficacy was evaluated comparing two groups: the experimental group engaged in the CPCs integrated with 1 h/week of the APAI administered by midwives and the control group participating in the standard CPCs. Pre-post evaluation was carried out in three stag...
Physical activity throughout pregnancy: guideline critical appraisal and implementation tool
PubMed, 2021
Objective: The 2019 Canadian guideline for physical activity throughout pregnancy provides evidencebased recommendations to promote maternal, fetal, and neonatal health. We aimed to 1) critically appraise the 2019 Canadian guideline for physical activity throughout pregnancy; and 2) develop a guideline summary for clinicians to facilitate the uptake of recommendations into practice. Methods: We used the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument to critically appraise the quality and reporting of this guideline. Four reviewers independently scored between 1 (strongly disagree) to 7 (strongly agree) for 23 items organized into six quality domains. Results: AGREE II quality domain scores ranged from 47%-64% and the overall quality of the guideline was rated as 83% (high quality). Conclusion: Based on its methodological quality, we recommend the use of this guideline. Our guideline summary includes six recommendations and other safety precautions that are relevant for clinicians in Canada.
Exercise during pregnancy: a practical approach
Current sports medicine reports, 2003
Attitudes toward exercise during pregnancy have changed dramatically over the past 20 years. Recent studies show that, in most cases, exercise is safe for both the mother and fetus during pregnancy, and support the recommendation to initiate or continue exercise in most pregnancies. This report discusses the rationale behind the changes, and offers educational tools that may be employed to initiate behavioral change. We also propose exercise prescriptions for pregnant women who are sedentary, physically active, and competitive athletes. Armed with this information, the practitioner will be better equipped to counsel patients and incorporate a discussion on physical activity into prenatal visits.
Professional Exercise Recommendations for Healthy Women Who Are Pregnant: A Systematic Review
Women's Health Reports
Background: Exercise in pregnancy favorably affects maternal and fetal outcomes, yet only 50% of women receive exercise guidance during prenatal care and 15% are told to stop exercising. Reasons for clinician reluctance to recommend exercise include safety concerns and ambiguity of recommendations. To better inform clinicians, this systematic review assembled a consensus exercise prescription (ExRx) for healthy pregnant women framed by the Frequency, Intensity, Time, and Type (FITT) principle. Methods: In April 2021, PubMed, Scopus, SPORTDiscus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Cochrane databases were searched. Reports were eligible if: (1) targeted healthy pregnant women, (2) framed the ExRx by the FITT, and (3) published by a professional society from 2000 to 2021 in English. The Appraisal of Guidelines for Research and Evaluation II tool assessed risk of bias. Results: Twelve reports of poor to good quality were included. Nine societies conducted systematic reviews, but only three provided a detailed, transparent description of the review conducted. Although the FITT varied, the most common was most days of the week, moderate intensity, 30 minutes/session to accumulate 150 minutes/week, and aerobic, resistance, and flexibility exercise with three societies advising neuromotor exercise. All professional societies specified activities to avoid and eight societies included contraindications to exercise. Conclusions: This systematic review produced a consensus ExRx for healthy pregnant women to better inform clinicians about advising their patients to exercise during pregnancy. Future research is needed to determine the upper limits of exercise while pregnant and provide better informed guidance relating to safety concerns for women who are pregnant.
BMC pregnancy and childbirth, 2024
Postpartum physical activity is a public health issue. Reporting on the quality of exercise interventions designs must be ensured in view of the reproducibility and successful implementation of such studies. The objective was to develop and preliminary validate a physical exercise program for postpartum recovery, aiming to promote physical fitness and health of the new mothers. The study was carried out through the three stages of development, piloting, and evaluation. The Consensus on Exercise Reporting Template (CERT) was used to describe the postpartum exercise program. The Criteria for Reporting the Development and Evaluation of Complex Interventions in Healthcare (CReDECI2) was followed to develop and preliminary validate the program. A tailored postpartum exercise program was developed based on evidence-based international recommendations to be implemented by qualified exercise professionals. A pilot intervention of 16 weeks was carried out, engaging a group of postpartum women. The viability of the program was subsequently evaluated by all participants. The present work provided guidance to develop a study protocol with a larger sample in order to prove the effectiveness of a supervised postpartum exercise program on selected parameters of health.