Activity Restriction and Hospitalization in Pregnancy: Can Bed-Rest Exercise Prevent Deconditioning? A Narrative Review

Abstract

Evidence suggests that exercise during pregnancy is beneficial to both parent and fetus. However, there are high-risk pregnancy conditions that may warrant hospitalization. In our narrative review, we first describe the clinical implications for activity restriction in pregnancy, the effects of hospitalization, and the impact of bed rest on non-pregnant individuals. We provide examples of a 30 min bed-rest exercise program for hospitalized pregnant patients using the principal of suggested frequency, intensity, time (duration) of activity, and type of activity (FITT) using a resistance tool while in bed. If the individual is able to ambulate, we recommend short walks around the ward. Every minute counts and activity should be incorporated into a program at least 3 times per week, or every day if possible. As in all exercise programs, motivation and accountability are essential. Flexibility in timing of the exercise intervention is important due to the scheduling of medical assessments that may occur throughout the day for these hospitalized patients. Evidence suggests that by improving physical and emotional health through a bed-rest exercise program during a hospitalized pregnancy may help the individual resume demanding daily activity in the postpartum period and improve quality of life once birth has occurred. More research is necessary to improve the health of those individuals who are hospitalized during pregnancy, with follow up and support into the postpartum period.

Prenatal immobility stress: Relationship with oxidative stress, inflammation, apoptosis, and intrauterine growth restriction in rats

“…Movement restriction and bed rest, which are traditionally believed to be therapeutic during pregnancy, have been a common treatment option in premature rupture of membranes, vaginal bleeding, placenta previa, and multiple pregnancies (da Silva Lopes et al, 2017). However, studies have reported that mandatory bed rest does not prevent adverse perinatal outcomes (Hassan et al, 2022; Palacio & Mottola, 2023).…”

Daily Activity Restriction Quantification in Older Population via Using Activity Frequency: Dual Roles in Preventing Falls

“…For instance, physical activity restriction is a common strategy for preventing heart attacks in patients with severe cardiomyopathy [1,2]. Daily activity restriction in the upright position is recommended to prevent preterm births in high-risk pregnancies [3]. Excessive fear of falling can induce general daily activity restriction and is therefore regarded as a strategy for preventing falls in the older population [4].…”

“…Nevertheless, we realized through literature review that the measures of activity restriction still need to be standardized. In general, two methods have been used to assess activity restrictions in previous studies [1][2][3][4]: a qualitative approach based on self-perception and a quantification method based on the actual activity amount. The qualitative approach is used more commonly than the quantification method.…”

Impact of Physical Activity Interventions on High-Risk Pregnancies: A Systematic Review and Meta-Analysis

“…Nevertheless, there exists a significant knowledge gap on this topic within the realm of scientific literature. There is an urgent need to investigate the potential impact of alternative therapies, such as light physical activity, as a means to potentially alleviate the notable complications associated with bed rest during pregnancy [30].…”