„Aqua-Fit“ in der Schwangerschaft: Maternale und fetale hämodynamische Reaktionen bei einem Trainingsprogramm im Wasser

Response of pregnancy leg edema to a single immersion exercise session

BACKGROUND

To quantify the effect of a single immersion exercise session on uncomplicated dependent edema in pregnancy.

METHODS

Lower leg volume was measured by water displacement volumetry and limb circumference in nine women with marked dependent edema, but otherwise normal second or third trimester pregnancy, before and after upright water immersion exercise session (Aqua-Fit) for 45 min. Maternal heart rate was monitored continuously throughout the session. Blood pressure was measured before and after the session.

RESULTS

Mean left leg volume decreased by 112 ml from 1665 to 1553 ml, and right leg volume by 84 ml from 1665 to 1581 ml (P = 0.007). Cardiovascular parameters fluctuated within the normal range, well below the upper limits recommended in pregnancy.

CONCLUSIONS

A single immersion exercise session is a safe, effective, and enjoyable complement, or alternative, to compression stockings for reduction of gestational dependent edema. Further study is required to determine its duration of effect and the optimum interval between sessions.

Immediate blood pressure changes and aquatic physiotherapy

OBJECTIVE

No studies to date have examined the effect on Blood pressure (BP) when pregnant women participate in aquatic physiotherapy (AP) classes; although, previous studies have indicated that there may be a detrimental outcome to the pregnant mother and fetus when there is a significant rise in the maternal BP. At least three components may contribute to BP changes: temperature, exercise, and immersion. This study examines BP changes in pregnant women attending AP classes.

METHOD

An experimental same-subject, repeated measures design was employed. Forty-five sets of data were collected from pregnant women attending routine, existing, nonaerobic AP classes. Blood pressure measurements were taken preimmersion, 2-5 minutes after entering the pool, immediately following the 50 minute AP class (while immersed), and 8-12 minutes after exiting the water.

RESULTS

Systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) data were analyzed using a repeated measures analysis of variance (ANOVA). For all sets of data a highly significant difference was observed (p = 0.0000). Post-hoc Tukey test results showed BP to decrease significantly on entering the water (MAP mean difference of 10.52 mm Hg, 95% CI 8.75 to 12.29), to remain at this low level postexercise while still immersed, and then return to preimmersion values 8-12 minutes after exiting the water.

CONCLUSION

These results indicate that AP classes are safe for nonhypertensive pregnant women in their third trimester. The use of AP in the antenatal care of women with unstable BP or who are hypertensive needs further research.