M7: 3

Question 1

General guidelines for safe exercise during low risk pregnancy?

Answer 1

• 3-5 days per week
• mod intensity (60-75% MHR)
• avoid ballistic, high velocity movements and straining

Question 2

What happens in supine hypotension syndrome?

Answer 2

Aorta and inferior vena cava may be occluded by increased weight and size of the uterus

Question 3

When does supine hypotension syndrome typically occur?

Answer 3

Usu after 4 months of pregnancy

Question 4

Which positions can you get supine hypotension syndrome in?

Answer 4

• supine

- prolonged standing

Question 5

S/s supine hypotension syndrome

Answer 5

• faint
• dizzy
• restless
• N/V
• chest/abd pain
• visual disturbances
• numbness/paresthesias
• HA
• cold legs
• weakness
• tinnitus
• fatigue
• desire to flex hips and knees
• anguish

Question 6

What should you do if you suspect supine hypotension syndrome?

Answer 6

Modify positioning

• more upright or SL
• frequent position changes
• small wedge, pillow under R hip when supine
• prone
• quadruped

Question 7

supine hypotension syndrome : why put a pillow under the right hip when supine?

Answer 7

Allows for max venous return in the LEFT lateral recumbant position

Question 8

What are signs that exercise should be modified or d/c?

Answer 8

• pain
• vaginal bleeding
• contractions
• persistent dizziness, N/T
• faintness
• SOB
• palpitations
• N/V
• leaking amniotic fluid
• gen’l edema
• HA
• calf pain or swelling

Question 9

Guidelines for exercise in postpartum period

Answer 9

• unilateral, no exercises in LE against gravity
• avoid abs and resistance
• progress gradually
• PFE
• gradual return to exercise
• avoid hips over heart exercises until bleeding stops postpartum, ballistic, extreme stretching, heavy lifting

Question 10

When can PFE’s be performed postpartum?

Answer 10

Within 24 hrs. Postop

Question 11

Important educational component postpartum (PFE)

Answer 11

• Contract pelvic floor prior to coughing, sneezing, laughing
• avoid valsalva

Question 12

Safe exercise guidelines for pt on bedrest

Answer 12

• unilateral, no LE exercise against gravity, no abd contractions
• exhale with movement effort to prevent IAP
• ankle pumps for DVT prevention
• slow, gradual progress
• need medical clearance prior to exercise

Question 13

What are the MSK and peripheral nerve problems often seen in a PT clinic during pregnancy?

Answer 13

1. Intercostal neuralgia
2. Thoracic outlet syndrome
3. CTS
4. Lateral femoral cutaneous nerve entrapment
5. TTS
6. Peroneal nerve compression

Question 14

Intercostal neuralgia

Answer 14

pain in rib cage or chest due to flaring of ribcage

Question 15

TOS

Answer 15

• may result from FHP and RSP with pregnancy

- may have pain, N/T in hand and forearm

Question 16

Tx for TOS

Answer 16

• strengthening upper back and scapular mm
• lengthening pectorals
• good bra with support

Question 17

CTS and pregnancy

Answer 17

• usually disappears after delivery, but may persist if breastfeeding
• usually bilateral

Question 18

Tx for CTS with pregnancy

Answer 18

• decrease in hand and wrist flexion activities
• night splints
• exercises for finger mobility and fluid movement

Question 19

Lateral femoral cutaneous nerve entrapment

Answer 19

nerve compressed as it emerges from the pelvis at the inguinal ligament adjacent to ASIS

Question 20

Lateral femoral cutaneous nerve entrapment tx

Answer 20

Lay on unaffected side to draw uterus away from compressed area to reduce sx

Soft tissue techniques to reduce stiffness in ITB

Question 21

TTS during pregnancy

Answer 21

• result of edema in tarsal tunnel
• N/T in medial aspect of foot
• weakness of toe flexors

Question 22

Tx for TTS during pregnancy

Answer 22

• elevation
• AROM to help decrease edema and reduce compression
• night splinting

Question 23

Peroneal nerve compression

Answer 23

• prolonged squatting may compress nerves and cause drop foot
• instruction on prevention