scholarly journals Maternal Cardiovascular and Birth Outcome Responses to At-Home vs. In-person Prenatal Exercise during COVID-19 Pandemic

2021 ◽  
Vol 9 (12) ◽  
Author(s):  
Breanna Wisseman ◽  
Christian Jones ◽  
Nia Golembe ◽  
Edward Newton ◽  
Christy Isler ◽  
...  

Background. The COVID-19 pandemic led to decreased physical activity, as well as increased stress, especially for pregnant women. Exercise is effective for decreasing stress and improving overall maternal and infant health. To date, research has not determined whether an at-home exercise program during pregnancy elicits similar results to in-person exercise. Objective. To examine the effect of in-person vs at-home moderate-intensity exercise training during pregnancy on maternal cardiovascular and birth outcomes during the COVID-19 pandemic. Methods. Pregnant women were recruited between 13-16 weeks’ gestation and randomized to either an exercise or control group. No control subjects were included in this analysis; exercisers were asked to complete at least 50-minutes of moderate-intensity activity 3 times each week either in-person (n=20) or at-home (n-17). Both groups were provided individualized exercise prescriptions including a 5-minute warm-up, 50-minutes of exercise related to group allocation, and a cool-down period. Maternal resting heart rate and blood pressure (BP) were recorded at 16- and 36-weeks' gestation. Gestational weight gain and birth outcomes were obtained via electronic health record at delivery. Results. From enrollment to late pregnancy, at-home exercisers have significant increases in systolic and diastolic BP (SBP and DBP, p<0.001 and 0.0003, respectively) whereas the in-person group did not (p=0.30 and 0.78, respectively). In-person exercisers had lower SBP and DBP in late pregnancy (p=0.04 and 0.01, respectively) relative to at-home exercisers. At-home exercise was correlated with higher late pregnancy SBP (r=-0.34, p=0.04), DBP (r=-0.42,p=0.01), and SBP change (r=-0.496, p=0.002). Group allocation was a predictor for late pregnancy DBP (p=0.007) and SBP change (0.036). There were no differences in infant birth outcomes. Conclusion. Supervised in-person exercise training with the proper precautions has similar birth outcomes and may be more beneficial for maternal cardiovascular health relative to at-home training.

Author(s):  
Brittany Rose Allman ◽  
Beverly J. Spray ◽  
Renny S. Lan ◽  
Aline Andres ◽  
Elisabet Børsheim

The purpose of this study was to determine the effect of exercise during pregnancy in sedentary women with obesity on longitudinal changes in long-chain acylcarnitine (LC-AC) concentrations. We hypothesized that exercise training would significantly decrease circulating LC-ACs throughout gestation compared to a non-exercise control group. Pregnant women with obesity considered otherwise healthy [n=80, mean ± SD; body mass index (BMI): 36.9±5.7 kg/m2] were randomized into an exercise (n=40, aerobic/resistance 3x/week, ~13th gestation week until birth) or a non-exercise control (n=40) group. At gestation week 12.2 ± 0.5 and 36.0 ± 0.4, a submaximal exercise test was conducted, and indirect calorimetry was used to measure relative resting energy expenditure (REE), as well as respiratory exchange ratio (RER) at rest. Fasting blood samples were collected and analyzed for LC-AC concentrations. Fitness improved with prenatal exercise training; however, exercise training did not affect circulating LC-AC. When groups were collapsed, LC-ACs decreased during gestation (combined groups, P < 0.001), whereas REE (kcal·kg-1·d-1, P = 0.008) increased. However, average REE relative to FFM (kcal·kgFFM-1·d-1) and RER did not change. There was an inverse relationship between the change in RER and all LC-ACs (except C18:2) throughout gestation (C14: r = -0.26, P = 0.04; C16: r = -0.27, P = 0.03; C18:1: r = -0.28, P = 0.02). In summary, a moderate intensity exercise intervention during pregnancy in women with obesity did not alter LC-ACs concentrations versus control, indicating that the balance between LCFA availability and oxidation neither improved nor worsened with an exercise intervention.


2020 ◽  
Vol 45 (5) ◽  
pp. 493-499 ◽  
Author(s):  
Kathryn M. Denize ◽  
Pegah Akbari ◽  
Danilo Fernandes da Silva ◽  
Francois Haman ◽  
Kristi B. Adamo

Pregnant women are recommended to engage in 150 min of moderate-intensity physical activity per week to reduce pregnancy complications. Many women struggle to remain physically active throughout pregnancy, and there is no consensus about whether women adopt a less efficient movement pattern as they progress through pregnancy and experience gestational weight gain. This study assessed the change in energy expenditure and mechanical efficiency in pregnant women (PREG; n = 10) when performing a walking treadmill task in early, mid, and late pregnancy and also compared with an age- and body mass index-matched, nonpregnant (CON; n = 10) group. On average, the PREG group gained within the Institute of Medicine’s gestational weight gain guidelines (11.6 ± 3.6 kg) and were all inactive (measured using accelerometry), except for 1 participant, by the third trimester, as per the 2019 Canadian physical activity guidelines for pregnant women. Energy expended to complete the walking task increased throughout pregnancy and was higher than the controls (111.5 ± 24.6 kcal) in mid and late pregnancy (139.0 ± 22.2 kcal, p = 0.02, and 147.3 ± 24.6 kcal, p = 0.005, respectively), but not early pregnancy (129.9 ± 18.9 kcal, p = 0.08). Walking mechanical efficiency was similar within pregnant women at each time point and compared to nonpregnant controls. Our findings add to the growing body of evidence demonstrating that pregnant women can safely perform physical activity by showing that walking mechanical efficiency is unchanged at low to moderate intensities. Novelty Energy demand during exercise increases proportionally to weight gain across pregnancy trimesters. However, mechanical efficiency remains unchanged during low- to moderate-intensity walking.


2014 ◽  
Vol 11 (7) ◽  
pp. 1324-1333 ◽  
Author(s):  
Sarah Kozey-Keadle ◽  
John Staudenmayer ◽  
Amanda Libertine ◽  
Marianna Mavilia ◽  
Kate Lyden ◽  
...  

Background:Individuals may compensate for exercise training by modifying nonexercise behavior (ie, increase sedentary time (ST) and decrease nonexercise physical activity [NEPA]).Purpose:To compare ST and NEPA during a 12-week exercise training and/or lifestyle intervention.Methods:Fifty-seven overweight/obese participants (19 M/39 F) completed the study (mean ± SD; age 43.6 ± 9.9 y, BMI 35.1 ± 4.6 kg/m2). There were no between-group differences in activity levels at baseline. Four-arm quasi-experimental intervention study 1) EX: exercise 5 days per week at a moderate intensity (40% to 65% VO2peak) 2) rST: reduce ST and increase NEPA, 3) EX-rST: combination of EX and rST and 4) CON: maintain habitual behavior.Results:For the EX group, ST did not decrease significantly (mean ((95% confidence interval) 0.48 (–2.2 to 3.1)% and there was no changes in NEPA at week-12 compared with baseline. The changes were variable, with approximately 50% of participants increasing ST and decreasing NEPA. The rST group decreased ST (–4.8 (0.8 to 7.9)% and increased NEPA. EX-rST significantly decreased ST (–5.1 (–2.2 to 7.9)% and increased time in NEPA at week-12 compared with baseline. The control group increased ST by 4.3 (0.8 to 7.9)%.Conclusions:Changes in nonexercise ST and NEPA are variable among participants in an exercise-training program, with nearly half decreasing NEPA compared with baseline. Interventions targeting multiple behaviors (ST and NEPA) may effectively reduce compensation and increase daily activity.


2018 ◽  
Vol 26 (1-2) ◽  
pp. 53-63 ◽  
Author(s):  
Byron Lai ◽  
Kristina Bond ◽  
Yumi Kim ◽  
Beth Barstow ◽  
Emil Jovanov ◽  
...  

Background People with Parkinson’s disease experience numerous barriers to exercise participation at fitness facilities. Advances in tele-monitoring technologies create alternative channels for managing and supervising exercise programmes in the home. However, the success of these programmes will depend on participants’ perceptions of using the technology and their exercise adherence. Thus, this pilot explored the uptake and implementation of two common methods of Internet-exercise training in Parkinson’s disease. Methods Twenty adults with Parkinson’s disease were randomized into either: telecoach-assisted exercise (TAE) or self-regulated exercise (SRE) groups. Both groups received the same eight-week exercise prescription (combined strength and aerobic exercise) and telehealth system that streamed and recorded vital signs and exercise data. TAE participants exercised under a telecoach’s supervision via videoconferencing. SRE participants independently managed their exercise training. Quantitative data were described and qualitative data underwent thematic analysis. Results Quantitative results demonstrated that TAE participants achieved strong attendance (99.2%), whereas SRE participants demonstrated 35.9% lower attendance, 48% less total time exercising, and 74.5% less time exercising at moderate intensity. Qualitatively, TAE participants reported overtly favourable programme experiences and that assistance from a telecoach enhanced their exercise motivation. SRE participants noted several challenges that impeded adherence. Conclusion Findings demonstrate that adults with Parkinson’s disease acknowledge benefits of exercising through a telehealth system and are open to utilizing this channel as a means of exercise. However, human-interactive support may be required to overcome unique impediments to participation. Study findings warrant validation in larger trials that can transfer the success of TAE towards more scalable methods of delivery.


1999 ◽  
Vol 7 (4) ◽  
pp. 374-383 ◽  
Author(s):  
Richard A. Boileau ◽  
Edward McAuley ◽  
Demetra Demetriou ◽  
Naveen K. Devabhaktuni ◽  
Gregory L. Dykstra ◽  
...  

A trial was conducted to examine the effect of moderate aerobic exercise training (AET) on cardiorespiratory (CR) fitness. Previously sedentary participants, age 60-75 years, were randomly assigned to either AET treatment or a control group for 6 months. The AET consisted of walking for 40 min three times/week at an intensity that elevated heart rate to 65% of maximum heart rate reserve. The control group performed a supervised stretching program for 40 min three times/week. CR fitness was assessed before and after the treatments during a grade-incremented treadmill walking test. Both absolute and relative peak V̇O2 significantly increased (p < .01) in the AET group, whereas they decreased modestly in the control group. Maximum treadmill time increased significantly (p < .01) in the AET group relative to the control group. These results indicate that CR fitness as measured by peak V̇O2 modestly improves in the elderly with a moderate-intensity, relatively long-term aerobic exercise program.


2018 ◽  
Vol 8 (1) ◽  
pp. 35-41
Author(s):  
Amila Kapetanović ◽  
Adila Horić ◽  
Dijana Avdic ◽  
Amila Jaganjac ◽  
Emina Softić

Introduction: The aim of this study was to assess effects of strength, stretching and balance home exercise program (moderate intensity, performed once a day, five times a week) on quality of life of people with knee osteoarthritis. Methods: Participants with knee osteoarthritis performed physical therapy for a period of two weeks at the Department for Physical Medicine and Rehabilitation. The study group (n=30) continued to perform exercise program at home while the control group (n=30) did not continue the exercise program. The participants in the study group performed strength, stretching and balance exercises of moderate intensity, once a day, five times a week, for a total of eight weeks. The Short Form-36 Health Questionnaire (SF-36) was used to examine the effects of exercise program. Results: There was no the difference between the average value of quality of life in all examined areas (physical functioning, role limitations due to physical problems, role limitations due to emotional problems, vitality/energy, mental health, social functioning, physical pain, perception of general health) at the beginning of the study between the study group and control group (p>0.05 in all eight areas). The difference between the average value of quality of life at the beginning and end of the study was statistically significantly higher in the study group compared to the control group (physical functioning p=0.0001; role limitations due to physical problems p=0.0001; role limitations due to emotional problems p=0.0001; vitality/energy p=0.0001; mental health p=0.0001; social functioning p=0.0001; bodily pain p=0.0001; perception of general health p=0.0001). Conclusion: Home exercise program consisting of strength, stretching and balance exercises, of moderate intensity, performed once a day, five times a week is effective in improving quality of life of people with knee osteoarthritis.


2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Urszula Sliwka ◽  
Katarzyna Przybylowicz ◽  
Neil MacLachlan ◽  
Jakub Morze ◽  
Anna Danielewicz ◽  
...  

AbstractThe role of nutritional status of pregnant women and birth outcomes is ambiguous. Recent studies show that pre-pregnancy body weight is equally important as weight gain during pregnancy. Body mass index (BMI) is the most accessible and easy to check a nutritional status index, which may help to control the gestation and predict infant health outcome. This study aimed to examine the associations between pre-pregnancy body mass index and the infant birth parameters. A presented observational study was offered to 200 pregnant women from Antenatal Clinic at Jersey General Hospital in 2017. Total number of 83 women agreed to take part in this project. Diet, lifestyle, socio-economic, and demographic data were obtained from participants. Delivery and birth data were taken from hospital records. Offspring feeding data and selected anthropometric measurements for mothers and their newborns were also collected. Differences between BMI for delivery type and way of feeding were verified with chi-square test. Differences and correlation between maternal BMI and newborn outcomes were verified with Kruskal-Wallis’ test and Spearman's rank test. Mean BMI of mothers included to the study was 22.8 ± 4.4 with mean weight 61.9 ± 11.6. Before pregnancy BMI was normal in 67% women and about 23% was overweight or obese. We do not observed differences between delivery type and way of feeding during first 48 hours, and women in BMI categories. Also no differences and correlation were observed for the Apgar score, gestational age of birth, and newborn's weight and length at birth. However, newborn weight correlated with newborn length (r = 0.433) and gestational age (r = 0.568) at birth. Concluding, the maternal pre-pregnancy BMI was not correlated with type of delivery, way of feeding and newborn outcomes. Previous studies show that high pre-pregnancy maternal BMI may be associated with adverse offspring outcomes at birth and later life. Future extended research is needed to explain these relations, with inclusion of the specific factors as maternal diet, lifestyle and ethnicity.


Author(s):  
Tanya Gujral ◽  
Jeyanthi Subburaj ◽  
Kiran Sharma

Abstract Objectives To examine the effects of moderate intensity resistance training with blood flow restriction on muscle strength and forearm girth. Methods Total of 39 students enrolled in this study were divided into three groups that is group A (control group), group B and group C. Group A performed exercise training without restrictive pressure, group B & C performed exercise training with 50 and 75 mmHg respectively. Both the outcome measures were evaluated on day 1 and day 12th with the help of digital dynamometer and measuring tape. Results Repeated measure ANOVA with Post hoc analysis was done using SPSS software version 20. The result of the study showed significant (p≤0.05) within subject improvement in muscle strength and muscle girth in all the three groups. However, significant improvement in muscle strength was found in between group analysis (p≤0.05). Conclusions The results of the study can be concluded as the partial blood flow restriction (50 mmHg) with moderate intensity resistance training resulted in greater handgrip strength than the other two groups. No difference was found in forearm girth among the three groups, however within the group difference was found.


2000 ◽  
Vol 98 (3) ◽  
pp. 259-268 ◽  
Author(s):  
Melanie J. BLAKE ◽  
Allison MARTIN ◽  
Brad N. MANKTELOW ◽  
Charles ARMSTRONG ◽  
Aidan W. HALLIGAN ◽  
...  

Normal pregnancy is associated with marked changes in cardiovascular haemodynamics, which in part may be due to changes in autonomic control mechanisms. Baroreflex sensitivity for heart rate (BRS) was calculated in the supine and standing positions using power spectral analysis of pulse interval (PI) and systolic blood pressure (SBP) in 16 normotensive pregnant women and 10 normotensive non-pregnant controls. The pregnant women were studied on three occasions during their pregnancy (early, mid- and late gestation) and once during the puerperium. Supine total SBP variability increased between early and late pregnancy by 79% [95% confidence intervals (CI) 30%, 145%; P < 0.001], and supine high-frequency PI variability decreased by 75% (CI 51%, 88%; P < 0.001). Supine BRS fell by 50% (P < 0.001), with values returning to early-pregnancy levels in the puerperium, which were similar to those recorded in the control group. Standing SBP variability and BRS values were unchanged during pregnancy and post partum. The low/high frequency ratio of PI variability, taken as a surrogate measure of sympathovagal balance, increased by 137% (CI 42%, 296%; P < 0.01) in the supine but not the standing position from early to late pregnancy. This was due to a decrease in high-frequency variability rather than to an increase in low-frequency variability, suggesting that these changes may have been due to vagal withdrawal rather than increased sympathetic activity. Normotensive pregnancy is associated with a marked decrease in supine BRS, although the exact mechanisms for these changes remain unclear. Further studies are required to define whether changes in BRS and sympathovagal tone in early pregnancy can be used to predict the onset of pregnancy-induced hypertension.


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