ANTENATAL EXERCISE.
•Goals of antenatal exercise
– Antenatal exercise is to promote and maintain physical and emotional health of lady throughout pregnancy.
– To identify and treat the medical and obstetric complications of pregnancy.
– To detect fetal abnormalities
– To inform and prepare family of parents about the pregnancy
– The main aim should be Healthy mother and healthy infant.
• Physiotherapy aims
– Antenatal education about physical and psychological changes during pregnancy
– Prepare the woman for delivery and prevent post operative complications
– psychological support
– Proper fluid and nutrition intake
– To teach leg, abdominal and pelvic floor exercises
– Advise on back care and lifting
– Regular checkups and examination
– To teach methods for controlling neuromuscular tension and prevent circulatory complication
– adequate relaxation
– Teach position required for labor
• Exercise program
A) Early bird classes
– To gain interest and motivation
– Antenatal education
– mental preparation
B) Backcare and posture
√postural awareness in lying , standing , sitting ( for e.g, standing erect, sitting erect with pillows )
√ Postural awareness during lifting, bending, and household activitie ( For e.g, While lifting objects from floor it is advisable to never stoop, feet should be apart to increae base of support and any object lifted must be held close to body )
C)Abdominal muscles exercise
– After delivery the muscles become slack and intra abdominal pressure is reduced.
– Prevent diastasis recti
– Increased ligament laxity
– Decreases Chances of spinal muscles strain after delivery
– For postural awareness
• Exercises
ANTENATAL EXERCISE ARE
√ Crook lying with pelvic lifting
√ Crook lying with back flattening
√ Crook lying with back flat and sliding legs forward and backward
√ Crook lying with tightening the abdominal muscles and lifting the head
√ Half Crook lying with hip hitching
√ Sitting with trunk Rotation side to side
√ Sitting with trunk bending from side to side
√ Crook lying with knees rolling from side to side
√ Contraction of hip extensors and maintaining forward / backward pelvic tilt
√ Prone lying with alternate leg raising and lowering
√ Prone lying and tightening of buttocks.
• Care of perineum
– Proper hygiene is maintained to prevent infection
– Frequent bathing
– Sanitary pad changing
– Area should be kept dry
– During bowel movement it should be supported by clean folded sanitary towel
• Relief of Perineal pain.
– Sitting on a cushion or pillow
– Side sitting or side lying for breast feeding
– Prone lying with pillows under knee and abdomen
– Ice massage, ice pack for 4-5 times
– PEME
– ultrasound
• Episiotomy management
* Physiotherapy management
• Aims :
√ To relieve pain
√ To promote healing
√ To improve circulation
√ To improve strength of pelvic floor muscles
√ To improve infection.
• Means of treatment
-Pelvic floor execises
√ Contraction and relaxation
– Passage of urine
– stop and pass wind
– to stop diarrhea
√ Quick contraction
√ Elevator exercises
√ Pelvic tilting / rolling
√ vaginal cones
√ Perinometer / kegel’s exercise
√ Foley’s catheter / tampon
Uses :
a)Improves strength
– Reduces pain
– Decreases edema
– Improve venous and Lymphatic return
– Remove transudates
b)Position
– Adequate positioning with proper pillow support
c) Ice Massage
– Crushed ice packed in damp gauze or damp cloth and is placed over the site of incision or at the site of edema for 5-10 min
– Ice massage can be done by the lady herself.
(d) Warm saline water
– To maintain patient hygiene.
– Reduce pain and relaxation
– To relieve burning sensation
(e) Ultrasound
– It is done in crook lying Position
– Pulsed mode is used
– intensity is 0.5-1 W/cm square
– Frequency : 3 MHz for superficial structure
– Duration :7-8 min
Uses :
– To relive pain
– remove Traumatic exudate
– Promote healing
(f) IRR
– In crook lying position
– Duration :m : 20 mins
– Distance : 50-70 cm
Uses :
– For pain relief
– improves circulation
– Improve healing process.
• late postural exercises
a) Ergonomic and postural awareness
– Adequate positioning in sitting , lying, standing , kneeling is taught
– Baby bathing
– Nappy changing
– Breast feeding.
– Appropriate use of carrying slings to avoid back problems
b) Postural home exercise
– Daily walking with her baby by sling
– Pelvic floor muscles exercise
– After diastasis recti has healed abdominal exercises can be done
– Adequate rest and relaxation in bed
c) Return to sports and exercise
– Aerobic exercise
– Jogging , cycling
– Distance walking
– Swimming.
THANK YOU
BY PHYSIOFEEDS.
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