Download - FITNESS DURING CHILD BEARING YEAR
![Page 1: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/1.jpg)
FITNESS IN CHILD BEARING YEAR
![Page 2: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/2.jpg)
CONTENTS
INTRODUCTION
AIMS OF PHYSIOTHERAPIST
FITNESS DURING ANTENATAL PERIOD- FIRST TRIMESTER- SECOND TRIMESTER- THIRD TRIMESTER
![Page 3: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/3.jpg)
FITNESS DURING LABOUR
FITNESS DURING POSTNATAL PERIOD
Recent advances
![Page 4: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/4.jpg)
INTRODUCTION
•What is child bearing year? - “ time from conception through post partum adjustments”
•Nine months of pregnancy + three months after birth of baby
•What is fitness? - physical + psycho-emotional well being
![Page 5: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/5.jpg)
•Conception
•First trimester
•Second trimester
![Page 6: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/6.jpg)
•Third trimester
• Labour
• Peurperium and post natal period
![Page 7: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/7.jpg)
AIMS OF OBSTRETRIC
PHYSIOTHERAPY
1) To promote good health, poise and sense of well being during pregnancy and encourage preventive medicine
2) To give opportunity to discuss fears and expectations
3) To provide instructions in skills to conserve energy, pain tolerance level and strains of pregnancy
![Page 8: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/8.jpg)
4) To alleviate the stress and strain
5) To rehabilitate women during puerperium and post natal life as same as pre – pregnant state
![Page 9: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/9.jpg)
Physiological changes
Biomechanical changes
Emotional changesChild bearing year
![Page 10: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/10.jpg)
Physiological changes
- Morning sickness
( nausea/ vomiting)
- Increased urinary frequency
- Mild enlargement of breast
- Increased vaginal secretions
- Fatigue
First trimester
![Page 11: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/11.jpg)
Biomechanical changes
![Page 12: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/12.jpg)
Emotional changes
- Mixed feelings
- acknowledgment
![Page 13: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/13.jpg)
• Goals :1) To educate the pregnant woman along with
her spouse by any means like ante natal classes, pictures, videos, booklets etc.
Physiotherapy management:
![Page 14: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/14.jpg)
• Education regarding :- Pregnancy physiology and psychology- Physical and psycho-emotional changes- Need for partner and family support- Screening examinations
![Page 15: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/15.jpg)
![Page 16: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/16.jpg)
- Coping with changes and minor discomforts- Small frequent meals
- Eat before rising
- Avid greasy and rich food
- Propping up the bed head
- If necessary, contact doctor
![Page 17: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/17.jpg)
- Empty bladder often
- Take frequent fluid intake
- Eat fiber reach diet
- If necessary, contact doctor
![Page 18: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/18.jpg)
- Warning signs:
![Page 19: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/19.jpg)
- Fetal development- Nutrition folic acid calcium omega – 3 fatty acid iron dietary fibers
![Page 20: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/20.jpg)
- Postural awareness
![Page 21: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/21.jpg)
![Page 22: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/22.jpg)
- Back care- Ergonomics at home and work place
![Page 23: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/23.jpg)
![Page 24: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/24.jpg)
![Page 25: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/25.jpg)
![Page 26: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/26.jpg)
- Relaxation techniques- Breath awareness
![Page 27: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/27.jpg)
• Referral for specific problems
![Page 28: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/28.jpg)
Physiological changes
- Uterus palpable above pubic bones
- Excess oil produce in skin leads to acne
- Increased perspiration
- Foetal movements felt by mother
- Increased blood volume
- Weight gain
- Supine hypotention
Second trimester
![Page 29: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/29.jpg)
Physiological changes
- Waist thickness
- Pigmentation changes
- Stretch marks
- Heart burn
- Indigestion
- Chloasma
- Varicosities
- Braxton Hicks contractions
![Page 30: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/30.jpg)
Biomechanical changes
![Page 31: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/31.jpg)
![Page 32: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/32.jpg)
Emotional changes - Stage of consolidation
![Page 33: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/33.jpg)
• Goals:1) To educate women to cope up with certain
physiological changes2) To perform brief screening assessment
before starting actual exercise programme3) To give proper exercise guidelines4) To check contraindications5) To inform regarding precautions
Physiotherapy management:
![Page 34: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/34.jpg)
6) To introduce proper exercise programme
![Page 35: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/35.jpg)
![Page 36: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/36.jpg)
- Light frequent meals
- Sleep in semi recumbent position
- Ingest proper milk
- Avoid fatty foods, coffee
![Page 37: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/37.jpg)
Constipation &
haemorrhoids
- Increased soluble fiber and fluid intake
- Increase activity level like exercise, walking
- Change iron supplements
- analgesics, ice , padding
![Page 38: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/38.jpg)
- Support hosiery
- Avoid prolonged standing
- Walk rather than stand
- Elevate feet when lying
- Rest frequently
![Page 39: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/39.jpg)
• Exercise guidelines : set by the American College of Obstetricians and Gynecologists
1) Consult with medical caregiver before commencing exercises
2) Gradually increase exercises if previously sedentary
3) Women can continue to exercise during pregnancy and can experience health benefits even from mild to moderate exercise. Regular exercise at least three times per week is recommended.
![Page 40: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/40.jpg)
4) Maximum heart rate should not exceed 140-150 beats/min or limit set in consultation with doctor.
5) Do not perform exercises that require lying on your back after the first trimester of pregnancy.
6)Prolonged periods of motionless standing should be avoided.
7) Avoid over flexing and overextending joints, quick direction changes, jumping and jarring motions. Be careful during exercises requiring balance and use outside support.
![Page 41: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/41.jpg)
8) Modify the intensity of cardio exercise according to perceived exertion or the “talk test.” Stop exercising when fatigued and do not exercise to exhaustion. ” listen to your body.”
9) Never exercise when you have a fever or if the climate is hot and humid. Wear loose, cool clothing to stay cool.
10) Drink liquids before, during and after exercise and be particularly careful to ensure an adequate diet due to increased caloric needs.
![Page 42: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/42.jpg)
11) Your fitness goals during pregnancy should not be exercising for weight loss, increase in flexibility or strength gain.
12) If a regular pattern of contractions, low back pain, pelvic pressure, or any other unusual symptom develops while exercising, stop and communicate with your health care provider.
13) Always include at least a 5-minute warm-up and a 5-minute cool down period.
14) Get up and down from floor carefully and keep legs moving when you first stand up. This prevents blood from pooling in the legs and causing dizziness.
![Page 43: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/43.jpg)
15) Pain, discomfort, or shortness of breath should be avoided. Valsalva manoeuvers should be avoided.
16) Vary your exercise program. Some excellent alternatives are walking, swimming and stationary cycling.
![Page 44: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/44.jpg)
Absolute contraindications Relative contraindicationsSevere cardiovascular, respiratory or systemic disease
History of repeated (3 or more) miscarriage or premature labor
Uncontrolled hypertension, diabetes or thyroid disease
Diabetes
Ruptured membranes or premature labor
History of rapid labor or poor fetal growth
Persistent bleeding after 1st trimester
Early pregnancy bleeding
Incompetent cervix Sedentary lifestyle with very poor fitness
Preeclampsia or toxemia Breech presentation after 28 weeks
Multiple pregnancy (triplets, etc.) Palpitations or arrhythmias
Poor fetal growth Anemia or iron deficiency
Extreme over- or underweight
![Page 45: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/45.jpg)
Potential risk to the foetus from maternal exercisesHypothermia Hypoxia Abnormal heart rateDecreased utero placental flow Increased uterine contractionsReduced maternal glucose levelDisruption of maternal endocrine haemostasisPoor growth
![Page 46: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/46.jpg)
• Warm up:
![Page 47: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/47.jpg)
![Page 48: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/48.jpg)
![Page 49: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/49.jpg)
![Page 50: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/50.jpg)
• Exercise programme : strengthning exercises
![Page 51: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/51.jpg)
Pelvic tilting ex’s
![Page 52: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/52.jpg)
![Page 53: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/53.jpg)
![Page 54: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/54.jpg)
![Page 55: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/55.jpg)
![Page 56: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/56.jpg)
![Page 57: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/57.jpg)
• Cool down:- Mild stretching- Breathing techniques- Mental imagery techniques- Relaxation- Listening calm music- Touch of spouse
![Page 58: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/58.jpg)
Benefits of exercise
• Maintain healthy body weight and avoid excess fat accumulation
• Maintain or improve cardiovascular fitness, muscular strength, endurance, and flexibility
• Decreased musculoskeletal complaints such as back pain
• Decreased minor discomforts of pregnancy• Improved posture and body mechanics, which
may improve coordination, balance, and body awareness
![Page 59: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/59.jpg)
• breath awareness and relaxation• Prevention and treatment of problems
associated with gestational diabetes, hypertension, and preeclampsia
• Stress reduction and enhanced self-image• Possible easing of labour with fewer
complications of delivery faster postnatal recovery
![Page 60: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/60.jpg)
Physiological changes
- Varicose veins
- Haemorrhoids
- Lower limb oedema
- Frequency of urination
- Breathlesness
Third trimester
![Page 61: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/61.jpg)
Physiological changes- indigestion and constipation
- “sick of being pregnant”
- “show” in the days or hours preceding labour
![Page 62: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/62.jpg)
Biomechanical changes
![Page 63: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/63.jpg)
Emotional changes- Mood swings increased
- Preparation for labour
![Page 64: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/64.jpg)
• Goals:1) To educate the woman to get relax and stress
free 2) To educate woman for dressing3) To continue exercises as much as possible of
second trimester but with mild intensity4) To educate the woman to cope up with changes5) To educate and practice for different positions
helpful in labour
Physiotherapy management:
![Page 65: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/65.jpg)
![Page 66: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/66.jpg)
Ex’s for circulation & cramp
![Page 67: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/67.jpg)
• Breathing exercise: - Explain how “ slow “ , “ low ”, “ deep “ , “ calm
“ abdominal breathing
![Page 68: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/68.jpg)
• Relaxation exercises/ techniques:- Major aim is to prevent the mother becoming
unduly tired- To help the mother in labour- To help the mother to control her thoughts
and emotions
![Page 69: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/69.jpg)
Mitchell method Jacobson relaxation
technique
Dissociation and blocking Imagery
technique
Relaxation techniques
![Page 70: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/70.jpg)
• Principles of teaching relaxation:- Enablement - Understanding - Beware - The ‘whole’- Flexibility - Practice - Motivation- Confidence - Safety
![Page 71: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/71.jpg)
• Teaching different positions for labour :
![Page 72: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/72.jpg)
![Page 73: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/73.jpg)
![Page 74: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/74.jpg)
• “ the process in which the foetus, placenta secundines are expelled from the uterus via the birth canal after minimum period of 20 weeks”
• Mainly 3 stages of labour
Labour
![Page 75: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/75.jpg)
• Stage 1 – from onset of labour untill full dilation of cervix
• Changes during this stage – pain and contractions
![Page 76: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/76.jpg)
![Page 77: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/77.jpg)
• Stage 2 – full cervical dilation to expulsion of the foetus from vagina
![Page 78: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/78.jpg)
![Page 79: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/79.jpg)
• Massage to the back:
![Page 80: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/80.jpg)
![Page 81: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/81.jpg)
![Page 82: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/82.jpg)
• Other approaches:- TENS- Acupuncture - Hypnosis - Water bath- Medications or injections
![Page 83: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/83.jpg)
Post natal period
![Page 84: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/84.jpg)
Delivery
Caesarian section
Normal / episiotomy
![Page 85: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/85.jpg)
Immediate post natal symptoms
- Episiotomy pain
- Muscles and ligament laxity causing diastasis recti
- Oedema
- Back pain
- Breast engorgment
- Psychological state
![Page 86: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/86.jpg)
• Goals :1) Relief of pain either of episiotomy or
caesarian2) Ergonomic advices for preventing further
complications3) Educate Exercise programme
Physiotherapy management :
![Page 87: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/87.jpg)
• Episiotomy pain:- Icing- Water baths- Ultra sound ( 3 MHz, 0.5 W/cm for 2 min)- Pulsed electromagnetic energy(40-50 pulse
width, 10-220 repetitions)
![Page 88: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/88.jpg)
- Advice for abdominal binder or tubigrip or supportive under wears
- Abdominal retraction exercises
- Pelvic tilting exercise
- Progression with coming up upto the hands
![Page 89: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/89.jpg)
DRAM management
![Page 90: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/90.jpg)
- Ultrasound to the periphery initially
- Warm compresses
- Crushed ice
- PEME
![Page 91: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/91.jpg)
![Page 92: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/92.jpg)
![Page 93: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/93.jpg)
![Page 94: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/94.jpg)
![Page 95: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/95.jpg)
![Page 96: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/96.jpg)
![Page 97: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/97.jpg)
![Page 98: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/98.jpg)
![Page 99: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/99.jpg)
![Page 100: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/100.jpg)
![Page 101: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/101.jpg)
1) Jennifer Hollowell et al., did study on The effectiveness of antenatal care programmes to reduce infant mortality and preterm birth in socially disadvantaged and vulnerable women in high-income countries: a systematic review
• 36 distinct eligible studies covering a wide range of interventions, including group antenatal care, clinic-based augmented care, teenage clinics, prenatal substance abuse programmes, home visiting programmes, maternal care coordination and nutritional programmes.
Recent advances
![Page 102: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/102.jpg)
• Conclusions: There was insufficient evidence of adequate quality to recommend routine implementation of any of the programmes as a means of reducing infant mortality in disadvantaged/vulnerable women.
• BMC Pregnancy and Childbirth 2011, 11:13
![Page 103: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/103.jpg)
• Ana L Vallim et al., did study on Water exercises and quality of life during pregnancy to evaluate the effects of a physical exercise program of water aerobics on the quality of life (QOL) of sedentary pregnant women
• 35 women was given routine antenatal care, while another group of 31 women, in addition to receiving the same routine care as the first group, also participated in three classes of water aerobics per week.
![Page 104: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/104.jpg)
• QOL was evaluated by applying the WHOQOL-BREF questionnaire in both groups at the 20th, 28th and 36th weeks of pregnancy.
• Conclusion : The great majority of the participants considered that the practice of water aerobics had benefitted them in some way. QOL scores were found to be high in both groups during follow-up. There was no association between the practice of water aerobics and QOL.
• Reproductive Health 2011, 8:14
![Page 105: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/105.jpg)
• Po-Chun Ko, Ching-Chung Liang et al. did study on A randomized controlled trial of antenatal pelvic floor exercises to prevent and treat urinary incontinence
• to evaluate the effect of antenatal pelvic floor muscle exercise (PFME) in the prevention and treatment of urinary incontinence during pregnancy and postpartum period
• Three hundred women were randomly assigned to the PFME group and control group.
![Page 106: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/106.jpg)
• Urogenital Distress Inventory-6 (UDI-6), Incontinence Impact Questionnaire-7 (IIQ-7), and question of self-reported urinary incontinence.
• Conclusions: PFME applied in pregnancy is effective in the treatment and prevention of urinary incontinence during pregnancy, and this effect may persist to postpartum period.
• International Urogynecology Journal January 2011, Volume 22, Issue 1, pp 17-22
![Page 107: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/107.jpg)
• J.T. van der Spank ET AL. did study on Pain relief in labour by transcutaneous electrical nerve stimulation (TENS) by burst – conventional obstetric TENS-apparatus
• On 59 women compare to epidural analgesia • Conclusion : During TENS application the pain
scores were significantly lower (p<0.0001)• Archives of Gynecology and Obstetrics
November 2000, Volume 264, Issue 3, pp 131-136
![Page 108: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/108.jpg)
• Keep the “WOMAN” fit and happy, always gives “SAFTEY” to “MUMMY AND
BABY”
Take Home Message
![Page 109: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/109.jpg)
• R Sapsford et all; WOMEN’S HEALTH – a textbook for physiotherapists, part two – child bearing year
• Jil mentle, Jeanette Haslam, Sue Barton, Physiotherapy in Obstetrics and Gynaecology, pg no 93 – 244
• Elizabeth Noble, Essential Exercises for the Childbearing Year: A Guide to Health and Comfort Before and After Your Baby Is Born
REFERENCES
![Page 110: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/110.jpg)
• Margaret Polden, Jill Mantle , Physiotherapy in Obstetrics and Gynaecology
• Exercise guidelines by The American College of Obstetricians and Gynecologists, 2001
• Ann Thomson, Alison Skinner, Joan Piercy, Tidy’s Physiotheray, twelfth edition , pg no :382-400
• Sandie Keane, Pilates for core strength• Roger L. Hammer, PhD ,Jan Perkins, MSc,Richard
Parr, EdD, FACSM, Exercise During the Childbearing Year. Journal of Perinatal Education, 9(1), 1-13; pregnancy, postpartum exercise, guidelines.
![Page 111: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/111.jpg)
• Jennifer Hollowell et al., The effectiveness of antenatal care programmes to reduce infant mortality and preterm birth in socially disadvantaged and vulnerable women in high-income countries: a systematic review, BMC Pregnancy and Childbirth 2011, 11:13
• Ana L Vallim et al., Water exercises and quality of life during pregnancy Reproductive Health 2011, 8:14
• Po-Chun Ko, Ching-Chung Liang et al. A randomized controlled trial of antenatal pelvic floor exercises to prevent and treat urinary incontinence. International Urogynecology Journal January 2011, Volume 22, Issue 1, pp 17-22
![Page 112: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/112.jpg)
• J.T. van der Spank ET AL. Pain relief in labour by transcutaneous electrical nerve stimulation (TENS) Archives of Gynecology and Obstetrics November 2000, Volume 264, Issue 3, pp 131-136
![Page 113: FITNESS DURING CHILD BEARING YEAR](https://reader037.vdocuments.site/reader037/viewer/2022102901/554aff40b4c905c12d8b4bf6/html5/thumbnails/113.jpg)
Thank You…