RESEARCH CRITIQUE
Research Critique of
Adherence to Walking or Stretching, and Risk of Preeclampsia in Sedentary Pregnant Women
Ana H. Corona
Western University of Health Sciences
CGN 5306: Biostatistics and Epidemiology
August 1, 2009
Research Critique of “Adherence to Walking or Stretching, and Risk of Preeclampsia in Sedentary Pregnant Women”
Introduction
This paper is to critique a study of adherence to walking or stretching during pregnancy in high risk women who were sedentary and had previously experienced preeclampsia. The introduction of this article does give a sense of the importance of the problem area. This four-year study investigates the effects of walking or stretching on the incidence of preeclampsia and
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Target population was pregnant women less than fourteen weeks gestation that had a sedentary lifestyle. The researcher used two data collection instruments to complete this study. The first is The Cornell Protocol Fitness Tool that measured cardiovascular fitness level and peak oxygen consumption. The second data collection instrument used was The Minnesota Leisure Time Physical Activity Questionnaire assessed energy expenditure and daily physical activity. Candidates were excluded if they had chronic hypertension, gestational diabetes, and any medical condition that will prohibit daily exercise, communication problems, or recommendation of primary care provider not to participate (Yeo 2009). Clinic nurses identified possible candidates and research staff members assessed their eligibility. One hundred twenty-four women were selected and randomized into two groups. A pre-generated allocation schedule with sealed envelopes was used to withhold information of future assignments from both the women and the researchers. These two groups consist of 64 women assigned to the walking group and 60 to the stretching group (Yeo, 2009). The sampling design for this study has been well planned. The study seems to be double blinded. A power analysis indicated the need for 40 subjects per group in order to provide 80% power so that it can well detect differences between the two groups. These differences were detected by using a
Cardiovascular disease is the number one killer in the United States, causing about 610,000 deaths yearly (Center for Disease Control and Prevention, 2015). Cardiovascular disease is defined as a group of disorders damaging the heart and blood vessels, usually involving the blockage of vessels, which in turn harm the heart (WHO, 2015). A 2011 American Heart Association statement predicted that without intervention, 40% of United States adults will have at least one form of Cardiovascular disease by 2030. A large portion of these deaths by cardiovascular disease is due to the sedentary population. To better prevent cardiovascular disease, the Physical Activity Guidelines for Americans Advisory Committee stated that adults should complete about 150 minutes of moderate intensity physical activity, or 75 minutes of vigorous intensity physical activity weekly (Barry, Blair, Church, Hooker, Sui, Warren, 2010). Research has shown that meeting these recommendations is linked with lower cardiovascular disease risk, as well as reduced risk of mortality. The Center for Disease Control and Prevention estimates that only about 20.3% of Americans meet these guidelines. These statistics show that the majority of the United States population does not get nearly the amount of physical activity they need. However, even though many people are not doing the recommended amount of physical activity, this may not mean that they are living a sedentary life. Living a sedentary lifestyle is
Cardiovascular and metabolic diseases are a growing problem around the world today. Not only do diseases such as diabetes and heart disease affect individuals and their lifestyles, they also affect the economy, politics, education and the professional work environment. 20-26% of individuals in the United States live with heart disease, and obesity and high blood pressure compose the greatest factors for developing this disease [20]. Studies have shown a direct correlation between the amount of sedentary time and cardiovascular and metabolic disease risk, regardless of baseline measurements [20]. Thus, increase in physical activity will decrease cardiometabolic risk factors [8]. Several studies indicate a positive correlation between physical activity and decreased cardiometabolic risk markers [2,4,11,16]. However, we now know that an individual who is getting the recommended physical activity per day can still have a large amount of sedentary time.
The second part of his gynecology procedure was the physical activity during the final two months of the pregnancy. He says that "'at the seventh month she should give up the more violent movements" (Dunn 51). Soranus believes that any physical activity could danger the women's chances of being able to conceive and deliver more children. This is similar to the final several months of pregnancy in modern-day because it takes a lot of energy to complete everyday tasks, so it is better for the future mother to rest to make sure no complications
Much like other types of childbirth-preparation classes, prenatal yoga is a multifaceted approach to exercise that encourages stretching, mental centering and focused breathing. Research suggests that prenatal yoga is safe and can have many benefits for pregnant women and their babies. Prenatal class includes breathing exercise, gentle stretching, postures, mini meditation, deep
Elements of health promotion that focuses on the benefits of exercise would be the main educational points. The rationale for this topic was a result of noted limited time spent with patients in the office setting. This media piece can serve as reinforcement of the rationale related to regular exercise during pregnancy. The waiting area is very accommodating to this type of media and would allow for repeated playing in the waiting room.
E. Paul Roetert documents (2008) that sedentary lifestyles are not isolated to the adult population but are being found among children and adolescents as well. With obesity becoming a huge epidemic across all ages, as well as being one of the major risk factors for heart disease (Kokkinos 2008) it is important to promote and educate individuals about physical activity, as it specifically targets obesity (Obesity Prevention n.d.). Roetert (2008) investigates the benefits of children taking part in regular physical activity and the effect it has on future coronary heart disease. It was observed that if individuals lead a sedentary lifestyle in their childhood, it is very likely to continue into adulthood, where there is an increased risk to develop heart disease (Roetert 2008). This study delved deeper, following a group of women for nine years. The findings stated that the most active women had a ‘39% lower risk of coronary heart disease’ (Roetert 2008, p.74) than the least active women.
Sarah is a twenty-eight year old expecting mother of her first child. She married her husband, Erik, four years ago in her hometown. A year after her wedding, she graduated at the University of Nebraska Medical Center for Physical Therapy. Since graduation she has been working at a small physical therapy clinic in Omaha, Nebraska. When she is not working, she enjoys running and staying active. Prior to being pregnant, she would wake up at five o’clock in the morning to go on a five mile run before work. Sarah and Erik also have their own work out equipment that they used occasionally. During her pregnancy she has continued to try to stay active. Rather than going on long runs, she tries to walk
During the first six weeks after pregnancy, gradually increase activity that are suitable for you. You could start with a five-minute walk, and gradually extend this time. Aerobic exercise, such as brisk walking, jogging, swimming, or cycling, will help you to lose some weight. Do 10 minutes of exercise to begin with, and then increase gradually. The effects of pregnancy hormones can affect your joints for up to six months after birth, so don't do any high-impact
Exercising while pregnant can help with preventing excess weight gain and boost strength and endurance. Activity such as a walk for 30 minutes can help with good blood flow throughout the body. Staying safe while exercising is very important, the best way to stay active is to participate in non contact sports. Exercising can help with having a positive attitude and increase energy levels during pregnancy.
Exercising pushed them to upkeep a better diet. They also said that the resistance training created a social environment for the expecting mothers that was fun and encouraging. They pushed each other to continue to exercise and sustain a healthy lifestyle for themselves and their babies. Knowledge of the benefits of weight training and the safest ways to execute exercise for the mother and fetus were also important motivators to keep them moving. The mothers were more comfortable and more capable of overcoming exercise obstacles because they now knew that they could alter intensity, manipulate their exercise goals, or adjust the exercise to meet their physiological needs while still maintaining a safe zone for the fetus. Motivation also came from the fact that they knew exercising while pregnant could help them to retain less weight post-partum
Haakstad and Bø (2011) sought to examine the effects of exercise on birth weight in previously sedentary women in Norway by establishing an exercise schedule using an assessor blinded RCT. They supposed lower birth rates would not result from pregnant women participating in moderate intensity exercise. The study included nulliparous women who had not participated in a structured exercise program of >60 minutes once a week or > 120 minutes of brisk walking per week over the last six months (Haakstad & Bø, 2011). Participants were chosen to examine effects of exercise during pregnancy in women without a previously established exercise program. Participants were placed either in the exercise group or the control group. The exercise (intervention) group participated in two 1-hour aerobic dance programs per week, and 30 minutes of additional exercise of choice on remaining weekdays. The control group was neither encouraged nor discouraged to exercise.
Pregnant women need to carefully track the exercise or sport that they do as there can be risks while exercising during pregnancy, for an example; overheating or premature labour as pregnancy progresses, weight increases and changes occur in weight distribution and body shape. This results in the body’s centre of gravity moving forward and the curvature of the spine increasing. Exercising during pregnancy can also cause overheating or premature labour pain, muscle
Exercising during pregnancy has a range of benefits, including contributing to the chance of a smoother delivery, as well as reducing the risk of gestational diabetes. Even if the changes in your body make it tempting to avoid exercise, consider these benefits and then if your doctor agrees, adopt a suitable exercise regime. That said, I don 't like the word regime, doesn 't it sound a bit tough? Instead it may help to look at doing exercise during pregnancy as a positive life change for both you and your unborn baby. Even after baby 's birth, if you have a pattern of exercising, this will be very helpful for getting back into shape and getting your hormones as balanced as possible. Let 's look at seven reasons why it is worth the effort
Staying active during pregnancy is essential to your health. While most types of exercises, such as walking and jogging, are considered safe for future moms, certain sports should be avoided. Rock climbing, football, baseball, volleyball, hockey, and ice skating involve a high risk of falling. Thus, it's better to stay on the safe side.
of primary importance to allow expectant mothers to understand that movements of the body are not a danger to an unborn child; many women continue pre-pregnancy exercise such as jogging, dance, and similar actions previously thought to be dangerous to continued gestation. In addition, a supportive family and social environment allows the mother-to-be to take the time away from family activities to devote to personal exercise without feelings of guilt.