- The Washington Times - Saturday, September 4, 2004

Women on bed rest need their physical strength as much as any pregnant woman facing labor and care for a baby, but their exercise regimen often is severely restricted to prevent complications.

“Physical activity is restricted because it causes the blood pressure to rise, which can lead to lower blood flow to the uterus,” says Dr. Helain Landy, director of the Department of Obstetrics and Gynecology at Georgetown University Hospital.

Mary Kay Casey, a physical therapist at Inova Fairfax Hospital who teaches exercise routines to women on bed rest, says she has to be very careful about picking appropriate exercises.

“You don’t want them to strain or bear down; you don’t want them to hold any exercise for more than five seconds; you don’t want them to engage their stomach muscles; and you don’t want them to hold their breath,” Ms. Casey says.

So what’s left?

“I would do the letters of the alphabet with my feet, and a few other exercises, but it was very limited,” says Shellie Bressler, who was on bed rest for about four months, including a month in the hospital, when pregnant with her twin boys four years ago.

Ms. Casey says an easy exercise routine that takes about 20 minutes and can be done two to three times a day is appropriate for most women on bed rest.

Dr. Landy agrees and says some easy exercising can be very beneficial.

“Bed rest can cause some weakening of the muscles from disuse, especially of the legs, so some exercising while in bed is advisable,” she says.

Among Ms. Casey’s exercises are ankle pumps (the ankle makes a motion like pumping a gas pedal), thigh tightening and releasing, and rolling legs inward and outward.

For the upper body, she suggests shoulder circling; stretching of the shoulder blades (putting one arm in front of the body and pressing it toward the chest); the pocket stretch (pretending to look into a chest pocket), which stretches out the trapezius; and biceps curls using latex tubing.

“They’re usually happy about the biceps curls because you engage your biceps when holding the baby. So, it feels like a useful exercise,” Ms. Casey says.

She says her patients can modify and add exercises as long as they make sure they don’t engage the abdominal muscles, as that can lead to lower blood flow to the uterus and baby. Also, she says, don’t exercise two extremities at once.

Clearly, these exercises are not going to help build bulging muscles or manage weight gain, nor are they meant to do so.

Mrs. Bressler, who was on a monthlong strict hospital bed rest, was allowed to do her physical therapy a couple of times a day. Still, she says she was shocked to see her image in the mirror when she finally was allowed out of bed at the very end of the pregnancy.

“I’m 5-2, and I think I was wider than I was tall at the end of the pregnancy,” Mrs. Bressler says, laughing at the memory. “I couldn’t believe my eyes.”

Many of Ms. Casey’s patients want to do more than the 20-minute exercise routine two times a day, she says.

“You have the Type A personalities who don’t feel like their day is complete unless they have run five miles,” she says. “You just have to tell them that this is temporary, and they can resume their previous activities soon.”

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