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Pregnant women could get on their bikes and stay healthy with better support Featured

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Research reveals obstacles to commuting by bicycle
Medical advice from risk-averse health professionals may contribute to some women’s decisions to stop cycling to work during pregnancy, meaning they miss out on the potential benefits of the active commute. A recent study in the Journal of Transport & Health reveals the reasons why women decide to stop or continue cycling to work when they are pregnant, including often ambiguously worded or overly-cautious advice from medical guidelines, midwives and obstetricians.

More people than ever are commuting to work by bicycle in London. According to data from the 2011 census, the city saw a 144% increase in cycle-commuting over the previous decade. This has big health benefits, for the health of the individual cyclist as well as for public health more broadly, as it helps people move more as part of their everyday activities.
Moderate intensity exercise provides benefits during pregnancy for mother and baby. In the UK, the National Institute for Clinical Excellence (NICE) and the National Health Service (NHS) both recommend pregnant women engage in daily exercise to help manage common discomforts, reduce pregnancy complications like preeclampsia, reduce discomfort and improve mood. But when it comes to cycling, the advice dries up: there are no clear recommendations women can use to decide whether to continue cycling.
“Despite the clear health benefits of cycling and the push to get more people commuting by bike, especially in cities like London, the medical advice on cycling during pregnancy remains murky,” commented Davara Lee Bennett, the author of the new study. “My research aimed to explore why women do – and don’t – cycle to work when they’re pregnant, with a view to supporting informed decision-making – including, if women so wish, rocking the rust off their chains, and bringing their bikes out from under the stairs and into the light.”
Bennett conducted three individual interviews and held three focus group discussions: with a group of women who had stopped cycling early, a group that had carried on into later pregnancy and a mixed group. She recorded and transcribed all of them, and analyzed the transcripts line-by-line to develop themes. The resulting factors that affected women’s decisions fell into a few main areas: physical obstacles and enablers, perceptions of risk and of pregnancy itself, and advice.
The idea of risk was a key factor in decisions about continued cycling: women adjusted their cycling practices to minimize risk, taking partners’ support or concern into account. Although some women had positive encounters with health professionals, the medical advice they received was often noncommittal or risk-averse.
During pregnancy, depending on women’s proportions and the type of bike, the growing belly can feel physically restrictive. Some women stopped cycling because of this, while others found comfort from their daily aches and pains when they commuted by bike. Either way, more comfortable bikes helped: women preferred Dutch-style, upright designs with a low crossbar and a wide, supportive seat.
Perceptions of pregnancy also had an impact on women’s decisions: some preferred to abandon their active commute, opting for a more peaceful state, while others continued to cycle in a bid to remain connected to their authentic selves.
“Understanding the obstacles to women’s cycling during pregnancy can support the development of safer cycling infrastructure and informed medical guidelines, ultimately offering more women the opportunity to benefit from an active commute,” said Bennett. “By addressing some of the more socially prohibitive public discourses on the topic, I hope that my research will not just enable informed decision-making by women, but also encourage more constructive support and advice for women from health professionals.”



Source: Elsevier

Full bibliographic information:
The article is "Bumps and bicycles: Women's experience of cycle-commuting during pregnancy," by Davara Lee Bennett.

It appears in the Journal of Transport & Health, published by Elsevier

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  • Postgrad course on exercise as medicine is being proposed

    Dear prospective applicant,

    A proposal for a postgrad course on physical activity (PA) as a therapy for non-communicable diseases is currently being evaluated. Hereunder, a two-question survey is being forwarded for your attention in order to assess whether the idea sounds appealable or not.

    Proposed award

    M.Sc in Therapeutic Physical Activity (TPA), with postgrad certificate (PgC) and postgrad diploma (PgD) exit routes

    Proposed specialisation titles[1]

    Holders of PgC, TPA can claim the title of: ‘Clinical exercise prescriber’.

    Holders of PgD, TPA can claim the titles of: ‘Advanced exercise prescriber’ or ‘Clinical and public health exercise prescriber’.

    Holders of M.Sc, TPA can claim the title of: ‘Physical activity - health specialist’.

    Are you sure you know why physical activity is so important?

    Everyone is aware that physical inactivity is a major health concern but, do you know that through the right type of exercise you can prevent or treat at least 35 chronic conditions? In 2007 the American College of Sports Medicine officially declared an important statement: ‘Exercise is medicine’. Moreover, health-enhancing physical activity (HEPA) is important in today’s world not only in view of improving health and wellbeing but also for its economic values. For example, a lifestyle intervention involving 150 minutes of weekly PA was scientifically shown to be significantly more effective than the administration of metformin.

    Possibilities of further career development in exercise prescription

    Exercise prescription, that is, being qualified to professionally recommend the right type of exercise for health does not stop on a one-to-one basis. Do you think you are qualified to: (a) conduct research on PA interventions, and (b) develop, implement and evaluate community or population programmes involving PA strategies? Unfortunately, many wide-scale programmes that are implemented undergo no evaluation to determine how they have worked or what their effects may be. Have you ever imagined the possibility of attending a tertiary course which would be designed to: (a) give you the ability to design a project for the generation of new knowledge and be able to publish it internationally, or (b) train you on how to evaluate wide-scale interventions and how to apply strategies to sustain their continuities?


    A glimpse of the proposed programme of studies

    Intended for:

    The programme of studies is aimed at a wide and diverse cohort of students wishing to pursue any careers in HEPA sectors mainly: exercise prescription; health promotion (policies and practice); general health and fitness industry; and to further their studies (e.g. PhD). It can also serve as an adjunct to enrich one’s knowledge of his / her established profession or career. Examples include: medical practitioners; pharmacists; nurses; physiotherapists; nutritionists; public health specialists; sport medicine specialists; sport psychologists; teachers of physical education (PE); coaches; gym instructors; and personal trainers. Fitness and sport enthusiasts are also encouraged to apply.

    Duration:

    Three years part-time leading to an M.Sc in PA as an effective therapy, with postgrad certificate and postgrad diploma exit routes after the first and second years respectively.

    Mode of delivery:

    Seventy per cent will be delivered online and the rest of the thought units will be offered on a once weekly two-hour evening basis starting at 18.00hrs.

    Admission criteria:

    You should provide evidence of higher educational qualification(s) - normally, a diploma or a degree related to health and / or PA / sport. An award in PE is also ideal. Mature students without these basic qualifications would be required to present evidence of experience related to PA and health.

    Mode of assessment:

    Units will be assessed through the submission of coursework. These will vary from short assessments to long essays. If you would like to progress at Masters’ level, a traditional dissertation or paper in the format for journal publication and a final presentation (in the form of slides or poster) of your research findings will have to be undertaken.

    Round-up

    Unlike other under- and postgrad courses which only cover a fraction from the whole science of HEPA, this comprehensive programme of studies would lead to a specialization specifically on TPA. For careers in promotion, prescription and research of PA, the proposed programme of studies is a must.

    Important notice

    All the above information is subject to change and would eventually have to be approved by the Programme Validation Committee of the University of Malta. Needless to say, your feedback in the next two questions is extremely important.

    Yours in health & exercise,

    Charles Micallef B.Pharm (Hons), M.Sc PAPH (Staff)                                                8th August 2017

    The two questions hereunder.

    1. In view of the above information, would you be interested in applying for this particular postgrad course leading to a specialisation in physical activity with respect to health, that is, a qualification that gives you the right to prescribe exercise for health, even at population levels?

    Yes or No: 

    1. What would you change from or suggest to what is being proposed?

    Please state your name & surname:

    Your current job / profession:

    Please save your changes and forward your reply to Charles Micallef on: This email address is being protected from spambots. You need JavaScript enabled to view it.

    Your cooperation is greatly appreciated.


    [1] In order to professionally recommend exercise for health, you may need to be registered in the appropriate regulatory board and be in possession of a warrant to operate with the respective titles.

    University of Malta

    Written on August 19, 2017
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