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NDIP LUCRECE EVANDI
(BSc: PHYSIOTHERAPY)
Supervised By:
Prof. ATANGA MARY
REPUBLIQUE DU CAMEROUN
PAIX-TRAVAIL-PATRIE
MINISTERE DE L’ENSEIGNEMENT SUPERIEUR
UNIVERSITE DE BAMENDA
FACULTE DES SCIENCES DE LA SANTE
PAIX-TRAVAIL-PATRIE
MINISTERE DE L’ENSEIGNEMENT SUPERIEUR
UNIVERSITE DE BAMENDA
FACULTE DES SCIENCES DE LA SANTE
APPLICATION OF HEALTHY PHYSICAL ACTIVITY BY PREGNANT
WOMEN IN THE SANTA HEALTH DISTRICT
2
2
Presentation Plan
1. Introduction
2. Problem Statement
3. Research Questions
4. Objectives
5. Methodology
3
3
Introduction
• Physical activity defined as any body movement produced by skeletal
muscles [1] that results in energy expenditure is recommended for pregnant
women regularly for the well being of the mother and developing child [1]
• The ACOG recommends that low-impact or moderate exercise for 30 minutes
on most days of the week, helps with weight management, reduced risk of
gestational diabetes mellitus (GDM), and improved psychological well-being
[1,9].
4
4
Introduction
• Studies reported that antenatal care (ANC) that included exercise
programs have an impact on the major preventable causes of fetal ill
health, infant death, shape trends of mortality, and morbidity among the
women population [9].
• Also, physical activity has been reported to help maintain
cardiorespiratory fitness levels throughout pregnancy and facilitation
of postpartum recovery [3].
5
5
INTRODUCTION
• Global maternal mortality remains high worldwide as in 2017, about
295 000 women died during and following pregnancy and childbirth
with the majority of these deaths (94%) occurring in low-resource
settings, most of which could have been prevented.
• Sub-Saharan Africa alone accounted for roughly two-thirds (196 000) of
maternal deaths [8
6
6
PROBLEM STATEMENT
2.What are the perceptions and beliefs of type 2 diabetics with regards to their choice of management
of type 2 diabetes in Bamenda III Health District?
1.What proportion of patients use herbal remedies and orthodox to
manage type 2 diabetes in Bamenda III Health District?
• Despite the clear guidelines and recommendations set by various
bodies and institutions and the multiple benefits for mother and child
during pregnancy, labour and post- partum, achieving sufficient levels
of PA and exercise remains a global challenge, not only to the general
population in Africa, but specifically to the population group of
pregnant women [2, 3, 5].
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7
RESEARCH QUESTIONS
• 1-Do pregnant women know about the recommended PA in pregnancy?
• 2-How do pregnant women perceive PA in pregnancy?
• 3- How often do pregnant women engage in PA during pregnancy?
• 4- What are some barriers to engaging in PA in pregnancy?
8
8
Objectives
MAIN OBJECTIVE
• Main Objective
• To assess the application of healthy physical activity by pregnant women in the
Santa Health District.
• Specific Objectives
• 1- To appraise the knowledge of pregnant women on physical activity during
pregnancy.
• 2- To establish the perception of pregnant on physical activity in pregnancy.
• 3- To assess the application of physical activity level of pregnant women in the
Santa Health District.
• 4- To identify the barriers if any to practicing physical activity during pregnancy.
9
9
Methodology
• Study site: Santa Health District
• Duration: This study was carried out from the June - September 2022.
• Study design: Hospital based cross-sectional study.
• Study population: Pregnant women attending ANC in the Santa Health
District.
• Sample size and sample technique: Using the Cochran’s formula, a total of
339 participants were enrolled for this study through a non probability
consecutive sampling technique.
10
10
Methodology
Inclusion criteria
• All pregnant women attending ANC
Exclusion criteria
• All women with pregnancy complications
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11
Methodology
Ethical consideration:
• Ethical clearance was obtained from the Institutional Review Board
(IRB) of the University of Bamenda.
• Administrative authorization was gotten from the regional delegate of
public health.
• Only consenting patients were included in this study after a detailed
explanation of the study were given to their satisfaction
12
12
Methodology
Data collection
• All data was taken in the hospital
• A semi-structured and standardized pregnancy physical activity
questionnaire which was modified to fit our setting was used to collect
data [48].
13
13
Methodology
Data collection
• The questionnaire collected self reported information on age, gender,
educational status, profession, etc
• A total of 340 questionnaire were administered and 250 analysed due to a
lot of missing information from participants
14
14
Methodology
Statistical Analysis
• Data for this study was analyzed using SPSS for windows version 26.
• Data cleaning was done by running frequency tables and all
inconsistency and errors in data were corrected.
• Participants Socio demographic data were presented using frequency
distribution tables.
15
15
• Logistic regression was used to assess statistical association and
significance of statistical association was assured or tested using 95%
confidence interval and P value (< .05).
• Descriptive statistics was used to characterize the sample.
• The intensity of each activity was estimated using 2011 compendium-
based metabolic equivalent (MET) values [48] to determine if they met
the recommended 150 minutes of exercise or not.
Methodology
16
16
RESULTS AND DISCUSSION
Variables Frequency
(n)
Percentage
(%)
15-24years 129 37.2%
25-34years 159 45.8%
35-44years 54 15.6%
>45 5 1.4%
Awing Health area 68 19.6%
Menkah health area 128 36.9%
Santa health area 151 43.5%
Civil servant 34 11.1%
Trader 102 33.3%
professional 39 12.7%
farming 131 42.8%
No formal education 35 10.8%
primary 79 24.4%
secondary 151 46.6%
tertiary 59 18.2%
1st trimester 80 23.6%
2nd trimester 172 50.7%
3rd trimester 87 25.7%
<50,000frs 0 0.0%
50,000-100,000frs 56 65.1%
100,000-200,000frs 8 9.3%
>200,000frs 22 25.6%
Christain 321 95.3%
muslim 12 3.6%
Others 4 1.2%
Single 85 27.9%
Married 180 59.0%
Divorced 15 4.9%
Widowed 12 3.9%
Cohabiting 13 4.3%
1 121 35.6%
2 126 37.1%
3 62 18.2%
16
17
17
Table 2: Awareness of physical exercise during pregnancy
Questions
Frequency
(n)
Percentage
(%)
Awareness about physical exercise during pregnancy
Yes 288 83.0%
No 59 17.0%
Practice physical exercise before pregnancy
Yes 231 69.0%
No 101 30.1%
11 3 0.9%
Source of information on physical exercise during pregnancy
ANC visit 249 86.5%
Family 25 8.7%
others 14 4.9%
Trimester when physical exercise started?
1st trimester 131 47.3%
2nd trimester 95 34.3%
3rd trimester 51 18.4%
17
18
18
Table 4: Perception of exercise during pregnancy
Questions
Frequency
(n)
Percentage
(%)
Exercise limits pregnancy weight gain
Yes 260 74.9%
No 87 25.1%
Exercise reduces lower limb edema
Yes 288 83.0%
No 59 17.0%
who never exercise can start during pregnancy
Yes 282 81.3%
No 65 18.7%
Reduces medical intervention during labour
Yes 268 77.7%
No 75 21.7%
22 2 0.6%
Increases the risk of musculoskeletal injury
Yes 160 46.4%
No 185 53.6%
Women who exercised before can continue
Yes 275 79.7%
No 70 20.3%
Decreases the risk of preterm delivery
Yes 278 80.6%
No 67 19.4%
Exercise is same as working at home/work
Yes 296 85.8%
No 49 14.2%
Increases energy
Yes 298 86.4%
No 47 13.6%
Do you think exercise if good for you and your baby
Yes 336 97.4%
No 9 2.6%
18
19
19
Figure. 2Physical activity Levels of pregnant women
19
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
45.0%
50.0%
Light intensity moderate intensity Vigorous intensity
49.9%
41.0%
9.0%
20
20
Figure. 3 Energy expenditure by type of activity
20
0
10
20
30
40
50
60
70
80
Household activities Occupational activities Sport Activities
Type of physical activity
Expenditure per week
21
21
Physical Activity Level
Chi Square P Value
Light activity Moderate Activity Vigorous activity
N (%) N (%) N (%)
Age
15-24years 71(40.3%) 94(40.7% 22(43.1%
4.925 0.220
25-34years 89(50.6%) 103(44.6% 24(47.1%
35-44years 16(9.1%) 31(13.4% 5(9.8%
>45 0(0.0%) 3(1.3% 0(0.0%
Health Area
Awing Health area 8(4.5%) 46(19.9% 28(54.9%
55.005 0.000*
Menkah health area 105(59.7%) 108(46.8% 3(5.9%
Santa health area 63(35.8%) 77(33.3% 20(39.2%
Occupation
Civil servant 21(12.7%) 19(9.0% 2(4.1%
14.347 0.001*
trader 63(38.2%) 78(36.8% 8(16.3%
professional 19(11.5%) 17(8.0% 7(14.3%
farming 62(37.6%) 98(46.2% 32(65.3%
retired 0(0.0%) 0(0.0% 0(0.0%
Level of Education
No formal education 5(3.0%) 18(8.2% 7(15.6%
12.884 0.048*
primary 28(16.7%) 51(23.3% 17(37.8%
secondary 93(55.4%) 110(50.2% 16(35.6%
tertiary 42(25.0%) 40(18.3% 5(11.1%
Trimester
1st trimester 33(18.8%) 46(20.4% 4(7.8%
10.642 0.021*
2nd trimester 106(60.2%) 135(59.7% 34(66.7%
3rd trimester 37(21.0%) 45(19.9% 13(25.5%
Marital status
Christian 168(95.5%) 223(96.5% 51(100.0%
4.598 0.205
Muslim 4(2.3%) 4(1.7% 0(0.0%
Others 4(2.3%) 4(1.7% 0(0.0%
Single 49(31.4%) 68(32.4% 17(34.7%
21
22
22
22
86.10%
78.70%
66.20%
64.60%
43.10%
29.40%
22.30%
19.60%
0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00% 100.00%
Stressful
Fear of miscarriage
No orientation or Instructor
No Time
Religious Belief
No access to facilities
I don’t see the importance
Culture Barriers
23
23
References
• Gronwald T, Budde H. Commentary: Physical Exercise as Personalized
Medicine for Dementia Prevention?. Front Physiol. 2019;10:1358.
Published 2019 Oct 31. doi:10.3389/fphys.2019.01358
• Physical Activity and Exercise During Pregnancy and the Postpartum
Period: ACOG Committee Opinion, Number 804. Obstet Gynecol.
2020;135(4):e178-e188. doi:10.1097/AOG.0000000000003772.
• Okafor, U.B., Goon, D.T. Physical activity and exercise during pregnancy
in Africa: a review of the literature. BMC Pregnancy Childbirth 20, 732
2020. https://doi.org/10.1186/s12884-020-03439-0
• American College of Obstetricians and Gynaecologists. Physical activity
and exercise during pregnancy and the postpartum period. Committee
Opinion No 650 Obstetr Gynaecol. 2017;126:e135–42.
24

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pre defense ppt.pptx

  • 1. 1 NDIP LUCRECE EVANDI (BSc: PHYSIOTHERAPY) Supervised By: Prof. ATANGA MARY REPUBLIQUE DU CAMEROUN PAIX-TRAVAIL-PATRIE MINISTERE DE L’ENSEIGNEMENT SUPERIEUR UNIVERSITE DE BAMENDA FACULTE DES SCIENCES DE LA SANTE PAIX-TRAVAIL-PATRIE MINISTERE DE L’ENSEIGNEMENT SUPERIEUR UNIVERSITE DE BAMENDA FACULTE DES SCIENCES DE LA SANTE APPLICATION OF HEALTHY PHYSICAL ACTIVITY BY PREGNANT WOMEN IN THE SANTA HEALTH DISTRICT
  • 2. 2 2 Presentation Plan 1. Introduction 2. Problem Statement 3. Research Questions 4. Objectives 5. Methodology
  • 3. 3 3 Introduction • Physical activity defined as any body movement produced by skeletal muscles [1] that results in energy expenditure is recommended for pregnant women regularly for the well being of the mother and developing child [1] • The ACOG recommends that low-impact or moderate exercise for 30 minutes on most days of the week, helps with weight management, reduced risk of gestational diabetes mellitus (GDM), and improved psychological well-being [1,9].
  • 4. 4 4 Introduction • Studies reported that antenatal care (ANC) that included exercise programs have an impact on the major preventable causes of fetal ill health, infant death, shape trends of mortality, and morbidity among the women population [9]. • Also, physical activity has been reported to help maintain cardiorespiratory fitness levels throughout pregnancy and facilitation of postpartum recovery [3].
  • 5. 5 5 INTRODUCTION • Global maternal mortality remains high worldwide as in 2017, about 295 000 women died during and following pregnancy and childbirth with the majority of these deaths (94%) occurring in low-resource settings, most of which could have been prevented. • Sub-Saharan Africa alone accounted for roughly two-thirds (196 000) of maternal deaths [8
  • 6. 6 6 PROBLEM STATEMENT 2.What are the perceptions and beliefs of type 2 diabetics with regards to their choice of management of type 2 diabetes in Bamenda III Health District? 1.What proportion of patients use herbal remedies and orthodox to manage type 2 diabetes in Bamenda III Health District? • Despite the clear guidelines and recommendations set by various bodies and institutions and the multiple benefits for mother and child during pregnancy, labour and post- partum, achieving sufficient levels of PA and exercise remains a global challenge, not only to the general population in Africa, but specifically to the population group of pregnant women [2, 3, 5].
  • 7. 7 7 RESEARCH QUESTIONS • 1-Do pregnant women know about the recommended PA in pregnancy? • 2-How do pregnant women perceive PA in pregnancy? • 3- How often do pregnant women engage in PA during pregnancy? • 4- What are some barriers to engaging in PA in pregnancy?
  • 8. 8 8 Objectives MAIN OBJECTIVE • Main Objective • To assess the application of healthy physical activity by pregnant women in the Santa Health District. • Specific Objectives • 1- To appraise the knowledge of pregnant women on physical activity during pregnancy. • 2- To establish the perception of pregnant on physical activity in pregnancy. • 3- To assess the application of physical activity level of pregnant women in the Santa Health District. • 4- To identify the barriers if any to practicing physical activity during pregnancy.
  • 9. 9 9 Methodology • Study site: Santa Health District • Duration: This study was carried out from the June - September 2022. • Study design: Hospital based cross-sectional study. • Study population: Pregnant women attending ANC in the Santa Health District. • Sample size and sample technique: Using the Cochran’s formula, a total of 339 participants were enrolled for this study through a non probability consecutive sampling technique.
  • 10. 10 10 Methodology Inclusion criteria • All pregnant women attending ANC Exclusion criteria • All women with pregnancy complications
  • 11. 11 11 Methodology Ethical consideration: • Ethical clearance was obtained from the Institutional Review Board (IRB) of the University of Bamenda. • Administrative authorization was gotten from the regional delegate of public health. • Only consenting patients were included in this study after a detailed explanation of the study were given to their satisfaction
  • 12. 12 12 Methodology Data collection • All data was taken in the hospital • A semi-structured and standardized pregnancy physical activity questionnaire which was modified to fit our setting was used to collect data [48].
  • 13. 13 13 Methodology Data collection • The questionnaire collected self reported information on age, gender, educational status, profession, etc • A total of 340 questionnaire were administered and 250 analysed due to a lot of missing information from participants
  • 14. 14 14 Methodology Statistical Analysis • Data for this study was analyzed using SPSS for windows version 26. • Data cleaning was done by running frequency tables and all inconsistency and errors in data were corrected. • Participants Socio demographic data were presented using frequency distribution tables.
  • 15. 15 15 • Logistic regression was used to assess statistical association and significance of statistical association was assured or tested using 95% confidence interval and P value (< .05). • Descriptive statistics was used to characterize the sample. • The intensity of each activity was estimated using 2011 compendium- based metabolic equivalent (MET) values [48] to determine if they met the recommended 150 minutes of exercise or not. Methodology
  • 16. 16 16 RESULTS AND DISCUSSION Variables Frequency (n) Percentage (%) 15-24years 129 37.2% 25-34years 159 45.8% 35-44years 54 15.6% >45 5 1.4% Awing Health area 68 19.6% Menkah health area 128 36.9% Santa health area 151 43.5% Civil servant 34 11.1% Trader 102 33.3% professional 39 12.7% farming 131 42.8% No formal education 35 10.8% primary 79 24.4% secondary 151 46.6% tertiary 59 18.2% 1st trimester 80 23.6% 2nd trimester 172 50.7% 3rd trimester 87 25.7% <50,000frs 0 0.0% 50,000-100,000frs 56 65.1% 100,000-200,000frs 8 9.3% >200,000frs 22 25.6% Christain 321 95.3% muslim 12 3.6% Others 4 1.2% Single 85 27.9% Married 180 59.0% Divorced 15 4.9% Widowed 12 3.9% Cohabiting 13 4.3% 1 121 35.6% 2 126 37.1% 3 62 18.2% 16
  • 17. 17 17 Table 2: Awareness of physical exercise during pregnancy Questions Frequency (n) Percentage (%) Awareness about physical exercise during pregnancy Yes 288 83.0% No 59 17.0% Practice physical exercise before pregnancy Yes 231 69.0% No 101 30.1% 11 3 0.9% Source of information on physical exercise during pregnancy ANC visit 249 86.5% Family 25 8.7% others 14 4.9% Trimester when physical exercise started? 1st trimester 131 47.3% 2nd trimester 95 34.3% 3rd trimester 51 18.4% 17
  • 18. 18 18 Table 4: Perception of exercise during pregnancy Questions Frequency (n) Percentage (%) Exercise limits pregnancy weight gain Yes 260 74.9% No 87 25.1% Exercise reduces lower limb edema Yes 288 83.0% No 59 17.0% who never exercise can start during pregnancy Yes 282 81.3% No 65 18.7% Reduces medical intervention during labour Yes 268 77.7% No 75 21.7% 22 2 0.6% Increases the risk of musculoskeletal injury Yes 160 46.4% No 185 53.6% Women who exercised before can continue Yes 275 79.7% No 70 20.3% Decreases the risk of preterm delivery Yes 278 80.6% No 67 19.4% Exercise is same as working at home/work Yes 296 85.8% No 49 14.2% Increases energy Yes 298 86.4% No 47 13.6% Do you think exercise if good for you and your baby Yes 336 97.4% No 9 2.6% 18
  • 19. 19 19 Figure. 2Physical activity Levels of pregnant women 19 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0% 50.0% Light intensity moderate intensity Vigorous intensity 49.9% 41.0% 9.0%
  • 20. 20 20 Figure. 3 Energy expenditure by type of activity 20 0 10 20 30 40 50 60 70 80 Household activities Occupational activities Sport Activities Type of physical activity Expenditure per week
  • 21. 21 21 Physical Activity Level Chi Square P Value Light activity Moderate Activity Vigorous activity N (%) N (%) N (%) Age 15-24years 71(40.3%) 94(40.7% 22(43.1% 4.925 0.220 25-34years 89(50.6%) 103(44.6% 24(47.1% 35-44years 16(9.1%) 31(13.4% 5(9.8% >45 0(0.0%) 3(1.3% 0(0.0% Health Area Awing Health area 8(4.5%) 46(19.9% 28(54.9% 55.005 0.000* Menkah health area 105(59.7%) 108(46.8% 3(5.9% Santa health area 63(35.8%) 77(33.3% 20(39.2% Occupation Civil servant 21(12.7%) 19(9.0% 2(4.1% 14.347 0.001* trader 63(38.2%) 78(36.8% 8(16.3% professional 19(11.5%) 17(8.0% 7(14.3% farming 62(37.6%) 98(46.2% 32(65.3% retired 0(0.0%) 0(0.0% 0(0.0% Level of Education No formal education 5(3.0%) 18(8.2% 7(15.6% 12.884 0.048* primary 28(16.7%) 51(23.3% 17(37.8% secondary 93(55.4%) 110(50.2% 16(35.6% tertiary 42(25.0%) 40(18.3% 5(11.1% Trimester 1st trimester 33(18.8%) 46(20.4% 4(7.8% 10.642 0.021* 2nd trimester 106(60.2%) 135(59.7% 34(66.7% 3rd trimester 37(21.0%) 45(19.9% 13(25.5% Marital status Christian 168(95.5%) 223(96.5% 51(100.0% 4.598 0.205 Muslim 4(2.3%) 4(1.7% 0(0.0% Others 4(2.3%) 4(1.7% 0(0.0% Single 49(31.4%) 68(32.4% 17(34.7% 21
  • 22. 22 22 22 86.10% 78.70% 66.20% 64.60% 43.10% 29.40% 22.30% 19.60% 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 90.00% 100.00% Stressful Fear of miscarriage No orientation or Instructor No Time Religious Belief No access to facilities I don’t see the importance Culture Barriers
  • 23. 23 23 References • Gronwald T, Budde H. Commentary: Physical Exercise as Personalized Medicine for Dementia Prevention?. Front Physiol. 2019;10:1358. Published 2019 Oct 31. doi:10.3389/fphys.2019.01358 • Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstet Gynecol. 2020;135(4):e178-e188. doi:10.1097/AOG.0000000000003772. • Okafor, U.B., Goon, D.T. Physical activity and exercise during pregnancy in Africa: a review of the literature. BMC Pregnancy Childbirth 20, 732 2020. https://doi.org/10.1186/s12884-020-03439-0 • American College of Obstetricians and Gynaecologists. Physical activity and exercise during pregnancy and the postpartum period. Committee Opinion No 650 Obstetr Gynaecol. 2017;126:e135–42.
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