Gebelik Döneminde Egzersiz Eğitiminin Gövde Stabilizatör Kas Kalınlığı, Fonksiyonellik ve Yaşam Kalitesi Üzerine Etkileri

Abstract

Üzelpasacı, E. The Effects of Exercise Training on Trunk Stabilizer Muscle Thickness, Functionality and Quality of Life During Pregnancy, Hacettepe University, Graduate School of Health Sciences, Physical Therapy and Rehabilitation Program, PhD Thesis, Ankara, 2021. The aim of this study was to investigate of the effects of long an exercise program (LEP) based on core stabilization and a short exercise program (SEP) on the transversus abdominis, rectus abdominis, external and internal oblique muscles and diaphragm muscle thickness, which are known as important muscles in core stabilization, functionality and quality of life. 32 pregnant women (LEP=16, SEP=16) completed this study. In this study; transversus abdominis, rectus abdominis, external and internal oblique muscles and diaphragm muscle thickness were determined by ultrasound imaging method; functional capacity was determined by the 6-minute walk test, physical activity level was determined by the Pregnancy Physical Activity Questionnaire, the severity of low back pain and functionality was determined by the Visual Analogue Scale and Oswestry Disability Questionnaire, and the quality of life was determined by the Short Form-36 Quality of Life Questionnaire. All outcome measures were evaluated at 16 (baseline), at 24 and 32 weeks of pregnancy. Starting from the 16th week of pregnancy to the 32nd week, for 16 weeks, 2 days a week, under the supervision of a physiotherapist, a stabilization-based exercise program consisting of posture training, upper extremity, lower extremity, abdominal and pelvic floor strengthening and breathing exercises was applied to the pregnant women by progressing modified. During the warm-up, loading and cool-down, While LEP consists of a total 20 different exercises; SEP consists of 9 different exercises. Both groups were advised to walk as an aerobic modarate exercise for 30 minutes, 3 days a week. In the intergroup comparison; there was no difference in abdominal and diaphragm muscle thickness at 24th and 32nd weeks of pregnancy (p>0.05). According to the results obtained at the 24th week of pregnancy, emotional role limitation and pain sub-dimension scores of health-related quality of life, 6-minute walking test distance, occupational physical activity level were found to be significantly higher in LEP (p<0.05). In the 32nd week of pregnancy, 6 minutes walking test distance and occupational physical activity level were found to be significantly higher in LEP (p<0.05). When the changes within the group are examined; in LEP, rectus abdominis and bilateral diaphragm muscle thickness, moderate intensity and sports/exercise physical activity level and quality of life related to energy/vitality and emotional well-being; on the other hand, in SEP, unilateral diaphragm muscle thickness, sports/exercise physical activity level and quality of life related to energy/vitality was improved significantly (p<0.05). As a result; while there was no superiority between exercise groups in terms of abdominal muscles and diaphragm muscle thickness; an increase was observed in the rectus abdominis and bilateral diaphragm muscle thickness in LEP, and in the unilateral diaphragm muscle thickness in SEP, despite progressing pregnancy over time. LEP is more effective in terms of increasing functional capacity, occupational physical activity level emotinal role limitation and pain-related quality of life in the short term and is more effective in terms of increasing functional capacity and occupational physical activity level in the long term than SEP.

Key words: pregnancy, exercise, abdominal muscle thickness, functionality, quality of life.