Background Both exercise and pregnancy influence serum irisin concentration. Aim To determine how the interaction of pregnancy and exercise affects irisin level and whether various patterns of exercise adherence had different effect on irisin concentration. Methods It was a one-group pretest-posttest study among 9 Caucasian nulliparous healthy women in normal pregnancy (age 23 ± 3 years, 21 ± 2 weeks of gestation; mean ± SD) who participated in 8-week group fitness program. Before and after exercise intervention, we determined serum concentrations of irisin and selected parameters of lipid profile and glucose homeostasis markers. Results In active women, irisin slightly decreased with the development of pregnancy. After 8 weeks of exercising, irisin correlated negatively with fasting glucose (R = −0.922; p = 0.001), glycated hemoglobin (R = −0.784; p = 0.012), and insulin concentrations (R = −0.845; p = 0.004). In women exercising below recommended level, we observed a significant drop in irisin concentration, whereas in women exercising at least three times a week this myokine slightly increased (31% difference; 90% confidence limits ±28; a large, clear effect). Conclusions Irisin stimulated by prenatal exercise may improve glucose homeostasis markers in healthy women and compensate for metabolic changes induced by pregnancy. Moreover, the frequency of exercise may regulate the changes in exercise-induced irisin concentration.

Background: Pregnancy and high-impact activity are considered as risk factors for pelvic floor dysfunctions, including urinary incontinence.Aim: To investigate whether a structured exercise program, including high- and low-impact aerobics and supported by pelvic floor muscle exercises, improves the neuromuscular activity of the pelvic floor and does not reduce the quality of life in terms of urinary incontinence in healthy pregnant women.Methods: This was a randomized control trial among 97 Caucasian healthy nulliparas in uncomplicated pregnancies (age 30 ± 4 years, 21 ± 5 weeks of gestation; mean ± SD). Women were assessed for pelvic floor muscle functions with surface electromyography (EMG) using vaginal probes and using the Incontinence Impact Questionnaire (IIQ). Only women able to contract pelvic floor muscles and with good quality of life based on IIQ were included for the study. Seventy women in the experimental group took part in a supervised exercise program including high-low impact aerobics and pelvic floor muscle exercises three times a week. Twenty-seven controls did not receive any exercise intervention. After 6 weeks both groups were re-tested with EMG and IIQ. Post- and pre-exercise program changes in each group were analyzed using a repeated-measures ANOVA.Results: Women in the experimental group improved the neuromuscular activity of the pelvic floor in some motor tasks without any adverse outcomes of the intervention. After the exercise program we observed in the experimental group significantly higher EMG amplitude in the pelvic floor muscles during 3-s contractions (p = 0.014). We also noticed a beneficial trend in the increase of neuromuscular activity during 10- and 60-s contractions, but the changes were not statistically significant. The exercising women substantially improved their abilities for relaxation following 3- and 10-s contractions (p = 0.013 and p < 0.001). In controls, we reported no statistically significant improvement in either of the motor tasks. All study participants maintained good quality of life related to urinary incontinence.Conclusion: Prenatal exercise programs that include high- and low-impact aerobics and are supported by pelvic floor muscle exercises should be recommended for pregnant women, especially those who are accustomed to higher exercise intensity before pregnancy. Nevertheless, these recommendations can be directed to continent women who can properly contract pelvic floor muscles.ISRCTN. DOI: 10.1186/ISRCTN92265528: “Pelvic floor muscle training with surface electromyography”, retrospectively registered on the 25th of July, 2016.

BackgroundPelvic floor muscle exercises are a widely used and well-established form of stress incontinence treatment, with success rates varying from 21% to 84%, although with a better subjective than objective outcome.Material/Methods“Incontinence Impact Questionnaire” (IIQ), PFM EMG assessment was done at the beginning and after the 6-week training program.ResultsStatistically significant differences appeared in the BASE and R values. In the symptomatic group (with SUI symptoms), the value of BASE was 3.26 μV, and after training it was 3.95 μV. The R values before and after training were 4.55 μV and 4.25 μV. In the symptomatic group (without SUI symptoms), the value of BASE was 2.88 μV and 3.52 μV and R values were 7.16 μV and 3.92 μV. In the control group, BASE was 3.05 μV and 4.11 μV and R was 7.82 μV and 4.39 μV.ConclusionsThe results indicate that a 6-week training process influences PFM EMG activity in pregnant women. During Q, the value of PFM activity after a training session tended to increase in the symptomatic and control groups, but in the symptomatic group it remains practically unchanged. Our results show the probable process of decreasing control of PFM activity during long-lasting contractions in symptomatic and control women. The comparison of BASE before and after training averaged the values of R after five 10-s contractions and showed an increase in the Base and decrease in the R.

Background: Regular physical activity during pregnancy has a positive effect on the psychophysical condition of the pregnant woman, pregnancy and fetal development, parturition and the postpartum period. However, its level in pregnant women is insufficient in most countries. For an exercise program to be effective it must take into account four training components: intensity, frequency, duration and its content - through a proper selection of the type of exercises and their technique. In this work we aimed to answer the question what information on the contents of prenatal exercises is provided in the current guidelines for exercise during pregnancy in different countries. Methods and Results: We have analyzed 11 documents, that were the official position of national obstetrics, gynecology, or sports medicine institutions from 7 countries. The guidelines provide little information on the contents of prenatal exercise and on the adaptation of sports activities to pregnancy. Conclusions: The guidelines for exercise in pregnancy should be updated based on high-quality research and in collaboration with practitioners in the field of prenatal physical activity, which could increase the chances of their implementation. Trustworthy and comprehensive guidelines created on the basis of international and interdisciplinary initiatives should be disseminated among all interested in prenatal physical activity: pregnant women and their families, obstetrics care providers and exercise professionals to enable them an effective cooperation and to globally promote exercise in pregnancy.

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