Therapeutic Aquatic Exercise in Pregnancy: A Systematic Review and Meta-Analysis

Abstract

This systematic review and meta-analysis aimed to assess evidence on the effects of aquatic exercise in pregnant women. The search included the following databases: Medline-PubMed, Web of science, PEDro, Scopus and SPORTDiscus databases. Seventeen randomized controlled trials were included (n = 2439, age 20–39 years; 31.30 ± 1.30 years). The systematic review carried out has indicated that aquatic exercise in pregnant women appears to have positive effects on preventing excessive maternal weight gain, improving maternal body image, as well as promoting healthy behavior, decreasing medical leave due to lower back pain during pregnancy, preventing gestational depression by improving maternal glucose tolerance levels, and reducing O’Sullivan test values. The Physiotherapy Evidence Database was used to evaluate the quality of the methodology of the selected studies, which were found to present an average methodological quality (PEDro scale: 5.05 points). Meta-analysis showed that aquatic exercise in pregnant women appears to have positive effects in the prevention of excessive maternal weight gain (mean difference −1.66 kg, 95% CI −2.67 to −0.66) and also to reduce birth weight mean differences (−89.13 g, 95% CI −143.18 to −35.08). The practice of aquatic exercise is appropriate throughout pregnancy. However, more research is needed to build more solid knowledge on the benefits of aquatic physical exercise on physical fitness (endurance, flexibility, agility and strength).

Influence of prenatal aquatic activities on fetal outcomes and maternal physical and mental outcomes: a systematic review and meta-analysis

“…Our ndings are consistent with previous systematic literature reviews and meta-analyses [34,35], which concluded that mothers could bene t from prenatal aquatic activities. However, the present meta-analysis included more fetal outcomes, such as fetal birth weight, fetal birth length, Apgar score at 1 minute, Apgar score at 5 minutes, and pH of umbilical cord blood, to further explore the effects and safety not only for pregnant women but also fetuses.…”

The effect of water exercise and sand exercise training methods on agility in basketball athletes

“…The pressure contained in the water can be used to provide a load during exercise [23]. In addition to using water pressure as a training load, exercising in the water is also easier and safer from injury to muscles or joints because, in the water, the players are better able to control the given load [24]. It also provides freedom of movement of muscles and joints, reducing pressure (resistance) caused by hard steps such as when exercising on land.…”

Current Understanding and Future Challenges in Physical Activity during Pregnancy

“…Aerobic, resistance and combined sports were the most studied among pregnant women [ 8 ]. In addition, therapeutic aquatic exercise, yoga and Pilates are gaining more and more attention for research [ 9 , 10 ]. The exercise programs designed in most studies were characterized with moderate intensity, commencement in the second trimester, a duration of 20–60 min and a frequency of 1–3 sessions per week [ 10 ].…”

“…The instrument used for the recording and measurement of physical activity plays a pivotal role in outcome analysis. The most widely applied tools are the International Physical Activity Questionnaire (IPAQ), Pregnancy Physical Activity Questionnaire (PPAQ) [ 11 ], Global Physical Activity Questionnaire (GPAQ) [ 9 ] for self-reported exercise data, Borg scale for perception of effort, and metabolic equivalent of task (MET) for intensity measurements and recording of the amount of exercise.…”

“…The short- and long-term influence of pregnancy physical activity on maternal and offspring health have always been a heated topic in this area. Previous systematic reviews and meta-analyses supported a positive effect of physical activity for preventing the onset of gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP) and excessive gestational weight gain [ 6 , 8 , 9 ]. Moreover, a beneficial impact of yoga and aquatic exercise on preventing perinatal depression and anxiety was also noticed [ 9 , 10 ].…”