8/13/2019 05_N050_31174

1/19

1

Miss. GAYATRI.S.MUGALI

1ST

YEAR M.Sc. NURSING

OBSTETRICS AND

GYNAECOLOGICAL NURSING

2011-13

SHREE SIDDAGANGA INSTITUTE OF

NURSING SCIENCES AND

RESEARCH CENTRE,

B. H.ROAD, TUMKUR- 572102.

8/13/2019 05_N050_31174

2/19

2

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA, BANGALORE.

SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT

FOR DISSERTATION

1.NAME OF THE

CANDIDATE AND

ADDRESS

MS.GAYATRI.S.MUGALI

I YEAR M.SC.NURSING

SHREE SIDDAGANGA INSTITUTE OF NURSING

SCIENCES AND RESEARCH CENTRE,

B.H.ROAD, TUMKUR-572 102.

2.

NAME OF THE

INSTITUTION

SHREE SIDDAGANGA INSTITUTE OF NURSING

SCIENCES AND RESEARCH CENTRE,

B.H.ROAD, TUMKUR.-572 102.

3.

COURSE OF STUDY

AND SUBJECT

MASTER OF SCIENCE IN NURSING

OBSTETRICS AND GYNAECOLOGICAL

NURSING

4.

DATE OF ADMISSION

TO THE COURSE11.07.2011

5. STATEMENT OF THE

PROBLEM

A STUDY TO EVALUATE THE EFFECTIVENESS

OF VIDEO ASSISTED TEACHING ON

KNOWLEDGE REGARDING EFFECT OF

ANTENATAL EXERCISES ON NATURE OF

DELIVERY AMONG PRIMI ANTENATAL

MOTHERS IN SELECTED HOSPITALS AT

TUMKUR.

8/13/2019 05_N050_31174

3/19

3

6. BRIEF RESUME OF THE INTENDED WORK

6.1 INTRODUCTION

To keep the body in good health is a duty...otherwise we shall not be able to

keep our mind strong and clear.

- Budda.

Health is a fundamental human right. It is central to the concept of quality of life.

Health and its maintenance is a major social investment and is World-wide social goal.

Health is multidimensional. This health may be assessed by such indicators as death rate,

infant mortality rate and expectation of life. Ideally, each piece of information should be

individually useful and when combined should permit a more complete health profile of

individuals and communities.1

Reproductive health is a universal concern, but is of special importance for

women arise during the reproductive years, in old age general health continues to reflect

Earlier reproductive life events.

During the childbearing year, from conception through postpartum recovery, a

woman's undergoes extensive changes which frequently necessitate many adaptations.

and hormonal changes occur gradually throughout the 9 months of pregnancy, and these

are reversed in a matter of weeks during postpartum recovery. Skeletal tissue, muscle and

connective tissue, blood volume, cardiac output, body weight, and posture are affected.

The antenatal period is a time of physical preparation of birth and parenthood.

Becoming a parent is a time of intense learning both for parents and for those close to

them. The prenatal period provides a unique opportunity for nurses and other members of

the health care team to influence family health. During this period, essentially healthy

http://thinkexist.com/quotation/to_keep_the_body_in_good_health_is_a_duty/147336.htmlhttp://thinkexist.com/quotation/to_keep_the_body_in_good_health_is_a_duty/147336.htmlhttp://thinkexist.com/quotation/to_keep_the_body_in_good_health_is_a_duty/147336.htmlhttp://thinkexist.com/quotation/to_keep_the_body_in_good_health_is_a_duty/147336.htmlhttp://thinkexist.com/quotation/to_keep_the_body_in_good_health_is_a_duty/147336.html

8/13/2019 05_N050_31174

4/19

4

woman seek regular care and guidance. The primary aim of antenatal care is to achieve

healthy mother and a healthy baby at the end of a pregnancy2.

Most women benefit greatly from exercising throughout their pregnancies and

these exercises are called as antenatal exercises for example transversus exercises, pelvic

tilting or rocking, pelvic floor exercise, foot and leg exercises, breathing exercise,

walking and aerobics etc. During pregnancy mother will need to discuss exercise plans

with doctor or other health care provider early on and make a few adjustments to normal

exercise routine. The level of exercise recommended will depend, in part, on level of pre-

pregnancy fitness. Maintaining a regular exercise routine throughout the pregnancy can

help to stay healthy and feel best. Regular exercise during pregnancy can improve the

posture and decrease some common discomforts such as backaches andfatigue.There is

evidence that physical activity may preventgestational diabetes,relieve stress, and build

more stamina needed forlabor and delivery.

The more active and fit mothers are during pregnancy, it will be the easier for

mother to adapt to hers changing shape and weight gain. It will also help mother to

cope withlabour and get back into shape after the birth. Keep up normal daily physical

activity or exercise for as long as mother feel comfortable.

Childbirth is a difficult process and exercise during pregnancy will help to

increase the flexibility, endurance, and muscle control which are necessary for labor and

delivery, thereby helpful in easier labor.Strengthening of the pelvic muscles will permit

the Vagina to widen more easily during childbirth and also prevent urinary problems

after delivery.

In addition to that More than 65% of the exercising women delivered in less than

four hours, Significant reduction in the incidence of umbilical cord entanglement, Much

lower incidence of fetus passing meconium from distress. Umbilical cord blood samples

indicated that babies of exercising mothers remained relatively stress-free with plenty of

http://www.webmd.com/baby/default.htmhttp://www.webmd.com/a-to-z-guides/weakness-and-fatigue-topic-overviewhttp://www.webmd.com/baby/tc/gestational-diabetes-topic-overviewhttp://www.webmd.com/baby/labor-signshttp://www.nhs.uk/Planners/pregnancycareplanner/pages/Labourandbirthhome.aspxhttp://www.indianwomenshealth.com/Exercise-In-Pregnancy-82.aspx?gclid=CLn3lvuN2awCFch56wodYkeArAhttp://www.indianwomenshealth.com/Exercise-In-Pregnancy-82.aspx?gclid=CLn3lvuN2awCFch56wodYkeArAhttp://www.nhs.uk/Planners/pregnancycareplanner/pages/Labourandbirthhome.aspxhttp://www.webmd.com/baby/labor-signshttp://www.webmd.com/baby/tc/gestational-diabetes-topic-overviewhttp://www.webmd.com/a-to-z-guides/weakness-and-fatigue-topic-overviewhttp://www.webmd.com/baby/default.htm

8/13/2019 05_N050_31174

5/19

5

oxygen. They seemed to tolerate the stresses of delivery. Placentas of exercising mothers

are larger, more efficient, and healthier-looking.

If mother never exercised regularly before, mother can safely begin an exercise

program during pregnancy after consulting with mother`s health care provider, but should

not try a new, strenuous activity. Walking is considered safe to initiate when pregnant.

The American College of Obstetrics and Gynecology recommends 30 minutes or more of

moderate exercise per day on most if not all days of the week, unless you have a medical

or pregnancy complication3.

In video assisted teaching busy people can learn more in less time. And there is a

higher retention rate, so that they remember and use the skills in their daily life. They

understand the impact of a dramatic and memorable photo. Video is even more

compelling. Participants will more readily participate if the environment is more

entertaining. Video assisted teaching contains much of the content. The greatest

advantage of video assisted teaching is that it allows us to integrate qualitative and

quantitative methods of analysis4.

6.1 NEED FOR THE STUDY

Pregnancy is a time when women need to be prepared physically to meet the

challenges of childbirth and the transitions to parenthood. However, this needs to be

within the realms of safe practice. The main aims of the study were to investigate the

effects of undertaking a regular exercise programme during and following pregnancy on

physical well-being, pregnancy and birth outcomes.

Current medical practice recommends that pregnant women should most

assuredly engage in some sort of exercise regimen while pregnant. Exercising during

pregnancy is good for the mother. Pregnant women who exercise tend to have reduced

risk of obesity, gestational diabetes, hypertension, and preeclampsia5.

8/13/2019 05_N050_31174

6/19

6

A study was conducted to find out the effects of exercise during pregnancy on

preterm births. The study consisting of 87,232 pregnant women. The study concludes that

any sort of exercise during pregnancy leads to a reduced risk of preterm birth,

Interestingly, it seems any kind of exercise no matter how light is better than no exercise

at all in terms of preventing preterm birth. They did find that exercising late in pregnancy

leads to a reduced risk of preterm birth, while early exercise showed no differences.

While it is uncertain if exercise provides an actual protective effect against preterm birth,

the study hints at an association and no negative effects were reported. Some adverse

effects from rigorous exercise have been reported, so it is better to exercise lightly or

moderately6.

A study was conducted on water aerobics and pregnancy outcome by onerandomized and controlled method, concluded similar findings that there were no adverse

outcomes to the mother or fetus from physical activity. The study found further benefits

in the group that participated in water aerobics had 58% less need for analgesics during

labor7.

The American Congress of Obstetricians and Gynecologists conduct study on

exercises in pregnancy benefits babies and recommends 30 minutes a day for pregnant

women, for as long as they are physically able. It's an even more important message for

overweight and obese mothers-to-be, who tend to deliver heavier babies, who are then at

higher risk of diabetes and obesity later in life. Those heavier children are then more

likely to become overweight adults and in turn give birth to bigger babies. The goal of

this study is to break the cycle of ever bigger generations of babie8.

Women who continue exercising regularly through the end of their pregnancies,

three times a week for at least 20 minutes demonstrated the following reduced risks

during the birth process. 35% decrease in the need for pain relief, 75% decrease in the

incidence of maternal exhaustion, 50% decrease in the need to artificially rupture

membranes, 50% decrease in the need to induce or augment labor with pitocin, 50%

decrease in the need to intervene because of abnormalities in the fetal heart rate, 55%

decrease in the need for episiotomy, 75% decrease in the need for operative intervention9.

8/13/2019 05_N050_31174

7/19

7

Exercise during pregnancy such as transversus exercises, pelvic tilting or rocking,

pelvic floor exercise, foot and leg exercises, breathing exercise, walking and aerobics etc.

helps to alleviate many of the common problems of pregnancy. It improves circulation

which helps to prevent constipation, hemorrhoids, varicose veins, leg cramps, and

swelling of the ankles. It also prevents back pain by strengthening the muscles that

support the back10

.

Approximately 20-25% of the mothers undergo caesarian section every year

which would have been reduce through early identification of problems. Researchers

have reported that exercise plays an important role in promoting health and well being of

the women in pre and postnatal period.

A survey was conducted regarding womens beliefs about exercises during

pregnancy in the Pacific. The result showed that most of the women were believed that

there were several benefits of exercises while pregnant. All agreed that exercises might

make women feel more energetic; 95.6% believed that physical activity can improve

labour and delivery. 89.1% believed that physical activity during pregnancy can improve

the baby health. The study concluded that pregnancy is not a prescription to stop

exercising rather an important time to maintain fitness11.

A study to check the effectiveness of video technologies was conducted. The

objective was to present a review of the current research literature regarding the use of

dynamic video media in instruction. Research on the effect of antenatal exercises on

nature of delivery was reviewed general of the effectiveness, acceptance and costs of

several forms of educational television, teaching techniques used effectively with video

media; combining visual and verbal information; the effect of motion, animation and

interactivity, the relationship between media perceptions and learning the effect of

various video production techniques on learning and critical perspective on learning from

media. This review can be used as background material for future research or

instructional development efforts concerned with learning from video based media12

.

8/13/2019 05_N050_31174

8/19

8

A very little information is received regarding effect of antenatal exercises on

nature of delivery. Thus the researcher felt the need to contribute towards the effect of

antenatal exercises on nature of delivery in order to educate the antenatal mothers with

the help of a video assisted teaching and to evaluate the effectiveness of teaching

programme and also to develop healthy life style among antenatal mothers.

6.2 REVIEW OF LITERATURE

An experimental study was conducted to assess the effect of a antenatal exercise

on low back pain during pregnancy, in primi and second gravidae. The study consisting

of twenty-six low risk pregnancies with no previous or present history of back pain were

identified at 20 weeks gestation and were randomly assigned into experimental and

control group for 20 weeks. The experimental group received specific exercises and

ergonomics. The control group received only ergonomic advice. Intensity of backpain

was assessed with Visual Analog Scale. Mann-Whitey test was used to assess the

differences between both the groups. The study reveals that antenatal exercise begun

early during pregnancy, and before the onset of backpain, can significantly reduce the

intensity of pain experienced during the course of pregnancy and postpartum. The study

concludes that the specific exercise group, after intervention showed statistically and

clinically significant lower pain intensity when compared to the group that received only

ergonomic advice13.

The study was conducted to determine the effect of pelvic floor muscle training

compared to usual antenatal and postnatal care on incontinence. There is some evidence

shows that about a third of women have urinary incontinence and up to a tenth havefaecal incontinence after childbirth. Pelvic floor muscle training in women having their

first baby can prevent urinary incontinence in late pregnancy and postpartum. It is

possible that the effects of Pelvic floor muscle training might be greater with targeted

rather than population-based approaches and in certain groups of women for example

women who had bladder neck hypermobility in early pregnancy, a large baby. The result

8/13/2019 05_N050_31174

9/19

9

shows that pelvic floor muscle training is commonly recommended during pregnancy and

after birth both for prevention and treatment of incontinence14

.

The study was conducted on critical evaluation of the scientific literature for the

effects of exercise on pregnancy outcome. Maternal outcomes analyzed in this review

were gestational diabetes mellitus, preeclampsia, and weight gain, fetal outcomes

evaluated were birth weight, time of delivery, and mode of delivery. Despite

methodological pitfalls in the studies published, the evidence suggests a benefit of

exercise in pregnancy. Conclusion of this study is exercise in pregnancy could prevent

and limit adverse maternal and fetal morbidities and provide a long-term benefit through

reduction of maternal weight gain during pregnancy, and improvement in cardiovascular

fitness. Pregnancy emerges as a unique time15

.

A descriptive study was conducted in which 161 women of 18 to 45 years of

age were interviewed in the third trimester of pregnancy. These women were receiving

prenatal care at National Health Service primary healthcare units and had no pathologies

for which physical exercise would constitute a risk. A previously elaborated knowledge,

attitude and practice (KAP) questionnaire was used to collect data, which were thenstored in an Epinfo database. Statistical analysis was conducted using Pearson's chi-

square test and Fisher's exact test to evaluate the association between the study variables

(p < 0.05). These results suggest that women's knowledge concerning the practice of

physical exercise during pregnancy is reasonable and their attitude is favorable; however,

relatively few actually exercise during pregnancy16

.

A study was conducted to examine the relation between physical exercise

during pregnancy and the risk of preterm birth. According to many national

recommendations, women should be physically active during pregnancy, Self-reported

data on physical exercise during pregnancy were collected prospectively for 87,232

singleton pregnancies. Hazard ratios for preterm birth according to hours of exercise per

8/13/2019 05_N050_31174

10/19

10

week, type of exercise, and metabolic equivalent-hours per week, respectively, were

calculated using Cox regression analysis. Results showed a reduced risk of preterm birth

among the almost 40% of women who engaged in some kind of exercise during

pregnancy in comparison with nonexercisers. The association was not affected by the

type of exercise, and the results were not altered when the degree of preterm birth was

taken into account. These findings do not indicate any adverse effects of exercise on the

risk of preterm birth.

A Mother and Child Cohort Study was conducted by the Norwegian Institute of

Public Health to estimate whether women doing pelvic floor muscle training before and

during pregnancy have increased risk of perineal lacerations, episiotomy, vacuum/forceps

delivery, or acute cesarean delivery. Participants were 18,865 primiparous women and

data were collected by self-completed questionnaires. Data about obstetric outcomes

were obtained from the Medical Birth Registry of Norway. Pelvic floor muscle training

was categorized as less than once per week, one to two times per week, and at least three

times per week both before and during pregnancy. The results of women who performed

pelvic floor muscle training less than once per week, 7.2% sustained a third-degree or

fourth-degree laceration compared with 6.3% of women who performed pelvic floor

muscle training at least three times per week. A similar pattern was present for rates of

episiotomy (29.1% compared with 24.9%), vacuum/forceps delivery (15.9% compared

with 15.0%), and acute cesarean delivery (9.5% compared with 7.5%).conclusion of this

study is Pelvic floor muscle training before and during pregnancy does not affect labor

and birth outcomes or complication rates17

.

An observational study was conducted regarding the effects of recommended

levels of physical activity on pregnancy outcomes in America. A sample of 44 healthy

antenatal mothers was taken as active and inactive mothers. Active mothers who engaged

>30 minutes of moderate physical activity per day had significantly better fitness and

lower sleeping heart rate compared to the inactive. The result showed duration of second

stage of labour was 88 and 146 minutes in the active v/s inactive mothers (p=0.05). Crude

8/13/2019 05_N050_31174

11/19

11

odds ratio of operative delivery in the inactive v/s active was 3.7 (95% CI, 0.87-16.08).

Birth weight, maternal weight gain and parity adjusted odds ratio was 7.6 (95% CI, 1.23-

45.8). The study concluded that active mothers had better outcome while compared to

inactive mothers18

.

A quasi experimental study was conducted to evaluate the effectiveness of

antenatal exercises on nature of delivery between control and experimental group. Two

hundred primi gravidae women who had normal pregnancy were selected by purposive

sampling technique. Out of which 100 mothers were selected for each experimental and

control group. The data was collected by using observational check list to find out the

nature of delivery such as normal, normal with episiotomy, instrumental and surgical.

The result of the study was primi mothers in control and experimental group according to

their nature of delivery revealed that majority of the mothers both in control and

experimental group had normal delivery with episiotomy 80% and 78% respectively.

Where as the mothers who had normal delivery with out episiotomy 2% and 10%

respectively and the mothers who had LSCS was 18% and12% respectively19

.

The study was conducted to evaluative research approach with quasi-experimental Pretest and Posttest control group design adopted. The study includes 60

staff nurses who were selected as sample by non probability purposive sampling

technique in selected hospitals of Hassan. Demographic data, structured knowledge,

attitude questionnaire and video assisted teaching (VAT) were implemented for data

collection procedure. It was observed that the over all post-test mean percentage of

knowledge and attitude was higher (88% and 83.2%) in experimental group than in

control group (37.86% and 54.6%) respectively, where t value were knowledge

(t=26.67 at p

8/13/2019 05_N050_31174

12/19

12

6.3 STATEMENT OF THE PROBLEM

A study to evaluate the effectiveness of video assisted teaching on knowledge

regarding effect of antenatal exercises on nature of delivery among primi antenatal

mothers in selected hospitals at Tumkur.

6.4 OBJECTIVES OF THE STUDY

1.To assess the knowledge regarding effect of antenatal exercises on nature of deliveryamong primi antenatal mothers.

2.To evaluate the effectiveness of video assisted teaching regarding effect of antenatalexercises on nature of delivery among primi antenatal mothers.

3.To find out an association between the pre test level of knowledge with their selectedsocio demographic variables.

6.5. OPERATIONAL DEFINITIONS

1. Knowledge-It refers to the correct response of the primi antenatal mothers regarding

effect of antenatal exercises on nature of delivery as elicited by self administered

knowledge questionnaire

2. Effectiveness- In thisstudy it refers to improvement in the knowledge of primi

antenatal mothers after video assisted teaching regarding effect of antenatal exercises on

nature of delivery as measured by significant difference between pre test and post test

knowledge score.

8/13/2019 05_N050_31174

13/19

13

3. Video assisted teaching- It refers to systematically organized teaching to provide

information to primi antenatal mothers regarding effect of antenatal exercises on nature

of delivery by using video clips.

4. Antenatal exercises- In this study it refers to the exercises which are needed during

the pregnancy such as transversus exercises, pelvic tilting or rocking, pelvic floor

exercise, foot and leg exercises and breathing exercise.

5. Primi antenatal mothers- In this study it refers to the mothers who are between the

age group of 20-35 years conceived for the first time.

6.6.ASSUMPTION

* Primi antenatal mothers may have limited knowledge regarding effect of antenatal

exercises on nature of delivery.

*Video assisted teaching is one of the best teaching strategies in imparting knowledge

regarding effect of antenatal exercises on nature of delivery.

6.7. HYPOTHESIS

H1: There will be a significant difference between pre test and post test knowledge

scores regarding effect of antenatal exercises on nature of delivery.

H2: There will be a significant association between the pre test level of knowledge with

their selected socio demographic variables.

8/13/2019 05_N050_31174

14/19

14

6.8 VARIABLES

Independent variable- Video assisted teaching.

Dependent variable- Knowledge score.

7. MATERIALS AND METHODS

7.1 SOURCE OF DATA

Information will be collected by means of self administered knowledge questionnaires

regarding effect of antenatal exercises on nature of delivery.

7.2 METHODS OF DATA COLLECTION:

7.2.1 Research design

Pre-experimental one group pre- test, post- test design.

7.2.2. Setting of the study

Selected hospitals at Tumkur.

7.2.3 Population

Primi antenatal mothers.

7.2.4 Sample

Primi antenatal mothers in selected hospitals at Tumkur.

8/13/2019 05_N050_31174

15/19

15

7.2.5 Sampling technique

Non probability convenient sampling technique.

7.2.6 Sample size

60 primi antenatal mothers.

7.2.7 Sampling Criteria

Inclusive criteria:

1. Primi antenatal mothers who are attending OPD in selected hospitals.

2. Primi antenatal mothers with I and II trimester.

3.Primi antenatal mothers who can read and write Kannada

Exclusive criteria:

1.Primi antenatal mothers who are not willing to participate.

2.Primiantenatal mothers with antenatal complication.

7.2.8 Tool for data collection

The tool for the present study is self administered knowledge questionnaire. It consist of:

Section A - Socio- demographic variables.

Section B- Self administered knowledge questionnaire regarding effect of

antenatal exercises on nature of delivery.

8/13/2019 05_N050_31174

16/19

16

7.2.9. METHOD OF DATA COLLECTION.

The data will be collected from primi antenatal mothers by using self administered

knowledge questionnaire, after obtaining permission from concerned authorities to

conduct main study. On the day one, pre test will be conducted, on the same day video

assisted teaching will be given to primi antenatal mothers. On the day eigh,t post test will

be conducted to the same primi antenatal mothers to evaluate the effectiveness of video

assisted teaching.

7.3 DATA ANALYSIS & INTERPRETATION

Descriptive statistics

Descriptive statistical techniques such as Frequency, Percentage, Mean, Median,

Standard deviation.

Inferential statistics

Paired ttest, Chi-square test

7.4. Does the study require any investigation or interventions to be conducted on

mothers?

YES.

7.5. Has ethical clearance been obtained from your institution?

YES.

8/13/2019 05_N050_31174

17/19

17

8. BIBLIOGRAPHIC REFERENCE:

1.Suneel Garg, Anita Nath. Current status of national rural health mission. Indian journal

of community medicine. 2007;38(2):1895.available from:

http://www.journaldatabase.org/journal/issn0970-0218.cited on:22.11.2011.

2. Basavanthappa BT. Essentials of midwifery & obstetrical nursing. 1st ed. Bangalore:

Jaypee brothers medical publishers(p) Ltd ;2011. p.130.

3.Dye TD, Knox KL, Artal Rl. Physical activity, obesity, and diabetes in pregnancy. Am

J Epidemiology (1997); 146(19): 961-5. Available from:

http://search.searchcompletion.com/Dye TD, Knox KL, Artal R1.physical activity obesityand diabetes in pregnancy. Am J epidemiology.

4. Features/Benefits of Video-Assisted Workshops.Canadian Medical

Association.CMAJ.2009; 1488-2329: 0820-3946. Available from:http://www.presenter-

pro.com.

5.Juhl M, Andersen PK. Physical exercise during pregnancy and the risk of birth.Am J

Epidemiology 2008; 167(7):859-66. Available from:

http://www.ncbi.nlm.nih.gov/pubmed/18303008

6.Baciuk,E.P, R.I.Pereira. Water aerobics in pregnancy: Cardiovascular response, labor

and neonatal outcomes. Reproductive Health 2008 5: 10. Available from:

http://www.infantrisk.com/content/exercise-and-pregnancy.

7. Hopkins SA. Baldi JC. Exercise training in pregnancy reduces offspring size

without changes in maternal insulin sensitivity. J Clin Endocrinol Metab. 2010; 2080-

8. Available from:http://www.infantrisk.com/content/exercise andpregnancy.

http://www.journaldatabase.org/journal/issn0970-0218http://search.searchcompletion.com/Dye%20TD,%20Knox%20KL,%20Artal%20R1.physical%20activity%20obesity%20and%20diabetes%20in%20pregnancy.%20Amhttp://search.searchcompletion.com/Dye%20TD,%20Knox%20KL,%20Artal%20R1.physical%20activity%20obesity%20and%20diabetes%20in%20pregnancy.%20Amhttp://www.cmaj.ca/site/misc/terms.xhtmlhttp://www.cmaj.ca/site/misc/terms.xhtmlhttp://www.presenter-pro.com/http://www.presenter-pro.com/http://www.ncbi.nlm.nih.gov/pubmed/18303008http://www.infantrisk.com/content/exercise-and-pregnancyhttp://www.infantrisk.com/content/exercise%20andhttp://www.infantrisk.com/content/exercise%20andhttp://www.infantrisk.com/content/exercise-and-pregnancyhttp://www.ncbi.nlm.nih.gov/pubmed/18303008http://www.presenter-pro.com/http://www.presenter-pro.com/http://www.cmaj.ca/site/misc/terms.xhtmlhttp://www.cmaj.ca/site/misc/terms.xhtmlhttp://search.searchcompletion.com/Dye%20TD,%20Knox%20KL,%20Artal%20R1.physical%20activity%20obesity%20and%20diabetes%20in%20pregnancy.%20Amhttp://search.searchcompletion.com/Dye%20TD,%20Knox%20KL,%20Artal%20R1.physical%20activity%20obesity%20and%20diabetes%20in%20pregnancy.%20Amhttp://www.journaldatabase.org/journal/issn0970-0218

8/13/2019 05_N050_31174

18/19

18

8. Buscando la luz T. The positive impact of prenatal exercises. Indian Journal of

physiotherapy. 2006;14(5):371-7. cited on: 21.11.2011.available from:

http://birthfaith.org/exercise/the-positive-impact-of-prenatal-exercise.

9 .Mikesksa, Erinn, CPT, And Dr.christine quarto. Delivering fitness. Dallas TX. brown

books publishing group; 2004. Cited on: .22,11,2011. Available from:

10. Agrawal Neha. Effect of a structured antenatal physiotherapy programme on back

pain. Indian Journal of physiotherapy. 2009;122(11):34-6. Available from:

http://www.indianjournals.com/volume=3&issue=2&article=008.

11.Krans EE, Gearhart JG, Dubbert PM, Klar PM, Miller AL, Replogle WH. Pregnant

Womens beliefs regarding exercise during pregnancy BMC Public Health 2005

Mar;46(3):67-73.

12.Wetzel et al. Review of the effectiveness of video media in instruction. Navy personal

research and development centre. Sanliego.1993;04:39-42.

13.Hay smith J, Herbison GP. pelvic floor muscle training for prevention & treatment of

urinary & faecal incontinence in antenatal & post natal women. Cochrane database of

systematic reviews. 2008;182(12):1895. Available from:

http://apps.who.int/rhl/pregnancy_childbirth/antenatal_care/general/CD007471/en/index.

html.

14.Gavard JA, Artal R. Effects on pregnancy outcome, Department of obstetrics,

gynaecology, women health. St. Louis university school of medicine. USA. available

from:http://www.ncbi.nlm.nih.gov/pubmed/18463475

15. Carmen P, Ribeiro,andHelaine Milanez. Department of Obstetrics and Gynecology.

School of Medical SciencesReproductive Health. 2011; 8:3:1180-6.

http://birthfaith.org/exercise/the-positive-impact-of-prenatal-exercisehttp://www.indianjournals.com/volume=3&issue=2&article=008http://apps.who.int/rhl/pregnancy_childbirth/antenatal_care/general/CD007471/en/index.htmlhttp://apps.who.int/rhl/pregnancy_childbirth/antenatal_care/general/CD007471/en/index.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/18463475http://www.ncbi.nlm.nih.gov/pubmed/18463475http://apps.who.int/rhl/pregnancy_childbirth/antenatal_care/general/CD007471/en/index.htmlhttp://apps.who.int/rhl/pregnancy_childbirth/antenatal_care/general/CD007471/en/index.htmlhttp://www.indianjournals.com/volume=3&issue=2&article=008http://birthfaith.org/exercise/the-positive-impact-of-prenatal-exercise

8/13/2019 05_N050_31174

19/19

19

16.Mette Juhl. National Institute of Public Health Obstetrics & Gynecology.

Copenhagen,\ Denmark. June 2009; Volume 113: 1279-84. available from:

http://www.ajog.org/article/S0002-9378(09)00820-5/abstract

17.Sternfeld B. Physical exercise during pregnancy. Journal Article 1997 Jan;23(1):33-

47.

18.Melzer K, Schutz.Y, Soehnchen N, et al. Physical activity on pregnancy outcomes.

American Journal of Obstetrics and Gynaecology 2002 Jan 6;202(3):266-70.

19.Selvanayaki. Effect of antenatal exercises on nature of delivery. Indian journal of

Nightingale Nursing Times.2011;7:27-8.

20.Kumar Mahendra. International journal of nursing Education.2010; 2(2):25-7.

http://aje.oxfordjournals.org/search?author1=Mette+Juhl&sortspec=date&submit=Submithttp://aje.oxfordjournals.org/search?author1=Mette+Juhl&sortspec=date&submit=Submit