Diastasis Recti - How to Overcome the After-Baby Body at Any Age
What is a Diastasis and how do you fix/prevent it? What do you do if you have a diastasis?
During pregnancy, exercise can help you stay fit and prepare for childbirth. From WTE we show a set of guidelines to perform any training most appropriate way.
Diastasis Recti - How to Overcome the After-Baby Body at Any Age
What is a Diastasis and how do you fix/prevent it? What do you do if you have a diastasis?
During pregnancy, exercise can help you stay fit and prepare for childbirth. From WTE we show a set of guidelines to perform any training most appropriate way.
Since then there has been a dramatic change in how doctors and scientists perceive exercise during pregnancy.
Exercise is now thought to be great for the mother and the unborn child.
Since then there has been a dramatic change in how doctors and scientists perceive exercise during pregnancy.
Exercise is now thought to be great for the mother and the unborn child.
PPT that made a short and crisp description on physiotherapy role in women's health at a glimpse.
Physical therapist plays a over all role in all stages of a women.Physiotherapist or a pelvicfloor physicall therapist plays a all arounder in childbirth educator, as a labour doula, as lactation expert , as a postpartum doula, as a pelvicrehab practitioner etc.. So all you need to understand is a WOMEN'S HEALTH/ PELVICFLOOR PT is a person who benifits women at all the stages.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
1. Role of Physiotherapy in
Antenatal and Post-natal
care
Dr. Venus
Pagare (PT)
MPT, KMC
Mangalore SEHA
Emirates Hospital
Abu Dhabi, UAE
2. CONTENTS
Introductio n
Maternal Physiology
Antenatal care:
Objectives Members
Role of physiotherapy Women with
special needs
Post-natal care:
Role of physiotherapy
Physiotherapy and post-natal problems
References
3. INTRODUCTION
Pregnancy is one of the most important period in the
life of a woman, a family and a society. Therefore,
great attention is given to antenatal care by the
health care systems of most countries.
9. •
POSTURAL
CHANGE
S
* Increase of lumbosacral angle
* Increase of lumbar lordosis and
thoracic kyphosis
* Bending forward over the
enlarging uterus
Counter-
balanced by:
COG shifts
anteriorly
Protraction of
the
shoulders
&
Hyperextensio
Increase in
the abdominal
size
11. INCORRECT UPRIGHT
POSTURE
CORRECT UPRIGHT
POSTURE
Chln pushing fo rward.
Eyes focus down
s ou LDERS AND
CHEST
Slouching constricts
the ribcage, makes
dreathJng rr1ore
difficult and causes
Indigestion
URL, BUTT & IJTE RUC
Slackmuscles oltow out the
back and tilts pelvis lanyard
causlng dactache.strained
abdamin als, and +xcess
eress ›re onthebladder.
KNFFN
If pressed back you strainjolnts
and push p•?IUis forward
FEED
Weight on inner
borders strains
arches and valves
causing legaches.
HFAD
Llft throughthe cronn of the
head and ka9]D Ehin
liftedand earsin flne vvlth
neck.
SfJOULD ERS A ND CFIE57
Draw shoulders baCk and rJown
whIe you lift the lib cage up.
CoMract addominals to
suport baby, turk butt
under and tilt pubic bone
slightly forward to center
pelvic bow|.
KNEES
Bend knees toease dody
weighI over feet.
FEE7
Dist butebA yt A ght oe rcsntn
ofeach foot
I°
13. It is care of the woman during pregnancy
• Primary aim is to achieve at the end of the
pregnancy, a healthy mother and a healthy
baby
• Starts immediately from the time of conception
ANTENATAL
14. HISTORY OF ANTENATAL
Prenatal care started in Edinburgh at the turn of
the 20th century
• During the 1920s a few midwifery departments of
hospitals and interested general practitioners saw
women at intervals to check their urine for protein
and some palpated abdomen.
• Most pregnant women had only a medical or
midwifery consultation once before labour
• Doctors were concerned with antenatal care only
“if any of the complications of pregnancy should
be noticed”
15. During the late 1920s a wider recognition emerged
of the maternal problems of pregnancy as well as
those of labour
• The medical profession and the then Ministry of
Health woke up to realise that events of labour had
their precursors in pregnancy
16. Janet Campbell, one of the most farsighted and
clear thinking women in medicine, started a
national system of antenatal clinics with a uniform
pattern of visits and procedures
Dame Janet Campbell
17. Based on her work in India in the 1930s,
Vaughan instituted antenatal exercise
classes in England. She wrote that “flexible
hips and spine are conducive to ease of
labor,” and women were encouraged to
squat
• During the mid-1950s, “keep fit” exercises
introduced by obstetric physiotherapist Helen
Heardman in Britain were included with
relaxation and breathing skills in Grantly
Dick- Read's book on pain management for
labor.
18. Screening for foetal abnormalities
Early identification of complications and their
treatment
Promote muscle tone, strength and
endurance
Enhance relaxation
Prepare for post-natal program
Providing education on nutrition, personal
hygiene, birthing process
Objectives
21. ROLE OF PHYSIOTHERAPY IN
ANTENATAL CARE
Prevention/Treatment of musculoskeletal problems
Promoting healthy lifestyles
Postural and Ergonomic advice Preparing for
labour
Teaching relaxation techniques
Optimal physical fitness
24. 2. Sacroiliac joint dysfunction
Support belt
Various self-help maneuvers can be
taught to relieve sacroiliac joint pain
25. 3. Symphysis pubis dysfunction
Diastesis Pubis
Rest and reduction of non essential chores
Keeping the leg adducted
Avoiding single-leg stance.
Avoid long strides when walking, walking on
uneven surfaces and excessive use of
steps
Gentle isometrics of hip adductors
Pelvic support belts
Ice pack
26. 4. Coccydynia
A cushion can be placed while sitting
Gentle mobilisations
Ice packs/heat, US and TENS
27. 5. Pelvic floor dysfunction
Stress incontinence
Increased risk of pelvic organ prolapse
Kegel’s exercise
Kegel balls or weights, vaginal cones,
electronic kegel exerciser
Electrical stimulation
Electromyography can be used to train
control
Interferential therapy
Bladder retraining programs
28. 6. Nerve compression syndromes
a. Carpal tunnel syndrome
Ice packs
Resting with the hands in
elevation
Ultrasound
Splinting limiting wrist flexion
b. Posterior tibial nerve compression
c. Meralgia paraesthetica
29. 7. Varicose veins
Avoid standing or sitting for long periods,
with the legs dependent
Frequent and vigorous ankle dorsiflexion
and plantar flexion may be performed
Brisk walking
Elevate feet when sitting or lying.
Elastic stockings may be worn
30. 8. Sciatica
Reducing the activity levels; within pain-free
range.
Advice on positioning, back care and
posture correction.
9. Muscle cramps
Calf stretches
Massage – deep kneading,
Vigorous foot exercises
A pre-bedtime brisk walk, vigorous foot
exercises, and a warm bath may be
32. 10. Chondromalacia patellae
Ice packs 2-3 times per day,
Strengthening of quadriceps
11. Restless Leg Syndrome
Bed rest
A period of reduced activity, e.g. giving up
work may give some relief
12. Uterine ligament pain
Warmth or cold, massaging or stroking,
over the site of the pain
33. Prenatal advice and education regarding :
Diet
• Personal hygiene
• Use of drug
• Alcohol and Smoking
• Air travel- can fly safely up to 36 weeks
ACOG Committee Opinion 2001 #264
Promoting healthy lifestyle
34. Seat belt
Above and below the bump, not over it
Three-point seat belts should be worn
throughout
(Why mothers die: a report on confidential
enquiries into maternal deaths in the UK 1997-1999)
35. 1. Lying:
2. Rolling:
Effective, safe and efficient (ESE)
roll
Posture and Ergonomic
advice
46. 6. Optimal physical fitness by
exercising
Exercise is safe for both mother and
fetus during pregnancy.
47. Benefits of exercise in pregnancy
Reduces common complaints of pregnancy
such as fatigue, varicosities and swelling of
extremities
• Reduces insomnia, stress, anxiety and
depression.
• Weight-bearing exercises reduce the
length of labour and prepares the woman
for physical demands of labour
• Improves core stability and pelvic floor
49. Improves glycaemic control
• Protective effect on coronary heart disease,
osteoporosis and hypertension
• Improves posture, strengthens muscles, and
maintains muscle length and flexibility
• Decreased birth weight and less maternal weight
gain
• Improves the feeling of wellbeing
• Helps in achieving the pre-pregnancy fitness levels
52. Chronic hypertension
Extreme morbid obesity
Poorly controlled seizure disorder
Mild to moderate cardiac
disease Severe anaemia
Twin pregnancy after 28th week
Exercise induced asthma
Relative
53. Signs to terminate Physiotherapy
1.
Excessive
shortness
of breath
2.
Chest
pain or
palpitations
3. Painful
uterine
contraction
4.
Presynco
p e or
dizziness
5. Vaginal
bleeding
6.
Excessi
ve
7.
Abdomin
al pain
8. Reduced
fetal
movement
9.
Leakage
of
amniotic
55. Assessment of fitness status and individual
goals
Type of
exercise
Intensity
exercises
Aerobic exercises
eg: walking,
swimming
Resistive and
flexibility
Exercise Prescription in
56. Maximal heart
rate of 60–70%
for women who
were sedentary 60–90%
for women wishing to maintain
fitness during pregnancy.
Borg scale of
perceived exertion.
58. Duratio
n
Frequency
Minimum of 3
times a week
Starting from
15 mins and
progressing
to 30 mins
Proper warm
up and cool
down periods
of 5 – 10 mins
each
Progressing to 4-5
times a week
59. Physical examination is a must
Jerky, bouncing, ballistic
movements/activities should be avoided
Warm up should precede ex. session
followed by a cool down or gradual
decline in activity
Maternal HR should not exceed 140
bpm
Do not overextend, overstretch joint or
rapidly change directions
General Guidelines for Exercise in
60. Avoid valsalva maneuver and avoid contact
sports
No prone position after 1st trimester
Avoid exercises in supine after 4th month
“No pain, no gain” does not apply
Fluid must be taken before, during, & after
exercise to avoid dehydration
61. Empty bladder before exercise and avoid GI
discomfort by eating atleast 1 hr prior to
exercise
Strenous exercise must be avoided in hot,
humid weather or when pregnant woman
is pyrexial
Horseback riding, gymnastics and cycling
during pregnancy are not allowed
62. Exercises according to the trimesters
Pregnancy is often divided into ‘trimesters’ each
equating to approximately three months. The
exercises permitted in each trimester differ.
Exercises in the 1st Trimester.docx
Exercises in the 2nd Trimester.docx
Exercises in the 3rd Trimester.docx
63. 1. Gestational diabetes
Walking, stationary bicycling, low-impact aerobics,
and swimming
• 5- to 10-minutes of warm-up and cool down period
involving some flexibility exercises
• Precautions including monitoring blood glucose,
scheduling rest periods and carefully tracking fetal
activity and uterine contractions.
Women with special
64. 2. Pregnancy-induced hypertension (PIH)
/pre- eclampsia and eclampsia
Bed rest is advised
Left side lying position so that there is no
compromise of the venous return
65. 3. Competitive
athletes
The major concerns are:
The effects of pregnancy on competitive ability;
The effects of strenuous training on pregnancy
• Constant supervision by an obstetric care
provider
• Additional evaluation to assess fetal growth and
wellbeing
66. 4. Women in the
workplace Special consideration should be given
Ergonomic analysis so as to reduce work-related
stress, injuries, disease or discomfort.
Control of the risk factors by making
modifications in the task or the working
technique.
Ergonomic advice and postural correction
67. POST-NATAL CARE
Post-natal period is the period following
delivery, during which the new mother’s body
begins to recover and returns to normal.
68. Role Of Physiotherapy In Post-natal
The main aims of physiotherapy during this period
are:
Introducing an exercise and relaxation
program, thereby assisting the new mother’s in
physical recovery
Restoration of the muscle strength and tone
Treatment of musculoskeletal problems
Teaching correct ergonomics for breast-
feeding, handling the baby and house-hold
chores
69. Using this opportunity to educate the mother
regarding the various family planning
methods and its importance.
• Providing support and counselling and
helping to cope with the stress
• Education regarding importance of post-
natal exercises and breastfeeding
70. Deep beathing exercises
Pelvic floor exercises
Physiotherapy following a normal vaginal
Exercise program
Active movements of the limbs eg: ATMs and
Heel slides
74. Teaching Posture and Ergonomic
principles
Correct posture in standing, sitting, lying
and kneeling should be taught
Special emphasis
on: feeding,
nappy changing,
baby bathing,
carrying/lifting
76. Appropriate use of
carrying slings
to avoid back
proolems.
Pramhandles atthe
correct height
to avoid bBGk
problems.
DON’
T
DO
77. TENS for pain
• Diaphragmatic breathing
and segmental
expansion exercises
• Splinted coughing
• Knee rolling
Physiotherapy following a cesarean
78. Movements of the limbs
• Pelvic floor exercises
• Pelvic tilts
• Bridging exercises
79. Posture correction
• Ambulation should be initiated as early as
possible
• Core stability exercises
• Vigorous exercises should be done after 6-
8 weeks
80. MUSCULOSKELETAL PROBLEMS
1. Perineal pain
Rest and apply ice for 10 to 15 mins, every 2-4
hours
Pelvic floor exercises using contract-relax technique
improves circulation and reduces swelling
Use of cushion when sitting
Electrotherapy: ultrasound, Pulsed electromagnetic
energy (PEME), low level laser therapy, infrared or
surface heat
Post-natal Problems and
81. 2. Diastasis of recti abdomini muscles
(DRAM)
A gap between the recti abdomini muscles of greater
than 25 mm, palpated just superior to the umbilicus
82. The corrective exercises include:
Isometric abdominal exercise
Head lifts
Head lifts with pelvic tilts
Leg sliding with pelvic tilts
Pelvic tilts in quadraped position
• If the diastasis is large, its recommended to
use a temporary abdominal support like
abdominal binder
83. 3. Back pain
Strengthening of the weak muscles by low load,
endurance exercises.
Mobilization for the sacro-iliac, lumbar or
lumbo- acral regions in case of low back pain
Teaching to maintain correct postures and
correct ergonomics
Hot pack
4. Thoracic pain
Postural correction
Gentle exercises
Hot or ice packs
84. 5. Symphysis pubis
In addition to treatments used antenatally, other
methods that can be used are:
Trochanter belts or a full pelvic binder
Drawing the abdomen in is encouraged
before moving around the bed.
TENS, US
Orthopaedic aids
85. 6. After pains
TENS over T10-L1 and S2-S4 that innervates the
uterus and perineum may relieve pain
Exercises
7. Abdominal induration
Moist pack or SWD can be given to resolve the
intramuscular haematoma
86. CIRCULATORY PROBLEMS
9. Varicose veins
Vigorous and frequent, dorsiflexion and
plantarflexion
Pressure stockings
Sitting or lying with the legs raised
10. Oedema
Vigorous ankle-toe movements
Resting with legs elevated
Pressure stockings
87. 11. Deep vein thrombosis If the DVT is in calf:
Vigorous ankle-toe movements and legs elevated
Avoid pressure on the back of the calf while
carrying out any activities
If the DVT is in iliofemoral region:
• Bed rest may be advised till the swelling subsides
• Legs in elevation
• Foot exercises, quadriceps and gluteal muscle
contractions, hip and knee flexion and extension
can aid in circulation.
88. BLADDER AND BOWEL PROBLEMS
12. Stress incontinence
Kegels exercise
Kegel balls or weights, vaginal cones,
electronic kegel exerciser can be used to
strengthen the pelvic floor muscles.
Electrical stimulation and interferential therapy
Electromyography can be used to train control
Bladder Retraining
13.Bowel incontinence
13.Constipation
89. PSYCHOLOGICAL PROBLEMS
15. The three common manifestations of Post- natal
depressive illness are:
The ‘maternity’, ‘baby’, ‘third day’ blues
Puerperal psychosis
Postnatal depression
16. Breast engorgement, mastitis, tender and
cracked nipples
90.
91. References
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Butterworth- Heinemann, Elsevier; 2005
1. Sapsford R, Bullock J, Markwell S. Women’s
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Saunders;1998
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of
Obstetrics & Gynaecology for postgraduates. 3rd ed.
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4. 2006. Available from:
http://www.rcog.org.uk/womens-health/clinical guidance/exercise-
pregnancy
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