Women’s pregnancy increases the odds of developing anxiety, depression, and low self-esteem. Physical activity can reduce the severity of maternal mental disorders and postpartum symptoms. The aim was to evaluate self-esteem, anxiety, and physical activity patterns among healthy pregnant women during three gestational trimesters (GTs). A longitudinal prospective study involving 248 Portuguese pregnant women, monitored for a year during all GTs, was conducted. Self-reported questionnaires were used to collect personal and obstetric data, and Rosenberg’s Self-Esteem Scale, Zung Anxiety Scale, and a Pregnancy Physical Activity Questionnaire were applied. A total of 152 women presented valid follow-up data considered for analysis. All test scores do not present normality (p < 0.001). Over the gestational trimesters, the Zung anxiety scores did not show a significant change between GTs. However, the self-esteem values reduced significantly from 1st to 2nd GT: (1st GT = 43.94 (±9.94) [95%CI: 42.37 to 45.53]; 2nd GT = 27.27 (±9.64) [95%CI: 25.74 to 28.81]; 3rd GT = 25.71 (±10.52) [95%CI: 24.04 to 27.39]; p < 0.001), remaining stable in the last GT. Moderate to vigorous (2nd GT = 73.43 (±88.69) [95%CI: 59.34 to 87.54]; 3rd GT = 65.05 (±82.65) [95%CI: 51.92 to 78.19]; p = 0.008), vigorous (1st GT = 0.45 (±3.95) [95%CI: 0.83 to 2.08]; 2nd GT = 1.63 (±3.52) [95%CI: 1.07 to 2.19]; 3rd GT = 0.81 (±2.16) [95%CI: 0.46 to 1.15]; p = 0.0475), and light (2nd GT = 101.68 (±48.77) [95%CI: 93.93 to 109.44]; 3rd GT = 98.42 (±49.05) [95%CI: 90.62 to 106.22]; p < 0.001) physical activity levels were significantly reduced throughout the GTs, but the time spent in sedentary activities did not change. In this follow-up study, it was possible to identify a critical point in the 2nd GT, when the drastic reduction in physical activity levels coincided with periods of lower self-esteem scores. However, anxiety levels do not seem to change over GTs.

Background: Obesity is common in women of reproductive age and increases the risk during pregnancy. Exercising during this period reduces health complications. Home e-health programs are effective in overcoming exercise barriers as pregnant women use technology and the internet for health information. Methods: A single-blind randomized controlled feasibility study with pregnant women with obesity (body mass index [BMI] ≥30 kg/m2) was conducted in the University Hospital Center of São João between January and April 2023. Pregnant women were randomized to a control group with standard care and to an experimental group with 8-week remote exercise program using a Phoenix® biofeedback device. Feasibility outcome measures were recruitment rate (≥35%), loss to follow-up (≤15%), and program fidelity (≥1 session/week). Secondary outcomes were evaluated through Pregnancy Physical Activity Questionnaire, Oswestry Index on Disability, and weight assessments at baseline and at the end of the program. Results: Of the 63 eligible participants, 24 (38.1%) were successfully randomized and completed the baseline assessment. Of these, 3 (4.8%) from experimental group did not perform the initial onboarding. The control group had 8.3% of follow-up losses and for the experimental group there were no follow-up losses. Program fidelity (mean ≥1 session/week) was fulfilled by 66.7% of successfully randomized participants. Regarding secondary outcomes assessed between baseline and the 8th week, experimental group compared to control group had higher levels of physical activity for sports activities, a lower level of inactivity, and lower disability rates caused by low back pain. Conclusions: Based on the recruitment rate, losses to follow-up, and fidelity rate, the GROB (obesity in pregnancy) study was deemed feasible and worthy of consideration for a larger study. Moreover, the GROB study has the potential to improve maternal outcomes by reducing sedentarism and disability caused by low back pain. Clinical Trial Registration: The study has been registered on https://classic.clinicaltrials.gov/ (registration number: NCT05331586).

Introduction: There is a linear association between pregestational body mass index (BMI) and almost all adverse pregnancy outcomes. Pregnancy is “a window of opportunities” in terms of changing behavior and improving awareness of healthy living. The proper assessment of physical activity levels, during pregnancy, determines trends, health benefits, and their effects over time. This study aims to describe maternal physical activity levels, stratified by pregestational BMI, verify the accomplishment of physical activity recommendations in pregnant women, and correlate pregestational BMI and physical activity accomplishment with maternal, delivery, and neonatal parameters. Methods: A retrospective cohort study was carried out with 103 pregnant women. Physical activity levels were evaluated using a questionnaire and accelerometry. Pregestational BMI was obtained through the Quetelet formula and used the American College of Sports Medicine’s guidelines were used to determine physical activity accomplishment levels. Continuous data were presented as mean and standard deviation and categorical data as numbers and percentages. The F test was used to examine the differences between groups. Results: Pregnant women in the sample spent 42.9% of their time on household activities, and for pregnant women with obesity, 91.5% of the time was spent on sedentary activities. Women with normative BMI had higher levels of moderate-intensity activities. Only 15.8% of participants with obesity reached the international recommendations for physical activity practice and women who accomplished physical activity recommendations gained less weight during pregnancy. A high percentage of pre-obesity and obese pregnant women exceeded the recommendations for gestational weight gain and the gestational diabetes prevalence was higher in the obesity group (p = 0.03 between groups). Regarding delivery and neonatal parameters (Apgar score 1st, Apgar score 5th, birth weight, length and head circumference), no statistical differences were found when adjusted to a gestational week at birth, between BMI (p = 0.58; p = 0.18; p = 0.60; p = 0.34; p = 0.34, respectively) or physical activity (p = 0.12; p = 0.15; p = 0.83; p = 0.70; p = 0.70, respectively) groups. Conclusion: Pregnant women with obesity, exhibit high levels of sedentary behavior, a high prevalence of gestational diabetes, and exceed recommended gestational weight gain. Healthcare professionals have a crucial role in promoting regular physical activity and lifestyle changes before and during pregnancy.

Objective: The aim of this study is to describe the availability and usage of Electrophysical Agents (EPAs) by Portuguese Physiotherapists (PTs), and identify factors affecting its’ usage, such as PTs expertise, setting and autonomy. Methods: A cross-sectional study was carried out between July and September 2018. Physiotherapists currently practicing in Portugal were invited to complete an online survey. The online survey included questions regarding the participants' practice, such as years of experience, rehabilitation autonomy, number of clients per hour, context and availability and use of EPAs. Results: From a total of 544 PTs that responded to the survey, 424 (78 %) used EPAs on their daily practice. The most common available EPAs are Transcutaneous Eletrical Nerve Stimulation (99%) and Ultasound (91%). When available, more than 80% of the participants reported using the different EPAs at least one time. All participants reported using the different EPAs more than 80%, when they are available. PTs expertise does not influence the selection of EPAs however, the autonomy and setting influenced the selection of almost of the different EPAs. Discussion: EPAs are commonly available and generally used by Portuguese PTs. PTs that works autonomously tend to use less EPAs. The EPAs selection seems to be dependent on the setting, number of clients per hour and autonomy. Keywords: Electrophysical agents, Physiotherapy, usage, availability; TENS; US

Physiotherapists can contribute significantly to women's pelvic health and other health conditions throughout the life stages, including adolescence, adulthood, pregnancy, childbirth, postpartum, menopause, and post-menopause. Their roles encompass education, rehabilitation, counselling, and empowerment, promoting health and facilitating recovery in various women's health conditions. The chapter underscores physiotherapy interventions during pregnancy and postpartum recovery, along with rehabilitation for pelvic floor and oncological conditions, emphasising the importance of tailored physical activity and exercise prescriptions. Additionally, it addresses physiotherapy's role in managing often underrepresented conditions, such as dysmenorrhoea and endometriosis. Emphasising a holistic approach, the chapter highlights physiotherapy's important role in supporting lifelong wellness and addressing the unique health needs of women within a collaborative, multidisciplinary healthcare team.