What are some physiological respiratory changes that occur during pregnancy?
- Pushed up diaphragm by 4cm
- Tidal volume increases by 30-50%
- Minute ventilation increases by 20-50%
- Chest wall compliance decreases (ability to stretch and expand)
What are some physiological physical changes that occur during pregnancy?
- 60% experience back pain
- Centre of mass moves anteriorly
- Increased body mass, metabolic rate
- Pelvic tilt
- Pelvic floor muscle activation
- Breasts enlarge by up to 40%
Manifests in greater fatigue
What are some physiological circulatory changes that occur during pregnancy?
- Cardiac output increases from 5 to 7L/min
- HR raises to 85-90bpm
- Blood pressure lowers (lowest at 2nd trimester)
- Blood volume increases by 50%
- Oxygen consumption increases by 20%
What are some physiological endocrine changes that occur during pregnancy?
More Vasopressin = Greater water retention
More Relaxin =
Greater joint laxity
Greater cortisol secretion (sustained high levels=inflammation and weaker immune system)
What are some gastrointestinal and nutritional changes that occur during pregnancy?
- Higher caloric needs
- Protein catabolism decreases (protein breakdown to make amino acids)
- Nausea and vomiting is more likely
- Gestational diabetes
- Peak calcium demand in 3rd trimester
What are some concerns for the foetus in terms of commencing exercise?
- Mechanical stress and trauma from swaying and bouncing
- Higher stress hormones in circulation
- Uterine-placental O2 supply could decrease
- Decreased uterine blood flow could comprise foetal blood flow
What are some concerns for the mother in terms of commencing exercise?
- Increased relaxin (higher joint laxity)
- Linea Alba (connective tissue from sternum to pubic bone)
- Osteitis Pubis (overuse inflammation of pubic joint)
- Hypoglycaemia can affect maternal and foetal glucose supply
What are a couple recommendations regarding exercise for pregnant women?
- To accumulate at least 150min of moderate intensity exercise/week
- Should train before, during and after pregnancy (provided there are no contraindications)
- Do both aerobic and resistance training
- Pelvic floor muscle training should be used
- Avoid supine position for prolonged periods (dizziness and lowers foetal blood flow)
What should we avoid prescribing and performing in terms of exercise for pregnancy?
- Valsalva maneouvres
- Exercises with falls risk AND high joint impact
- Higher intensity >90%HRmax
- Prolonged exposure to heat
What would be an appropriate intensity for aerobic and strength training for pregnancy?
Aerobic: 55-60% VO2max, 3-5x/week, 30-60mins
12-14 on Borg Scale
Strength: Light-moderate intensity, avoiding heavy lifts and focusing on safe technique
What are some ABSOLUTE contraindications to exercise for pregnancy?
- Ruptured membranes
- Premature labour
- Uncontrolled Type 1 Diabetes
- Uncontrolled Hypertension
- Uncontrolled Thyroid Disease (abnormal hormone amounts)
- Proteinuria and High Blood Pressure
What are some RELATIVE contraindications to exercise for pregnancy?
- Gestational hypertension
- Malnutrition
- Eating disorders
- Mild/moderate CVD/respiratory disease
- Recurrent pregnancy loss
List some overall health benefits to exercise before, during and after pregnancy.
- Improves psychological wellbeing
- Less weight gain
- Positive body image
- Greater energy reserve
- Lower fitness decline
- Rapid return to pre-pregnancy fitness levels
What is EMS?
Electromuscle Stimulation. Essentially reproducing CNS signal to contract the muscle
Why would people consider EMS as a form of recovery?
Low frequencies can make the muscle not fully contact but ‘pulse’.
This maximises blood flow and pain relief by oxygenating the target muscle and encouraging metabolic waste removal.
How else would EMS be used apart from promoting recovery?
- Preventing muscle atrophy
- Reducing spasms
- Aids preservation of mobility
