1. Presentation title (Date) Presentation Title Presentation title (Date) ACOG Exercise guidelines (2005) Prescription for exercise?

2. Presentation title (Date) Lesson objectives Explain the ACOG Guidelines concerning exercising during pregnancy Determine how much exercise is enough during the ante natal period Detail how the F.I.T.T. Principles would alter antenatally List the types of activities and exercises suitable for the pregnant population

3. Presentation title (Date) ACOG (2005) Recommendations Regular, mild-moderate activity at least 3x per week Avoid supine position after 1st trimester & avoid long periods of motionless standing Stop at fatigue not exhaustion, less oxygen available for aerobic exercise. Modify in line with maternal symptoms Avoid activity where there is risk of abdominal trauma Ensure adequate diet and carbohydrate Beware heat dissipation - hydration, clothing, environment

4. Presentation title (Date) ACOG (2005) Guidelines on Exercise During Pregnancy Regular Exercisers –Can continue training without major modifications –Modifications to F.I.T.T principles in line with levels of comfort & maternal symptoms Non-exercisers –Advised to seek medical approval –Begin with low intensity & low impact activities

5. Presentation title (Date) Summary Guidelines contain useful information for you and your participants to ensure that there workouts are safe and effective They should encourage the individual to take personal responsibility for their own workout They are ideal to deliver in an information leaflet Working within these guidelines should reduce the risk of your participants becoming injured during your sessions and from you being involved in legal action

6. Presentation title (Date) Exercise prescription for ante natal clients

7. Presentation title (Date) Suggestions for Antenatal Cardiovascular Training Inactive client Frequency: 3 x per week between 13th-36th weeks None before 13th week 1-2 x per week after 36th week Intensity: Talk test - conversational level RPE 5-6 Time: 5-45 minutes per session

8. Presentation title (Date) Suggestions for Antenatal Cardiovascular Training Active client Frequency: 3-4 x per week up to 14th week 3-5 x per week up to 30th week 3 x per week after 30th week Intensity: Talk test - conversational level RPE 6-7 Time: 5-45 minutes per session

9. Presentation title (Date) Guidelines for Antenatal Resistance Training Appropriate resistance training poses little risk to Regular breathing should be encouraged to prevent valsalva maneuver Heavy resistance training should be avoided Sets of 12-20 repetitions without undue fatigue are appropriate Progression should increase reps before weights Machines provide more stability than free weights If specific exercise causes pain or discomfort they should be discontinued

10. Presentation title (Date) Antenatal Progression – Resistance Training As pregnancy progresses: Decrease weight Decrease sets Increase recovery between sets Increase recovery between sessions Avoid maximal lifts Beware of overhead lifts (lordosis, blood pressure)

11. Presentation title (Date) The Valsalva Maneuver Definition: –Excessively holding ones breath with a closed glottis during performance of a resistance training exercise. –If valsalva maneuver performed both systolic and diastolic blood pressure elevates significantly

12. Presentation title (Date) Ante natal Gym Programme Adaptations Suitability of cardiovascular machines & resistance machines Resistance vs free weight options Progression? Reps & sets Specificity Fitness maintenance Adequate recovery Built-in overload (jogging 9 months) – reverse progression Daily re-assessment Listen to body & individual Alternatives / adaptations ROM & movement speed Joint laxity / Postural re-alignment / muscle imbalances Clothing / support / footwear Hydration / nutrition

13. Presentation title (Date) Ante Class Adaptations Your attire & motivation techniques Class focus (component or postural) Music speed Changes in direction (frequency, speed & cueing) Warm-up duration? Aerobic duration & content Impact issues (low impact offered) MSE content (specificity, flow, positioning) Length, type & position of stretches Relaxation (need, position, time) Breaks / water (enforced) Breathing (cued) Time for questions & social

14. Presentation title (Date) Alternative Activities? Step Aqua Pilates Yoga / T’ai Chi Boxercise / kick boxing Walking Jogging Rollerblading Ski-ing / snowboarding Horse riding Swimming

15. Presentation title (Date) Activity Plan an exercise programme for Grace who is 34 weeks pregnant to include: CV element Balanced resistance exercises Core exercises Stretching Any other advice to plan a safe and effective programme

16. Presentation title (Date) Summary All exercise prescription should take into account the previous activities and fitness levels of the participant Thorough screening and information gathering (taking notes) is essential to ensure programmes are safe, effective and individualised Very few activities are contra-indicated, many are controversial and dependent on skill, size and the feelings of the individual on the day of training The controversy of many gym machines and exercises will vary throughout the different stages of the pregnancy