REVIEW :
EXERCISING FOR 2 ? UPDATED GUIDELINES FOR AN ACTIVE PREGNANCY
A review of evidence-based research has delivered some highly recommended reading for fitness professionals – comprehensive guidelines on physical activity for pregnant women .
WORDS : ASSOCIATE PROFESSOR MIKE CLIMSTEIN & JOE WALSH
Title : Exercise and pregnancy in recreational and elite athletes : Evidence summary from the IOC , exercise in women planning pregnancy and those who are pregnant . Author : Drs Bo and colleagues . ( Department of Sports Medicine , Oslo , Norway ) Source : British Journal of Sports Medicine . Available free online : bjsm . bmj . com / content / 50 / 10 / 571 . full
Introduction : In a recent tutorial for the Master ’ s degree in Clinical Exercise Physiology , a student inquired which of the ‘ guidelines ’ she should follow for exercise prescription for women who are survivors of breast cancer . This was actually a very good question which had resulted from previously providing two different sets of exercise prescription guidelines in the course lecture . One of the guidelines was from Exercise and Sports Science Australia ( 2009 ) and the other from the American College of Sports Medicine ’ s initiative Exercise is Medicine ( 2014 ).
I prefaced my answer by reminding the students that their exercise prescriptions must be evidence-based . In case you ’ re unfamiliar with this term , Sackett defined evidence-based practice ( EBP ) as ‘ the integration of best research evidence with clinical expertise and patient values ’. That ’ s why it is of the utmost importance that we are always abreast of the literature in our area ( s ) of expertise – to ensure the best outcomes for our clients / patients .
In short , all exercise prescriptions , regardless of whether they are prescribed by a medical doctor , accredited exercise physiologist ( AEP ) or personal trainer , must be safe and effective . These guidelines ( also called position statements ), which we follow for exercise prescriptions , are derived by experts from the currently available scientific research . The guidelines will change over time as new research findings become available , particularly with regard to the best outcomes using exercise as medicine / treatment . For example , Exercise and Sports Science Australia released a new position statement in October on exercise for the prevention and management of osteoporosis ( clearly an important read for all AEPs , personal trainers and fitness enthusiasts ). So , getting back to the question I was asked by my student , both of the guidelines presented were acceptable because they were evidence-based , and if the students were to look closely , they would find that there are only minor , subtle differences between the two guidelines .
Professor Bo and her colleagues have updated the guidelines on physical activity / exercise for women planning to be pregnant or those currently pregnant . The guidelines are quite comprehensive , so we have only addressed a number of the topics in this Research Review . As this is quite a comprehensive set of guidelines , we ' ll provide an overview in this Research Review on the following selected areas :
Musculoskeletal adaptations to pregnancy : The growth of the uterus results in a change in the centre of gravity , which may result in progressive lumbar lordosis and anterior rotation of the pelvis on the femur – both of which could interfere with certain exercises or performance in specific sports .
The 30-second article
• Exercise prescriptions must be evidence-based , a term defined as ‘ the integration of best research evidence with clinical expertise and patient values ’
• Using evidence-based research findings , scientists updated the guidelines on physical activity / exercise for women who are , or are planning to be , pregnant
• The guidelines address areas affected by pregnancy , including balance ; musculoskeletal , thermoregulatory , and cardiorespiratory adaptations ; and gestational weight gain
• The guidelines also address strength and endurance recommendations , as well as contraindicated behaviours , such as high-intensity exercise at altitude , scuba diving , Olympic lifts and sports in which collision or impact could occur .
Balance with pregnancy : Balance is affected after the first trimester , and this places women at an increased risk of falling ( 2 to 3-fold higher risk ).
Cardiorespiratory adaptations to pregnancy : From the fifth week of gestation , there is a significant alteration to the cardiovascular system as blood flow must be shifted to the foetus . The heart
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