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Aquatic physical exercise aimed at pregnant women has proliferated in recent years, thanks to the benefits provided by the aquatic environment, such as a decrease in gravitational pull, an improved sense of physical comfort, improved mobility and flexibility, reduction of post-exercise pain and an improvement of venous return due to the increased hydrostatic pressure.
Reference | Purpose | Participants | Mean Age ± SD (Median/Range) | Gestational Age (Weeks) | Type of Intervention (E/C) | Intervention (Wk/f/min) | Adherence | Findings | Measurement Tools |
---|---|---|---|---|---|---|---|---|---|
Aguilar-Cordero et al. [17] | Determine if physical activity in pregnancy relieves PPP. | EG = 65 CG = 64 |
EG = 34.52 ± 4.50 CG = 33.67 ± 5.37 |
20th–37th | EG = Aerobic and resistance activities-SWEP (water) CG = Routine prenatal care |
EG = 17/3/60 CG = NR |
EG = 92.82% CG = 91.4% |
Less at risk of Depression (EPDS) in EG. Overweight and obesity are closely associated with PPD. | Perception of effort (Borg scale) BMI (Formula QUETELET) Depression postpartum (Edinburgh Postnatal Depression Scale-EPDS-) |
Bacchi et al. [18] | Evaluate and compare maternal HR in water and land exercises with the same intensity | EG = 15 CG = 15 |
NR | 3rd TRIMESTRE (27th–38th–42nd) |
EG = Calisthenics exercise (water) CG = Calisthenics exercise (land) |
EG = 1/1/25 CG = 1/1/25 |
EG = 100% CG = 100% |
Calisthenics exercise (land) produce higher FC elevations (110.86 ± 6.10) than calisthenics exercise (water) (105.40 ± 6.10), but not significant differences. | Perception of effort (Borg scale) Heart rate monitor (Polar F6); |
Bacchi et al. [19] | Study the effect of a program of aquatic activities on pregnancy on maternal weight and birth weight | EG = 49 CG = 62 |
EG = 30.4 ± 4.0 CG = 31.0 ± 5.0 |
10 to 12th/38 to 39th | EG = Aerobic and resistance activities (water) CG = Routine prenatal care |
EG = 26–29/3/55–60 CG = NR |
EG = 70% CG = 88.57% |
Higher percentage of women with excessive maternal weight gain in the CG (45.2%; n = 28) than in the EG (24.5%). Aerobic and resistance activities (Water) increase maternal weight and preserves birth weight. | Perception of effort (Borg scale) BMI (Formula QUETELET) |
Barakat et al. [20] | Analyze glucose tolerance through aquatic exercises for pregnant women | EG = 40 CG = 43 |
EG = 32 ± 4 CG = 31 ± 3 |
24th–28th | EG = Aerobic activities (land + water) CG = Routine prenatal care |
EG = 32–33/2 + 1/35–45 CG = NR |
EG = 80% CG = 86% |
The glucose values corresponding to the EG (103.80 ± 20.40 mg/dL) were better (significant differences; p = 0.001) than those of the CG (126.9 ± 29.5 mg/dL). No differences in maternal weight and cases of gestational diabetes. Exercise during pregnancy improves the level of tolerance to maternal glucose. | Heart rate monitor (Accurex Plus, Sark Products, Waltham, MA, USA); Polar Electro OY (Polar, Kempele, Finland) Perception of effort (Borg scale) Blood glucose level (blood test) |
Barakat et al. [21] | Compare terrestrial or aquatic exercises during pregnancy in maternal and neonatal outcomes. | EG1 = 107 EG2 = 49 EG3 = 101 CG = 311 |
EG1 = 31.5 ± 3.8 EG2 = 30.9 ± 4.0 EG3 = 32.0 ± 3.5 EC = 31.9 ± 4.5 |
9th–11th | EG1 = aerobic activities (land) EG2 = aerobic + resistance activities (water) EG3 = aerobic activities (land) + resistance activities (water) CG = Routine prenatal care |
EG1 = 30/3/55–60 EG2 = 30/3/55–60 EG3 = 30/2 + 1/55–60 CG = NR |
EG1 = 79.68% EG2 = 79.28% EG3 = 75.14% CG = NR |
Exercise on land is more effective in preventing excessive maternal weight gain (p = 0.001). Combined programs or aquatic programs seem more effective in preventing gestational diabetes (p = 0.03). Both are safe for the baby. | Evaluate knowledge, attitudes and reasoning (questionnaire ad hoc) Height (stature meter) Weight (weight scale) |
Cordero et al. [22] | Evaluate the effectiveness of a moderate exercise program during pregnancy on maternal weight, glucose and gestational diabetes. | EG = 25 CG = 30 |
EG = 34.1 ± 4.7 CG = 31.6 ± 2.0 |
6th–10th/38th–39th | EG = aerobic activities (land) + resistance activities (water) CG: Routine prenatal care |
EG = 28/2 + 1/50 CG = NR |
EG = 62.50%; CG = 75.00% |
The exercise program performed during pregnancy reduced maternal weight gain (p = 0.03), values of the maternal glucose screen test (p = 0.002) and appears to prevent gestational diabetes. | Perception of effort (Borg scale) Heart rate monitor (Accurex Plus, Polar Electro OY). Blood glucose level (blood test) |
Cordero et al. [23] | Assess the effectiveness of a maternal exercise program (land/aquatic activities) in preventing gestational diabetes mellitus. | EG = 100 CG = 146 |
EG = 33.6 ± 4.1 CG = 32.9 ± 4.5 |
10th–12th | EG = aerobic activities (land) + resistance activities (water) CG = Routine prenatal care |
EG = 26–30/2 + 1/50–60 CG = NR |
EG = 81.96% GC = 66.36% |
The prevalence of GDM was reduced in the EG group (EG, 1%, n = 1, vs. CG, 8.8%, n = 13 (p = 0.009)). Exercise on land and in water reduced the incidence of DMG is associated with a decreased gestational weight gain and conserved glucose tolerance | Perception of effort (Borg scale) Heart rate monitor (Accurex Plus, Polar Electro OY) Blood glucose level (blood test) BMI (Formula QUETELET) |
Granath et al. [24] | Evaluate and compare low back or pelvic and pain due to illness in pregnant women through terrestrial and aquatic exercises | EG = 132 CG = 134 |
EG = 29.10 ± 4.50 CG = 29.10 ± 4.50 |
11th–12th | EG = Aerobic activities (water) CG = Aerobic activities (land) |
EG = 28–29/1/60 CG = 28–29/1/60 |
EG = 68.75% CG = 67.68% |
Aerobic activities (Water) decreased low back pain related to pregnancy (p = 0.04) and sick leave (p = 0.03) more than a physical exercise program on land. Water exercises are recommended for pregnant women. | Pregnancy-related pelvic girdle pain (PLBP) Pregnancy-related low back pain (PPP) |
Rodríguez-Blanque et al. [25] | Analyze the influence of a physical activity program in the aquatic environment on the newborn weight | EG = 65 CG = 64 |
EG = 34.52 ± 4.50 CG = 33.67 ± 5.37 |
20th–37th | EG = Aerobic and resistance activities-SWEP—(water) CG = Routine prenatal care |
EG = 17/3/60 CG = NR |
EG = 91.42%; CG = 92.85% |
The aerobic and resistance activities-SWEP—(Water) doesn’t present birth risks premature and gestation time is not altered. The SWEP has achieved a significant decrease in the weight of the newborn and a lower weight gain during pregnancy. | BMI (Formula QUETELET) Perception of effort (Borg scale) Heart Rate Monitor (Quirumed OXYM2000, London, UK) |
Rodríguez-Blanque et al. [26] | Determine if there is an association between physical activity in the aquatic environment and sleep quality in pregnant women. | EG = 65 CG = 64 |
EG = 32.12 ± 4.43 CG = 30.58 ± 4.75 |
20th–37th | EG = Aerobic and resistance activities-SWEP—(water) CG = Routine prenatal care |
EG = 17/3/60 CG = NR |
EG = 91.42%; CG = 92.85% |
The SWEP methodology improves sleep quality, both subjectively and in terms of latency, duration and efficiency. | Evaluate BMI (Formula QUETELET) Perception of Effort (Borg scale) Heart Rate Monitor (Quirumed OXYM2000, London, UK) Evaluate self-perception (Pittsburgh Sleep Quality Index PSQI) |
Rodríguez-Blanque et al. [27] | Determine the effect of a water exercise program on the rate of perineum intact after delivery. | EG = 65 CG = 64 |
EG = 32.12 ± 4.43 CG = 30.58 ± 4.75 |
20th–37th | EG = Aerobic and resistance activities-SWEP—(water) CG = Routine prenatal care |
EG = 17/3/60 CG = NR |
EG = 92.82%; CG = 91.40% |
The women who followed the SWEP methodology were significantly more likely to have intact perinea after childbirth. | Physical activity level (Global Physical Activity Questionnaire, GPAQ) Perception of effort (Borg scale) |
Rodríguez-Blanque et al. [28] | Determine the duration of labor in pregnant women who completed a program of moderate physical exercise in water and subsequently presented eutocic birth. | EG = 65 CG = 64 |
EG = 32.12 ± 4.43 CG = 30.58 ± 4.75 |
20th–37th | EG = Aerobic and resistance activities-SWEP—(Water) CG = Routine Prenatal Care |
EG = 17/3/60 CG = NR |
EG = 92.82%; CG = 91.40% |
Women who exercised in water during pregnancy have a shorter duration of labor than those who did not. The difference was especially marked with respect to the duration of the first and second stages of labor (p < 0.001). | Perception of effort (Borg scale) Heart rate monitor (Quirumed OXYM2000) Total duration (minutes) of labor (Ad hoc questionnaire) |
Sánchez García et al. [29] | Analyze the evolution of weight, gestational and postpartum, in pregnant women who perform an aquatic program. | EG = 65 CG = 64 |
EG = 32.12 ± 4.43 CG = 30.58 ± 4.75 |
20th–37th | EG = Aerobic and resistance activities-SWEP—(water) CG = Routine prenatal care |
EG = 17/3/60 CG: NR |
EG = 93.84%; CG = 90.60% |
The SWEP methodology during pregnancy helps to control gestational weight gain and weight recovery before pregnancy. | Body weight (calibrated scale) Height (calibrated metal rod) BMI (Formula QUETELET) Physical activity level (Global Physical Activity Questionnaire, GPAQ) Perception of effort (Borg scale) |
Sillero et al. [30] | Analyze the effect of two physical activities on skin temperature in women 31 weeks pregnant. | EG = 14 CG = 14 |
EG = NR CG = NR |
31st | EG = Swimming; CG = Yoga |
EG = NR CG = NR |
EG = 100%; CG = 100% |
Significant reduction in skin temperature of pregnant mothers after aquatic activity, in the areas of the mother and belly, in case of an inadequate water temperature. Tsk values are not dangerous for the fetus. | Thermograms (T335FLIR infrared camera) |
Smith and Michel. [31] | Evaluate the impact of a water exercise program on the perception of body image, participation in health behaviors, participation in health promotion, level of physical discomfort and mobility. | EG = 20 CG = 20 |
EG = 25.10 ± 4.90 CG = 24.80 ± 5.60 |
19th | EG = Calisthenics exercise (water); CG = Normal activity of daily living |
EG = 6/3/60 CG = NR |
EG = 100%; CG = 100% |
Water exercise can improve physical functioning, decrease maternal discomfort, improvement of the maternal body and improve health behaviors. | Body image (Prenancy Body shape Questionnaire, PBSQ) Effects of aquatic exercise (Pender’s Health Promotion Lifestyle Profile (HPLP)). Mobility (timed get up and go test) Physical discomfort (Smith’s Prenancy Discomfort Intensity Index (SPDII)) |
Vallim et al. [32] | Analyze the quality of life (QOL) in sedentary pregnant women through aerobic physical exercises in water | EG = 31 CG = 35 |
EG = 26 CG = 24 |
28th–36th | EG = Aerobic activities (Water) CG = Routine prenatal care |
EG = 28–36/3/50 CG: NR |
EG = 64.52% CG = 65.72% |
The majority had eight or more years of schooling: 52% (EG) and 83% (CG), this difference being statistically significant (p = 0.0065). | Quality of life (Questionnaire WHOQOL-BREF) |
Vázquez-Lara et al. [33] | Examine the effect of physical activity in the aquatic environment on hemodynamic constants in pregnant women. | EG = 18 EC = 28 |
EG = 31.0 ± 4.6 CG = 29.5 ± 6.1 |
25th–27th | EG = Calisthenics exercise AEPPW (water) CG = Routine prenatal care |
EG: 6/2/45 CG: NR |
EG = 90% CG = 100% |
An aquatic exercise programme for pregnant women (AEPPW), contributes to the hydrosaline balance, preventing the excessive increase in the usual plasma volume (p < 0.010), increasing the secretion of sodium (0.050) and reducing the arterial pressures (p < 0.050) | Blood pressure monitor (Riester, Jungingen, Germany), Calculate plasma volume (Dill y Costill’s) Blood and urine test Heart rate monitor (Polar F4, Kempele Finland)) |
Reference | Eligibility Criteria * |
Random Allocation |
Concealed Allocation |
Groups Similar at Baseline | Blind Participant |
Blind Therapist |
Blind Assessor |
Follow-Up | Intention to Treat Analysis |
Between-Group Comparisons |
Point Measure and Variability |
PEDro Score Total |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Aguilar-Cordero et al. [17] | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 5 |
Bacchi et al. [18] | 0 | 1 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 5 |
Bacchi et al. [19] | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 10 |
Barakat et al. [20] | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 6 |
Barakat et al. [21] | 0 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 5 |
Cordero et al. [22] | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 4 |
Cordero et al. [23] | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 1 | 0 | 1 | 1 | 7 |
Granath et al. [24] | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 4 |
Rodríguez-Blanque et al. [25] | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 5 |
Rodríguez-Blanque., et al. [26] | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 5 |
Rodríguez-Blanque et al. [27] | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 5 |
Rodríguez-Blanque et al. [28] | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 5 |
Sánchez García et al. [29] | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 6 |
Sillero et al. [30] | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 3 |
Smith and Michel [31] | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 3 |
Vallim et al. [32] | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 3 |
Vázquez-Lara et al. [33] | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 5 |