产后妇女体适能训练指引详解.ppt

PostNatalFitnessGuidelines产后妇女体适能训练指引,AASFPFitnessSpecialist(PersonalTraining),Presentedby:,PRENATALFITNESS产前体适能,Introduction胎儿和子宫介绍,ProposedBenefitsofExerciseDuringPregnancy孕期训练的益处,Cardiovascular心肺系统方面Increaseormaintainaerobicfitness提高或保持有氧体适能水平Increasecardiopulmonaryreserve提高心肺储备Possibilitytoreducetheriskofhypertension减少高血压的危险Musculoskeletal骨骼肌肉方面Promotegoodposture促进好的身体姿态Improveand/ormaintainmusclestrengthandtone提高和/或保持肌肉力量和线条Preventand/orhelptoreducelowbackpain防止和/或帮助减少腰背痛Maintainorimprovepelvicfloorintegrityandrecovery保持或促进骨盆底部肌肉的完整和恢复,Hormonal荷尔蒙方面Reducetheriskofgestationaldiabetes降低妊娠期糖尿病的危险Labour分娩方面Possiblyexperienceaneasierorshorterlabour?有可能帮助顺产或减短分娩时间？Promotefasterrecoveryfromlabourandpregnancy加快产后恢复Reducepostdatedeliveries减少晚于预产期的情况Reducefetaldistress降低胎儿窘迫症的发生?Biggerplacenta增大胎盘？,General综合方面Preventexcessive“fatgain”防止过量获得脂肪Improvepsychologicalaspectsofpregnancyandreducepostpartumdepression孕妇心理方面的帮助以及减少产后心情消沉Improvesleep增进睡眠Aiddigestionandreduceconstipation帮助消化，减少便秘,Cardiovascular/RespiratoryIssues心肺/呼吸系统相关事宜,PregnancyRelatedCardiovascularexregularly;shorterdurationandlesserintensity)频率（避免高强度运动；经常运动；减少训练时间和降低强度）Intensity(140bpm;avoidanaerobicworkouts,exhaustiveex;monitoring;RPE15强度（心率140；避免无氧运动/力竭运动；进行监测；RPEloads建议进行大肌肉群的力量训练，重点主要放在训练技巧上，而不是负重多少Strengthenweakmuscles(e.g.)andstretchtightmuscles(e.g.)训练无力的肌肉（如：）拉伸紧张的肌肉（如：）Useappropriatesupportwhennecessary需要的时候进行适当的支持,Encourageswimmingorwateraerobics(reducestressonthejointsandaidsedema)建议进行游泳训练或水中有氧运动（可以减少对于关节的压力和帮助减轻水肿）AvoidValsalvamaneuver避免捏鼻闭嘴呼气法Consultwithphysiotherapistandreferanywomenwithchronicachesandpains如果有慢性的周身疼痛，需要与医生沟通Nodatashowsthatexerciseincreasetheriskofinjury没有数据表明训练会增加受伤的危险,Thermoregulation体温调节,PregnancyRelatedChangesthatAffectExercise孕期身体改变对运动的影响,Increaseinbasalmetabolicrate(BMR)increaseinheatproduction基础代谢率（BMR）提高产生热量增多Fluidloss水分流失,PotentialProblemsdrinkoneglassevery15min训练前，中，后都要补充水分；每15分钟喝一杯水DONOTexercisewithafever发烧时不能运动,ExercisePrescription训练处方,1.Medicalscreeningbeforeexercise运动前进行医务检查History:overallhealth,obstetric(e.g.maternalage,previouslowbirthweighthistory,shortintervalbetweenbirths)avoidfatigue;expectsomeweightgain;RPE;usecommonsense)（尿液颜色；避免疲劳；体重增加；自觉运动强度表（RPE）；运用常识判断）,RecommendationsforSportActivitiesDuringPregnancy(ACOG,1994)孕期运动建议,ActivitiestoEncourage建议运动,Walking步行Stationarycycling固定自行车Low-impactaerobics低冲击有氧运动Swimming游泳,ActivitiestoDiscourage不建议的运动,Contactsports(increasedriskofabdominaltrauma)有身体碰撞的运动（增加腹部外伤危险）Hockey(fieldandice)曲棍球（野外和冰上）Boxing拳击Football橄榄球Soccer足球High-risksports(increasedpotentialforfalls/trauma)高危险的运动（增加摔倒/外伤的危险）GymnasticsHorsebackriding体操、马术Skating溜冰Skiing(snowandwater)滑雪和滑水Hanggliding滑翔Vigorousracquetsports剧烈球类运动Weightlifting举重Scubadiving潜水,Guideline指引,1.Precautions注意事项,Avoidmoderatelystrenuousactivitiesifthereisvaginalbleedingorsorenessofepisiotomy如果阴道出血或由于外阴切开术疼痛，要避免进行中等强度的训练Stopexercisingifvaginalbleedingincreasesorbrightredbloodappears如果阴道出血增加或出现鲜红色血液要停止运动Avoidwatersportsifpersistentdischargeandunhealedepisiotomy;typicalrecommendation4weeks.如果持续流血和外阴切开术没有痊愈要避免水中运动，一般建议周Useallpre-pregnancyprecautionsregardingmusculoskeletalrisks在骨骼肌肉方面的危险同产前注意事项Avoidfatigueanddehydration避免疲劳和脱水Gradualprogressionofexercise运动循序渐进,2.NutritionandWeightLoss营养和降低体重,Followgeneralweightlossguidelines根据一般降低体重的指引Mayhaveextraweightlossbyincreasedenergyoutputduetomilkproductionordecreasededema由于乳汁分泌或水肿使能量消耗增多会额外减少体重Extra300-400kcal/dayforthefirst3monthsofbreast-feeding母乳喂养首个月每日会额外消耗300-400卡路里8-12glassesoffluid(avoidcaffeine)补充8-12杯水（避免含有咖啡因的饮料）Severecaloricrestrictionwilldecreasemilkproduction严重卡路里摄入不足会减少乳汁分泌,RectusDiastasis腹直肌分离,3.MusculoskeletalIssuesandExercise骨骼肌肉相关事宜和训练,3.MusculoskeletalIssuesandExercise骨骼肌肉相关事宜和训练,AbdominaldiastasisandTrAexercise腹肌分离和腹横肌训练(Sheppard,1996),BeforeTrAexercise(60mm)腹横肌训练前(60mm),AfterTrAexercise(7mm)腹横肌训练后(7mm),15weeks周,3.MusculoskeletalIssuesandExercise骨骼肌肉相关事宜和训练,Performpelvicfloorexerciseswithin24hoursafterdelivery产后24小时内进行骨盆底部肌肉的训练Thepelvicfloorisaslingofmusclesthatsupporttheintestines,uterus,bowel,andbladder.Theyareveryimportantinclosingthebladderandbowelopenings,hencepreventingunwantedleakages.骨盆底部肌肉是可以支持肠，子宫，大肠和膀胱的肌肉。它们对于合拢膀胱和大肠开口非常重要，可以预防不自觉漏出排泄物Duringavaginaldeliverytheyarestretchedbythepassageofthebabythroughthebirthcanal.Episiotomyortearingresultsinfurtherdamagetothesemuscles.在生产时由于胎儿经过阴道会使肌肉拉伸。外阴切开术或肌肉撕裂在将来会对这些产生破坏作用,ThePelvicFloorMuscles骨盆底部肌肉,HowtoDoPelvicFloorExercise1如何训练骨盆底部肌肉1,Position:Startinlyingonyourback,sideorfrontandprogresslatertostanding,straddlingachairthensquatting.姿势：开始以仰卧，侧卧或俯卧，逐渐进阶到站立，跨骑在椅子上，最后到蹲举姿势Imaginethatyouaretryingtostopyourselffrompassingwindandatthesametimetryingtostopyourflowofurinemidstream;thefeelingisoneofsqueezeandlift,closinganddrawingupbothfrontandbackpassages.想象你试图憋屁同时憋尿；是夹紧和上提的感觉，关闭和上提前和后的通路Whenyouaredoingthisyoushouldnotholdyourbreath,orsqueezeyourbottomorthighstogetherbuttrytorelaxandbreathenormally做时不要憋气，不要夹紧臀部或大腿，反而要放松和自然的呼吸.,HowtoDoPelvicFloorExercise2如何进行骨盆底部肌肉的训练2,Tocheckthefeelingofyourpelvicfloormusclesworking,trystoppingtheflowofurinenexttimeyougotothetoilet.Remember,youwontbeabletostopitcompletelyatfirst.Onceyouarefamiliarwiththesensationtrytopracticeitatothertimes.在想上厕所时憋住尿，可以体会到骨盆底部肌肉收缩的感觉。记住，你在第一次时不会完全憋住。多做练习直到熟悉这种感觉下次就会好很多,HowtoDoPelvicFloorExercise3如何进行骨盆底部肌肉的训练3,Therearetwowaystodothisexercise:有两种方式进行这个练习：ForStrengthening=Quickly,asrepeatedsqueezingandrelaxingofthemuscles.强化力量快速，重复收紧和放松这些肌肉ForEndurance=Slowly,sothatyousqueezethepelvicfloormusclesupslowly,holdthecontractionforaslongasyoucan(keepbreathing!)thenrelaxslowly.提高耐力慢速，慢些夹紧骨盆底部肌肉，尽可能保持这种收缩（保持呼吸），然后慢慢放松,HowtoDoPelvicFloorExercise4如何训练骨盆底部肌肉-4,Toprogresstheendurancecapacityofthesemusclesimaginethatyourpelvicfloorisaliftinaliftshaft.Whenyouarenotconsciouslycontractingthemuscles,itisatgroundfloor.逐渐提高这些肌肉的耐力，想象你的骨盆底部肌肉是上升的电梯。当你不能持续收紧这些肌肉，就好像电梯下到底层一样Trytocontractalittlebitandraisethe“lift”tothefirstfloor,thenalittlemoretothesecondfloorandthentothethirdfloor.Whenyouhavesqueezedasmuchasyoucan,holditthereforaslongasyoucankeepingbreathing!试图收紧多一些，将电梯升高到1楼，再多一些来到2楼，然后再到三楼。尽可能多的夹紧，能保持多久就多久，不要忘记呼吸！Now,taketheliftbackslowlytothesecondfloor,thentothefirstfloorandthentoground.Goingdownismuchharderthangoingup!现在，慢慢将电梯下降到2楼，然后到1楼，然后到底层。向下降比向上升会感觉更困难！,HowtoDoPelvicFloorExercise5如何训练骨盆底部肌肉训练-5,Strength:力量OnMonday,WednesdayandFriday周一，周三和周五8-12maximaleffortcontractions8-12次最大力量收缩Hold5secondseach每次保持5秒Repeat3timesaday每天重复3次Endurance:耐力OnTuesday,ThursdayandSaturday周二，周四和周六Liftandholdaslongaspossible尽可能上提并且保持Rest5secondsbetweeneach每次之间休息5秒Repeat4times重复4次Rest2minutes休息2分钟Reapeat重复,HowtoDoPelvicFloorExercise6如何训练骨盆底部肌肉-6,Ifyoufeelintheearlydays