Regular moderate-intensity exercise performed over the second-third trimesters of pregnancy can be used to attenuate important GDM-related adverse outcomes.
In this study, the authors assessed the effects of a structured, moderate-intensity exercise program during the entire length of pregnancy on a woman's method of delivery.
Methods:A randomized controlled trial was conducted with 290 healthy pregnant Caucasian (Spanish) women with a singleton gestation who were randomly assigned to either an exercise (n=138) or a control (n=152) group. Pregnancy outcomes, including the type of delivery, were measured at the end of the pregnancy.Results:The percentage of cesarean and instrumental deliveries in the exercise group were lower than in the control group (15.9%, n=22; 11.6%, n=16 vs. 23%, n=35; 19.1%, n=29, respectively; p=0.03). The overall health status of the newborn as well as other pregnancy outcomes were unaffected.
Conclusions:Based on these results, a supervised program of moderate-intensity exercise performed throughout pregnancy was associated with a reduction in the rate of cesarean sections and can be recommended for healthy women in pregnancy.
Aims: To investigate the effect of pelvic floor muscle training (PFMT) taught in a general exercise class during pregnancy on the prevention of urinary incontinence (UI) in nulliparous continent pregnant women. Methods: This was a unicenter two armed randomized controlled trial. One hundred sixty-nine women were randomized by a central computer system to an exercise group (EG) (exercise class including PFMT) (n ¼ 73) or a control group (CG) (n ¼ 96). 10.1% loss to follow-up: 10 from EG and 7 from CG. The intervention consisted of 70-75 sessions (22 weeks, three times per week, 55-60 min/session including 10 min of PFMT). The CG received usual care (which included follow up by midwifes including information about PFMT). Questions on prevalence and degree of UI were posed before (week 10-14) and after intervention (week 36-39) using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Results: At the end of the intervention, there was a statistically significant difference in favor of the EG. Reported frequency of UI [Never: CG: 54/60.7%, EG: 60/95.2% (P < 0.001)]. Amount of leakage [None: CG: 45/60.7%, EG: 60/95.2% (P < 0.001)]. There was also a statistically significant difference in ICIQ-UI SF Score between groups after the intervention period [CG: 2.7 (SD 4.1), EG: 0.2 (SD 1.2) (P < 0.001)]. The estimated effect size was 0.8. Conclusion: PFMT taught in a general exercise class three times per week for at least 22 weeks, without former assessment of ability to perform a correct contraction was effective in primary prevention of UI in primiparous pregnant women. Neurourol. Urodynam. ß 2013 Wiley Periodicals, Inc.Key words: gestation; nulliparous; physical exercise; physical therapy; prevention
INTRODUCTIONUrinary incontinence (UI) is a well recognized health problem that significantly reduces the quality of life and affects women of all ages.1-3 Pregnancy and childbirth are considered to be important risk factors in the development and the worsening of UI. 1,4 Pelvic floor muscle training (PFMT) is an effective technique in the prevention and treatment of UI in the general population 4 and its effectiveness has also been found during pregnancy.1 Moreover, based on different studies, it has been found to be as effective as other treatments 5,6 and according to a review by Cochrane, it should be included in the first line of conservative management and of primary prevention of UI.
7In most studies, PMFT is conducted by physiotherapists and its efficacy when taught by other professionals such as fitness instructors has not been found. 8 To quote Bø and Haakstad 8 it would be less time-consuming, more cost-effective and possibly more motivating if PFMT could be taught in a group setting by fitness instructors. However the professional who should design and lead the session must meet different requirements. A Physical Activity and Sport Sciences graduate has both the theoretical and practical knowledge to design exercise programs taking into account the training p...
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