There is strong scientific evidence that prenatal physical activity of moderate-to-high in-tensity is a prerequisite of the proper course of pregnancy, childbirth and fetus development. How-ever, to date little data have been available on high intensity interval training (HIIT) performed during pregnancy. Following the PRISMA guidelines, this systematic review aimed at: first, to characterize HIIT protocols used or planned to be implemented during pregnancy; second, to determine their training effects on participant’s health and obstetric outcomes. We included nine original works and three clinical trials in the analysis. The HIIT protocols substantially differed in terms of the training components (type, intensity, frequency, duration and progression) and the structure of intervals (intensity and time of workout and recovery intervals). Our most important finding is that performing HIIT during pregnancy is safe in terms of obstetric outcomes and well tolerated by pregnant participants, while providing them with the enjoyment of exercise. HIIT interventions either led to an improvement in selected maternal and fetal health parameters or had no impact. No adverse effects were observed. Pregnant women may benefit from HIIT programs in the same way as other populations. Evidence-based recommendations on prenatal HIIT should be developed and promoted worldwide among pregnant women, exercise and health professionals.

Background: Before starting PA, pregnant women should select the appropriate type of training and adjust its components to the development of pregnancy and her capabilities. This review aimed to analyze current recommendations for pregnant women on methods for determining and assessing PA intensity levels and characterize the extent and nature of the information provided to pregnant women in official documents published by public health and sports medicine institutions. Methods: The review was conducted as per the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched scientific databases (PubMed, ScienceDirect, Web of Science, Academic Search Complete, and SPORTDiscus with Full Text via EBSCO) and the Internet to identify papers regarding recommendations for the PA intensity level for pregnant women. We analyzed 22 eligible guidelines, published over the last 10 years in English, from nine countries and three international organizations. Results: The PA of pregnant women should be at a moderate level. As for higher levels, the analyzed recommendations are contradictory. Methods for assessing PA intensity levels are often not included. The most frequently recommended methods for determining and assessing the PA intensity level for pregnant women are the rating of perceived exertion, the Talk Test, and heart rate measurements. Few guidelines offer specific advice for highly active women (e.g., elite athletes) or trimester-specific considerations. Conclusions: The number of published recommendations regarding PA during pregnancy has increased over the last decade. The amount of information on PA intensity levels is still insufficient. There is a need to update them, based on high-quality scientific work.

Pregnancy triggers significant hormonal and neuroplastic changes to support fetal development and prepare the mother for childcare. These profound adaptations can significantly influence maternal cognitive functions and behavior, crucial for a successful transition to motherhood. This review synthesizes current knowledge on structural and functional brain changes during pregnancy and their potential implications for maternal well-being. This review aims to synthesize and critically evaluate the dynamic brain adaptations occurring during pregnancy, focusing on key regions like the prefrontal cortex, amygdala, and hippocampus, primarily based on human studies. It also discusses the potential implications of these changes for cognitive functions, mental health, and overall maternal adaptation. This is a narrative review study. A comprehensive search for relevant scientific literature was conducted in five databases: PubMed, Scopus, Web of Science, EBSCOhost, and Wiley Online Library. Titles, abstracts, and full texts were reviewed to ascertain the relevance and eligibility of studies that addressed brain morphology, function, and hormonal influences during pregnancy and their potential implications for maternal well-being. While primarily adaptive and essential for supporting both mother and fetus, the brain adaptations during pregnancy can concurrently influence cognitive functions and maternal mental health. Therefore, integrated approaches involving education, comprehensive mental health support, promotion of physical activity, and personalized care are crucial for fostering positive maternal adaptation and well-being throughout the perinatal period. Level V.

BACKGROUND Individuals with mild intellectual disabilities (ID) often exhibit significant deficits in motor proficiency, coordination, and reaction time, which negatively impact their functional independence. While virtual reality (VR) exergames offer a highly immersive and motivating environment for physical activation, objective evidence regarding their impact on specific motor scales in this population remains limited. Previous research has established a structured teaching methodology (WISH and WON protocols) to achieve gameplay independence. However, there is a need to quantify the physiological and motor benefits resulting from such interventions. By utilizing standardized tools like the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) and specialized reaction time measures, we can evaluate how systematic VR-based training influences motor control and cognitive processing speed. OBJECTIVE The primary objective of this study was to evaluate the effectiveness of a 16-session structured VR exergame intervention (based on WISH and WON protocols) in improving motor proficiency and shortening simple reaction time among adolescents with mild intellectual disabilities. METHODS This pilot study used a multisession, single-group pre-test/post-test research design involving 8 adolescents with mild ID (mean age 17.63 years, SD 1.77). The intervention consisted of 16 VR exergame sessions using the "OhShape!" game, conducted according to the WISH and WON protocols during physical education classes. Motor proficiency was assessed at pre-test and post-test) using the short form of the BOT-2, covering eight subtests including bilateral coordination, balance, and strength. Simultaneously, simple reaction time (SRT) to light and sound stimuli was measured using a standardized Alfa-Electronics reaction time meter. RESULTS Total BOT-2 scores significantly improved from a baseline mean of 69.25 (SD 6.80; range 55–74) to 80.50 (SD 5.50; range 72–88) at the post-test (P < .05; r = 0.74). Based on the standardized 5-point proficiency scale, the group mean rose from 1.88 (SD 0.64; range 1–3; below average) at baseline to 2.88 (SD 0.35; range 2–3; average) post-intervention (P < .01; r = .89). Similarly, the mean SRT decreased from 426.50 ms (SD 52.3; range 350–510) to 392.10 ms (SD 38.4; range 340–450) at the final assessment (P < .05; r = .72). CONCLUSIONS This pilot study suggests that the structured WISH and WON training protocols for VR exergames may effectively enhance motor proficiency and cognitive processing in adolescents with mild ID. The observed gains, significantly exceeding MCID thresholds, provide preliminary evidence that immersive VR can serve as a potent supportive tool in special education. Further large-scale research is warranted to confirm these long-term functional benefits. INTERNATIONAL REGISTERED REPORT RR2-10.2196/71823

Background: Adolescents with mild intellectual disabilities often exhibit deficits in motor proficiency and neurocognitive processing, which can limit their functional independence. Although virtual reality (VR) exergames provide a motivating platform for physical activity, objective data quantifying their impact on standardized motor scales remain scarce, particularly when implemented through structured pedagogical frameworks. Earlier research established the WISH (warm-up, imitation, settings, half-hour) and WON (warm-up, objective evaluation, no problem!) protocols to facilitate gameplay independence in this population. However, the extent to which this systematic approach translates into measurable clinical motor and reaction time gains requires further investigation. Objective: This study evaluated the effectiveness of a 16-session structured VR exergame intervention, using the WISH and WON protocols, in enhancing motor proficiency and shortening simple reaction time among adolescents with mild intellectual disability. Methods: A multisession, single-group pretest and posttest pilot design was used. A convenience sample of 8 adolescents (3 males, 5 females; mean age 17.63, SD 1.77, range 15‐20 years) was recruited from a special school complex in Poland. The intervention was conducted over an 8-month period (October 2023 to May 2024), consisting of 16 sessions conducted once every 2 weeks. The rhythmic fitness game “OhShape!” (Odders Lab) was played on the Meta Quest 2 system. Motor proficiency was assessed with the Bruininks-Oseretsky Test of Motor Proficiency short form, and simple reaction time to visual and auditory stimuli was measured using a standardized Alfa-Electronics meter. Statistical analysis was performed using the Wilcoxon signed-rank test (α=.05). Results: Total Bruininks-Oseretsky Test of Motor Proficiency scores significantly improved from a baseline mean of 69.25 (SD 6.80; 95% CI 63.56‐74.94) to 80.50 (SD 5.50; 95% CI 75.90‐85.10) at the posttest ( P =.01; r =0.74). Based on the standardized 5-point proficiency scale, the group mean rose from 1.88 (SD .64; 95% CI 1.34‐2.42) at baseline to 2.88 (SD .35; 95% CI 2.59‐3.17) postintervention ( P =.008; r =0.89). Furthermore, the mean simple reaction time decreased from 426.50 (SD 52.3; 95% CI 382.78‐470.22) ms to 392.10 (SD 38.4; 95% CI 359.98‐424.22) ms at the final assessment ( P =.02; r =0.72). Conclusions: This pilot study suggests structured VR exergaming may address motor deficits in adolescents with mild intellectual disability. Promoting autonomy via protocols was associated with measurable motor gains within this cohort. Although the absence of a control group limits causal claims, immersive VR may offer a supportive tool for neuro-motor adaptations in special education, warranting validation in larger controlled trials.