include dynamic exertion using major muscle
groups, such as brisk walking, swimming, aqua
aerobics, cycling and rowing (Artal et al. 2003).
The recommended dose of exercise for a
woman during pregnancy is three to five times
per week for at least 30 minutes at moderate
intensity (betterhealth.vic.gov.au). Moderate
exercise is defined as exercise or any activity
that is equivalent in difficulty to brisk walking.
Strengthen for prevention
Strength is key to injury prevention during
pregnancy. By assisting your client to
strengthen her core and global muscle
systems she will benefit from enhanced
support of the lumbar spine and pelvis.
Core strength
Due to the laxity of the ligaments and the
reduction in muscle tone during pregnancy,
exercises that activate the pelvic floor and
the core without increasing intra–abdominal
pressure are very beneficial. Pelvic floor muscle
training during pregnancy has been found to
improve muscular control, reduce lower back
pain and prevent urinary incontinence during
pregnancy and after childbirth. Pelaez et al.
(2013) found that women who performed a
structured pelvic floor program three times
per week experienced reduced leakage during
pregnancy compared to a control group.
Pilates is a great form of exercise for
pregnant clients because it is low impact,
emphasises posture and body alignment and
can reduce the risk or severity of incontinence
through facilitating pelvic floor muscles.
Global muscle strengthening
Once the core is functioning optimally, the
next goal should be to strengthen the global
muscle systems to provide support to the
lumbar spine and pelvis during this vulnerable
time. This can be done with exercises which
integrate the muscle sling systems, which
are groups of muscles that work together to
provide stability across the pelvis.
The anterior oblique muscle system (AOS)
spans across the front of the pelvis and is
an important stabiliser of the lumbar spine
and pubic symphysis. The AOS incorporates
the adductor muscle and the contralateral
oblique muscles. Exercises that work the
anterior oblique system include:
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