Factors related to exercise over the course of pregnancy including women's beliefs about the safety of exercise during pregnancy.

OBJECTIVE: to explore pregnant women's exercise patterns across pregnancy, reported reasons for exercising or not exercising, beliefs about the safety of exercise during pregnancy and the association of those beliefs with the amount and intensity of exercise that women participated in. DESIGN: a prospective questionnaire-based approach was implemented over three pregnancy time points 8 weeks apart, with retrospective pre-pregnancy data obtained at the first time point. SETTING: participants were mailed questionnaires at 16-23-weeks pregnancy (T1), 24-31-weeks pregnancy (T2), and 32-38-weeks pregnancy (T3). PARTICIPANTS: a total of 158 pregnant women participated. MEASUREMENTS: at 16-23-weeks pregnancy women completed an Exercise Safety Beliefs Questionnaire in which they described their beliefs about the safety of low to medium exercise, high intensity exercise, gentle exercise, and weight bearing exercise. At T1, T2 and T3 reasons for exercising and not exercising were described, and participants maintained a 1-week exercise diary in which they recorded amount and intensity of physical activity. Physical symptoms experienced over time were also reported. FINDINGS: the amount and intensity of exercise decreased over the course of pregnancy, with main reasons for not exercising including feeling tired or unwell, being too busy, and, particularly in late pregnancy, exercise being uncomfortable. Some women also reported safety concerns. Safety concerns predicted amount and/ or intensity of exercise. KEY CONCLUSIONS: overall, most women had clear beliefs about what forms of exercise were safe or not safe during pregnancy. Women who rated gentle and low to medium exercise as unsafe reported engaging in less intense and fewer minutes of exercise. IMPLICATIONS FOR PRACTICE: information and discussion about ways to exercise safely, enjoyably, and comfortably should be offered to pregnant women by health professionals in early pregnancy, when safety beliefs may impact on women's exercise patterns across pregnancy, and throughout pregnancy since the most appropriate forms of exercise may need to be modified over time.

How well do women adapt to changes in their body size and shape across the course of pregnancy?

This study examined body image across pregnancy. Pregnant women ( N = 158) completed measures of general attractiveness, feeling fat, fitness and strength, salience of weight and shape, and ideal and current body size at pre-pregnancy (retrospective), and in early, middle and late pregnancy. Body image was found to be fairly stable across pregnancy such that women who started with greater body concerns maintained them over time. Although women were least satisfied with their stomach size at late pregnancy, women's ideal body shape increased in parallel with increases in body size. Women with the most body concerns reported more depressive symptoms, tendency towards dieting, and smoking during pregnancy suggesting they were at greater risk in terms of health and well-being during pregnancy.

Vigorous exercise and birth outcomes in a sample of recreational exercisers: a prospective study across pregnancy.

OBJECTIVE: This study examined the question of whether vigorous exercise undertaken by recreational exercisers across pregnancy, defined in two ways, were associated with reduced infant birthweight and gestational age at birth. METHODS: A prospective approach was implemented. A total of 148 pregnant women participated. Average intensity duration and frequency of vigorous exercise reported were examined and compared with two existing definitions of vigorous exercise. Participants completed questionnaires (including retrospective reports on 3 months prepregnancy) and an exercise diary at 16-23 weeks pregnancy, 24-31 weeks pregnancy and 32-38 weeks pregnancy, and at 7 to 14 days post-partum a birth outcomes questionnaire was completed. RESULTS: There were no significant differences between exercise groups for birthweight and gestational age at birth. CONCLUSIONS: There was no evidence that the intensity duration and frequency of vigorous exercise were associated with significant reductions in mean birth outcomes for the infants of women who participated in the study. Replication in a large, more diverse sample is recommended.

A prospective study of factors that lead to body dissatisfaction during pregnancy.

This study examined changes in body image and predictors of body dissatisfaction during pregnancy. It was expected that higher levels of depression, social comparison tendencies, teasing, societal pressure to be thin and public self-consciousness would predict body dissatisfaction prospectively. Healthy pregnant women (n=128) completed questionnaires on three occasions during their pregnancies reporting on a total of four time points: 3 months prior to pregnancy (retrospectively reported), in the early to mid-second trimester, the late-second/early-third trimester, and the latter part of the third trimester. For the most part women reported adapting to the changes that occurred in their body; however, women were most likely to experience higher levels of body dissatisfaction in early to mid-second trimester. Findings related to predictors of body dissatisfaction revealed that both social and psychological factors contributed to body image changes in pregnancy. Implications of the findings are discussed.

Validity of the AusTOM scales: a comparison of the AusTOMs and EuroQol-5D.

BACKGROUND: Clinicians require brief outcome measures in their busy daily practice to document global client outcomes. Based on the UK Therapy Outcome Measure, the Australian Therapy Outcome Measures were designed to capture global therapy outcomes of occupational therapy, physiotherapy and speech pathology in the Australian clinical context. The aim of this study was to investigate the construct (convergent) validity of the Australian Therapy Outcome Measures (AusTOMs) by comparing it with the EuroQuol-5D (EQ-5D). METHODS: The research was a prospective, longitudinal cohort study, with data collected over a seven month time period. The study was conducted at a total of 13 metropolitan and rural health-care sites including acute, sub-acute and community facilities. Two-hundred and five clients were asked to score themselves on the EQ-5D, and the same clients were scored by approximately 115 therapists (physiotherapists, speech pathologists and occupational therapists) using the AusTOMs at admission and discharge. Clients were consecutive admissions who agreed to participate in the study. Clients of all diagnoses, aged 18 years and over (a criteria of the EQ-5D), and able to give informed consent were scored on the measures. Spearman rank order correlation coefficients were used to analyze the relationships between scores from the two tools. The clients were scored on the AusTOMs and EQ-5D. RESULTS: There were many health care areas where correlations were expected and found between scores on the AusTOMs and the EQ-5D. CONCLUSION: In the quest to measure the effectiveness of therapy services, managers, health care founders and clinicians are urgently seeking to undertake the first step by identifying tools that can measure therapy outcome. AusTOMs is one tool that can measure global client outcomes following therapy. In this study, it was found that on the whole, the AusTOMs and the EQ-5D measure similar constructs. Hence, although the validity of a tool is never 'proven', this study offers preliminary support for the construct validity of AusTOMs.