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The role of physiotherapy in pregnancy

DR MD SAIFUL ISLAM
Regular exercise during pregnancy can prepare your body for the rigors of labour and help you to reach your pre-pregnancy weight goal sooner. Caring for a newborn is exhausting and physically demanding, so it is in your best interests to be fit and capable.
Importance of exercise during pregnancy
Benefits of regular exercise throughout pregnancy include: l Resistance to fatigue.
l Stronger back muscles, which can help manage back pain and strain as belly grows.
l Improved posture.
l Smaller gain of body fat.
l Stress relief.
l Preparation for the physical demands of labour.
l Faster recuperation after labour. l Faster return to pre-pregnancy fitness and healthy weight.
l Increased ability to cope with physical demands of motherhood.
Physiological and physical changes during pregnancy
Pregnancy affects the way your body copes or responds to exercise, including --
l Hormones such as relaxin soften ligaments, which could increase your risk of joint injuries (for example, sprains).
l Your growing belly will push your centre of gravity forwards, affecting your balance.
l The average weight gain during pregnancy is 10 to 15kg, and this extra weight puts greater strain on your joints and muscles.
l Metabolism decrease in first trimester and increase in second and third trimester (one of the three 3-month periods of a pregnancy).
l Increase respiratory rate.
Cautions for exercise
It should be guided by a doctor or physiotherapist, but general cautions include --
l Avoid raising your body temperature too high - for example, don't soak in hot spas or exercise to the
point of heavy sweating.
l Reduce your level of exercise on hot or humid days.
l If weight training, choose low weights and medium to high repetitions -- avoid lifting heavy weights altogether.
l Don't exercise if you are ill or feverish.
If you don't feel like exercising on a particular day -- then don't do it. It is important to listen to your body to avoid unnecessarily depleting your energy reserves.
Exercises that should be avoided
Exercises to avoid during pregnancy include --
l Outdoor cycling, roller lading or
vigorous stretching.
l Contact sports, activities that carry a risk of falling.
l Competition sports, depending on the stage of pregnancy, the level of competition and your level of fitness.
l After about the fourth month, exercises that involve lying on your back - the weight of your baby can compress your main artery. This will lower your blood pressure and make you feel dizzy and light-headed.
l In the later stages of pregnancy, activities that involve jolting or jarring the body, such as running and jumping, or that demand rapid changes of direction.
l Your growing baby needs oxygen, so never exercise to the point of breathlessness.
l The level of exertion will depend on your level of fitness but even fit athletes should only exercise at moderate levels of intensity.
General exercise
This should be guided by your physiotherapist --
l Aim for four exercise sessions per week.
l Don't try to exercise too far beyond your current fitness level.
l Warm up thoroughly for at least 10 minutes.
l Exercise on soft surfaces, such as grass or carpet.
l Maintain a moderate intensity - a general rule of thumb is to keep your heart rate below 140 beats per minute.
l If exercising in water, keep your heart rate below 125 beats per minute.
l Do no more than 20 minutes of vigorous activity per exercise session, and keep an eye on your heart rate.
l Rest frequently, especially if you are feeling breathless.
l Don't hold your breath -- as a rule, breathe out through the movements that need the most effort.
l Change positions carefully and slowly.
l Drink plenty of water before, during and after exercise.
l Cool down thoroughly for at least 10 minutes.
l Include stretching in your exercise program - aim for slow, sustained stretches and avoid 'bouncing'.
l Monitor your body temperature -if you are feeling too hot slow down your activity and take in some water.
l Wear multiple layers of clothing that you can remove, rather than one bulky layer. Choose natural fibres such as cotton.
l Wear a supportive bra.
l Have at least two rest days every week.
The writer is a physiotherapist at Gono Bishwabidyalay, Dhaka.