• It is strongly recommended for all women to participate in mild to moderate exercise, for both strength and cardiopulmonary benefits, 15 to 30 minutes/session, most days of the week. Individualized programs, based on prepregnancy fitness level, are preferable.

• Currently, there are no data in humans suggesting that pregnant women need to decrease their intensity of exercise or lower their target heart rates, but because of decreased oxygen supply, they should modify exercise intensity according to their tolerance. Conventional (age-based) target heart rate zones may be too aggressive for the average pregnant patient. Use of the Borg scale of perceived exertion is more appropriate in this population, with exertion between 12 and 14 suggested during pregnancy. When fatigued, a woman should stop exercising and never exercise to exhaustion.

• Activities to avoid include contact sports, anything with a high risk of abdominal trauma or falling, high-altitude activities (greater than 6000 ft), and scuba diving. The fetus is at increased risk of decompression sickness during scuba diving.

• Nonweight-bearing aerobic exercises such as stationary cycling, swimming, or water aerobics will minimize the risk of injury throughout pregnancy and the postpartum period.
• If the woman cannot safely maintain balance because of the shifting and increasing weight, have her modify exercises that could result in falling and injury to herself or the fetus.

• Adequate caloric intake for nutrition, adequate fluid intake, and appropriate clothing for heat dissipation are critical.

• Resumption of prepregnancy exercise routines during the postpartum period should be gradual. Initiation of pelvic floor exercises immediately postpartum may reduce symptoms and duration of incontinence.

• Physiologic and morphologic changes of pregnancy continue for a minimum of 4 to 6 weeks postpartum. Encourage continued joint protection if the woman is nursing. Breastfeeding women can be reassured that moderate exercise does not impair quantity of breast milk or infant growth. There may be a short-term increase in lactic acid secreted in breast milk after exercise; if the baby appears to eat less after an exercise session, this can easily be remedied by nursing before exercise.

Borg Rating Scale for Perceived Exertion
6-Very, very light
7
8
9-Very light
10
11-Fairly light
12
13-Moderately hard
14
15-Hard
16
17-Very hard
18
19-Very, very hard
20-Exhaustion

Buy the Book that holds this excerpt: Therapeutic Exercise: Foundations and Techniques (Therapeutic Exercise: Foundations & Techniques)

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