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Harsh jainnnAntenatal physiotherapy.pptx
- 1. Antenatal physiotherapy - By GarimaShah - - 1st Year MPT
- 2. Aims of antenatalcare Explain about importance of antenatal care and exercise for health and pregnancy. To promote and maintain optimal physical and maternal heath throughout pregnancy. To enhance relaxation. To promote muscle tone, strength, and endurance. To prepare for postnatal program.
- 3. Benefits of antenatalcare Improves stamina and endurance Strengthen the muscles. It improves posture, balance and coordination. Improves muscle tone, enhances relaxation. Reduces fatigue, stress and anxiety. Prevents excessive weight gain. Reduces risk of DVT, prevent back pain, diastasis recti and incontinence. Assists in post natal recovery.
- 4. Guidelines/ what careshould be taken of while exercises. Physical examination prior to exercise. Low resistance and more repetitve exercise prescription. Avoid prolong standing , jerky movements, bouncing/ ballistic movements. Avoid over stretching , taking joints beyond the normal physiological range. Avoid single leg weight bearing, breath holding . Fluid intake- before, after and during exercise.
- 5. Precautions Vaginal bleeding Persistant pain in chest, pelvic girdle/ low back Leakage of amniotic fluid Regular painful contractions which persists during exercise. Decreased fetal movements Persistant shortness of breath Tachycardia, headache, dizziness, swelling/pain in calf. Difficulty in walking / maintaining balance
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- 7. Antenatal classes Needfor antenatal classes are: Couples should be helped to check and increase their knowledge of the physiological changes of pregnancy, labour and the puerperium. They should be shown ways that may be useful for coping with the physical changes of pregnancy and their associated discomforts. They should be guided towards a realistic understanding of labour and the assembly of a ‘tool kit’ of coping skills.
- 8. Couples shouldbe encouraged to consider the profound change in lifestyle that parenthood brings, and the emotional maturity necessary to manage successfully their additional responsibilities. They should be encouraged to talk and air any fears, ask questions, and be helped to obtain satisfactory answers in an open environment.
- 9. Exercise prescription Foraerobic exercise: Frequency: >= 3-5 days/week Time : = 30 min /day Moderate: 150 min /week High: 75 min /week Intensity: Moderate : (3-6 METS) High : >= 6 METS Max HR 60-70% of sedentary Max HR 60-70% for fitness maintain Type: WB and NWB exercises. Swimming Group exercises
- 10. For Resistiveexercises For Flexibility exercises Frequency Time Intensity Type Frequency Time Intensity Type
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- 12. Stretching Upper neckextensors and scalene Scapular protractors, shoulder internal rotators, and levator scapulae Low back extensors Hip flexors, adductors, hamstring Ankle plantar flexors
- 13. Aerobic Activity Walking Stationery cycle Jogging Low impact dancing Swimming Low impact aerobic classes
- 14. Postural exercises/ strengthening exercises Exercise for diastasis recti. Pelvic tilting / pelvic floor exercises. Strengthening of Upper and lower extremeties.
- 15. •For diastasis recti: Head lift- Headlift with pelvic tilt
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- 17. •Upper and lowerextremity strengthening Standing pushups Supine bridging Quadruped hip extension Modified squatting Scapular retraction
- 18. Exercise for thePelvic Floor Begin with empty bladder. Give gravity assisted positioning. Exercises given for pelvic floor are: Contract relax – Kegel’s Exs Quick contractions Elevator exercise. Pelvic floor relaxation. Hip rotation
- 19. Relaxation and breathing exercises Developing the ability to relax requires awareness of stress and muscle tension. Techniques of relaxation allow individual to manage and response to stress and make alert to task by relaxing tensed muscle.
- 21. Visual imagery- -useinstrumental music and verbal guidance. - ask women to concentrate on relaxing image such as beach, mountains or favorite vacation spot. - suggest that she focuses on same image throughout pregnancy so that the image can be called up to the consious level when need up to relax during the labour.
- 22. Muscle setting: Jacobson’s technique Mitchell method of relaxation Have woman lie in comfortable position. Instruct her to gently contract and relax first the muscles of feet then legs, thighs, pelvic floor and then buttocks. Add deep slow and relaxed breathing to the routine. Progress by emphasizing awareness of muscles contracting in one part of body while remain relax in other parts.
- 23. Breathing exercise- Slow and deep breathing with relaxed upper thorax. Teach to relax abdomen while inspiration and contract while exhalation. To prevent hyperventilation, emphasize slow rate of breathing.
- 24. Touch andMassage- Therapists naturally appreciate physiological potential of massage in inducing relaxation and relieving pain. Smooth touch can communicate sense of caring and sharing. Soothing stroking, efflurage or kneading can be given for the good effects.
- 25. Body mechanics andposture training Lying supine- place a towel roll under waist and pillow under knees. Sidelying- place pillow behind the top thigh and between the knees to prevent pelvic rotations.
- 26. Sitting- sitwith hip and knee at right angle, back supported( pillow behind the back) and low stool under the foot as footrest. Standing/ walking- walking is more preferable than standing. Try to distribute weight equally while standing. Avoid stooping. Avoid forward bending and repetitive trunk rotation.
- 29. Exercises For crampand for circulation Explanation should be given how pregnancy can affect leg circulation . Women who travel long distances and have sedentary jobs should especially be encouraged to carry out frequent foot ankle exercises.
- 31. References 1- Therapeutic exercisefoundation and techniques- Carolyn kisner- 7th edition 2- Physiotherapy in obstetrics and gynecology- Margaret polden and jill mantle