ACOG Exercise guidelines (2005)

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• ACOG Exercise guidelines (2005)
• Prescription for exercise?

Presentation Title
Presentation title (Date)
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Lesson objectives

• Explain the ACOG Guidelines concerning exercising
  during pregnancy
• Determine how much exercise is enough during the
  ante natal period
• Detail how the F.I.T.T. Principles would alter
  antenatally
• List the types of activities and exercises
  suitable for the pregnant population

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ACOG (2005) Recommendations

• Regular, mild-moderate activity at least 3x per
  week
• Avoid supine position after 1st trimester avoid
  long periods of motionless standing
• Stop at fatigue not exhaustion, less oxygen
  available for aerobic exercise. Modify in line
  with maternal symptoms
• Avoid activity where there is risk of abdominal
  trauma
• Ensure adequate diet and carbohydrate
• Beware heat dissipation - hydration, clothing,
  environment

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ACOG (2005) Guidelines on Exercise During
Pregnancy

• Regular Exercisers
• Can continue training without major modifications
• Modifications to F.I.T.T principles in line with
  levels of comfort maternal symptoms

• Non-exercisers
• Advised to seek medical approval
• Begin with low intensity low impact activities

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Summary

• Guidelines contain useful information for you and
  your participants to ensure that there workouts
  are safe and effective
• They should encourage the individual to take
  personal responsibility for their own workout
• They are ideal to deliver in an information
  leaflet
• Working within these guidelines should reduce the
  risk of your participants becoming injured during
  your sessions and from you being involved in
  legal action

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• Exercise prescription for
• ante natal clients

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Suggestions for Antenatal Cardiovascular Training

• Inactive client
• Frequency
• 3 x per week between 13th-36th weeks
• None before 13th week
• 1-2 x per week after 36th week
• Intensity
• Talk test - conversational level
• RPE 5-6
• Time
• 5-45 minutes per session

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Suggestions for Antenatal Cardiovascular Training

• Active client
• Frequency
• 3-4 x per week up to 14th week
• 3-5 x per week up to 30th week
• 3 x per week after 30th week
• Intensity
• Talk test - conversational level
• RPE 6-7
• Time
• 5-45 minutes per session

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Guidelines for Antenatal Resistance Training

• Appropriate resistance training poses little risk
  to
• Regular breathing should be encouraged to prevent
  valsalva maneuver
• Heavy resistance training should be avoided
• Sets of 12-20 repetitions without undue fatigue
  are appropriate
• Progression should increase reps before weights
• Machines provide more stability than free weights
• If specific exercise causes pain or discomfort
  they should be discontinued

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Antenatal Progression Resistance Training

• As pregnancy progresses
• Decrease weight
• Decrease sets
• Increase recovery between sets
• Increase recovery between sessions
• Avoid maximal lifts
• Beware of overhead lifts (lordosis, blood
  pressure)

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The Valsalva Maneuver

• Definition
• Excessively holding ones breath with a closed
  glottis during performance of a resistance
  training exercise.
• If valsalva maneuver performed both systolic and
  diastolic blood pressure elevates significantly

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Ante natal Gym Programme Adaptations

• Suitability of cardiovascular machines
• resistance machines
• Resistance vs free weight options
• Progression?
• Reps sets
• Specificity
• Fitness maintenance
• Adequate recovery

• Built-in overload (jogging 9 months) reverse
  progression
• Daily re-assessment
• Listen to body individual
• Alternatives / adaptations
• ROM movement speed
• Joint laxity / Postural re-alignment / muscle
• imbalances
• Clothing / support / footwear
• Hydration / nutrition

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Ante Class Adaptations

• Your attire motivation techniques
• Class focus (component or postural)
• Music speed
• Changes in direction (frequency, speed cueing)
• Warm-up duration?
• Aerobic duration content
• Impact issues (low impact offered)
• MSE content (specificity, flow, positioning)
• Length, type position of stretches
• Relaxation (need, position, time)
• Breaks / water (enforced)
• Breathing (cued)
• Time for questions social

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Alternative Activities?

• Step
• Aqua
• Pilates
• Yoga / Tai Chi
• Boxercise / kick boxing
• Walking
• Jogging
• Rollerblading
• Ski-ing / snowboarding
• Horse riding
• Swimming

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Activity

• Plan an exercise programme for Grace who is 34
  weeks pregnant to include
• CV element
• Balanced resistance exercises
• Core exercises
• Stretching
• Any other advice to plan a safe and effective
  programme

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Summary

• All exercise prescription should take into
  account the previous activities and fitness
  levels of the participant
• Thorough screening and information gathering
  (taking notes) is essential to ensure programmes
  are safe, effective and individualised
• Very few activities are contra-indicated, many
  are controversial and dependent on skill, size
  and the feelings of the individual on the day of
  training
• The controversy of many gym machines and
  exercises will vary throughout the different
  stages of the pregnancy