presentation title (date) presentation title presentation title (date) acog exercise guidelines...
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Presentation Title
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ACOG Exercise guidelines (2005)
Prescription for exercise?
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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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Suggestions for Antenatal Cardiovascular Training
• Inactive clientFrequency:
3 x per week between 13th-36th weeksNone before 13th week1-2 x per week after 36th week
Intensity:Talk test - conversational levelRPE 5-6
Time:5-45 minutes per session
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Suggestions for Antenatal Cardiovascular Training
• Active clientFrequency:
3-4 x per week up to 14th week3-5 x per week up to 30th week3 x per week after 30th week
Intensity:Talk test - conversational levelRPE 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 / T’ai 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