Bone Status in Activity-Restricted Pregnant Women Assessed Using Calcaneal Quantitative Ultrasound

Brandao, Kristen L.; Mottola, Michelle F.; Gratton, Robert; Maloni, Judith A.

doi:10.1177/1099800411423807

Cited by 11 publications

(7 citation statements)

References 41 publications

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“…Data available suggest that hospitalized pregnant individuals self-impose bed rest even in the absence of a medical recommendation [20]. Studies on ambulatory third trimester pregnant individuals show a step count of 6495, hospitalized with partial or no bed rest prescribed, show that these individuals perform about 1300-1500 steps and indeed, the level of step counts in those with strict bed rest drops dramatically to 378 steps [21][22][23][24]. Since the activity levels of hospital-admitted pregnant individuals are drastically reduced, many show similar physiological side-effects to non-pregnant bed-rested individuals.…”

Section: Effects Of Hospitalization and Bed Rest In Pregnancymentioning

confidence: 99%

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

Palacio

Mottola

2023

IJERPH

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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.

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Section: Effects Of Hospitalization and Bed Rest In Pregnancymentioning

confidence: 99%

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

Palacio

Mottola

2023

IJERPH

Self Cite

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“…Postpartum bone density has been shown to be associated with activity restrictions due to high-risk obstetric conditions, body mass index (BMI), previous lactation periods, exercise, and other such factors. [4][5][6] However, the factors that can be intervened upon are still limited. It has been reported that an exercise program focusing on resistance exercise may be effective for preventing a decrease in bone density during the lactation period among women.…”

Section: Daily Physical Activity Is Associated With Increased Sonogramentioning

confidence: 99%

Daily physical activity is associated with increased sonographically measured bone status during lactation

Ebina

Sawa

Kondo

et al. 2020

Womens Health (Lond Engl)

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Objectives: The purpose of this cross-sectional study was to investigate the association between daily physical activity and sonographically measured bone status among women during the lactation period. Methods: Final participants were 152 women 4 months after childbirth. Bone status of the participants was measured using quantitative ultrasonometry of the calcaneus (speed of sound). Daily physical activity was assessed using the Japanese version of International Physical Activity Questionnaire short version. After getting the International Physical Activity Questionnaire results, we classified participants into three categories (low/moderate/high) according to a protocol. Participants categorized into the low group according to the International Physical Activity Questionnaire were considered to be in the low physical activity group and those categorized into the moderate and high groups were considered to be in the moderate to vigorous physical activity group. Results: Speed of sound was significantly higher in the moderate to vigorous physical activity group (moderate to vigorous physical activity versus low physical activity, 1533 m/s versus 1523 m/s, p = 0.03). Daily physical activity was significantly associated with speed of sound, even after adjustment for confounding factors and prognosticators ( β = 0.195, p = 0.02). Conclusion: Sonographically measured bone status was significantly higher in women who were physically active than in those who were physically inactive, suggesting that daily physical activity might help to maintain good bone status.

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“…Bone resorption rapidly increased as bed rest was initiated. Last, in a recent pilot study of bone loss in the calcaneus assessed by quantitative ultrasound, the speed of sound and broadband attenuation scores were not significantly different after 7 days of bed rest between an ambulatory and bed-rest group [33]. However, bone stiffness index scores, were significantly different between the groups, suggesting a greater relative risk for fracture in the women treated with activity restriction.…”

Section: Physiological Side Effects Of Antepartum Bed-rest Treatmentmentioning

confidence: 99%

Lack of evidence for prescription of antepartum bed rest

Maloni

2011

Expert Review of Obstetrics & Gynecology

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Antepartum bed-rest treatment is based on assumptions that it is both effective and safe for mother and fetus. However, research indicates, that bed-rest treatment is ineffective for preventing preterm birth and fetal growth restriction, and for increasing gestational age at birth and infant birthweight. Studies of women treated with pregnancy bed-rest identify numerous side effects, including muscle atrophy, bone loss, weight loss, decreased infant birthweight in singleton gestations and gestational age at birth, and psychosocial problems. Studies conducted by aerospace scientists who have used bed rest as a model for the study of weightlessness in space using nonpregnant individuals report similar results. Antepartum bed-rest treatment should be discontinued until evidence of effectiveness is found.

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Bone Status in Activity-Restricted Pregnant Women Assessed Using Calcaneal Quantitative Ultrasound

Cited by 11 publications

References 41 publications

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

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

Daily physical activity is associated with increased sonographically measured bone status during lactation

Lack of evidence for prescription of antepartum bed rest

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