Feasibility, Clinical Efficacy, and Maternal Outcomes of a Remote Exercise Program in Pregnant Women with Obesity: The GROB Randomized Control Pilot Study

Diana Bernardo^{1,2,3,4,5,†}, Carolina Bobadilla-Agouborde^5,6,7, Clarinda Festas^4,8,9, Carlos Carvalho¹⁰, Pedro Pugliesi Abdalla¹¹, Carmen Amezcua-Prieto^6,12,13, Zeltia Naia-Entonado¹⁴, Cristina Carvalho Mesquita^15,16, Jorge Mota^5,17, Paula Clara Santos^{5,15,16,17,*,†}

Show Less

¹ Department of Physical Medicine and Rehabilitation, University Hospital Center of São João, 4200-319 Porto, Portugal

² Now with KinesioLab Research Unit in Human Movement, Piaget Institute, 4405-678 Vila Nova de Gaia, Portugal

³ Now with Department of Physiotherapy, Health School, Institute Piaget, 4405-678 Vila Nova de Gaia, Portugal

⁴ Now with Department of Physiotherapy, Health School Fernando Pessoa, 4249-004 Porto, Portugal

⁵ Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport University of Porto (FADEUP), 4200-450 Porto, Portugal

⁶ Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18010 Granada, Spain

⁷ Departamento de Procesos Terapéuticos, Faculdad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco 4813302, Chile

⁸ I3ID-FP, Instituto de Investigação, Inovação e Desenvolvimento Fernando Pessoa, FP-BHS, Biomedical and Health Sciences, 4249-004 Porto, Portugal

⁹ RISE, I3ID Centro de Investigação em Saúde, Universidade Fernando Pessoa, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal

¹⁰ Department of Physyiothepy, Clinical Physiotherapy Practice, 4100-465 Porto, Portugal

¹¹ Study and Research Group in Anthropometry, Training, and Sport (GEPETE), University of São Paulo, School of Physical Education and Sport of Ribeirão Preto (EEFERP-USP), 14040-907 Ribeirão Preto (São Paulo), Brazil

¹² CIBER de Epidemiología y Salud Pública, Instituto de Salud Carlos III, 28029 Madrid, Spain

¹³ Department of Preventive Medicine and Public Health, Instituto de Investigación Biosanitaria IBS, 18010 Granada, Spain

¹⁴ Department of Physiotherapy, Medicine and Biomedical Sciences, Faculty of Physiotherapy, University of A Coruña, 15071 Coruña, Spain

¹⁵ Centro de Investigação em Reabilitação, Escola Superior de Saúde, Instituto Politécnico do Porto, 4249-015 Porto, Portugal

¹⁶ Departamento de Fisioterapia, Escola Superior de Saúde, Instituto Politécnico do Porto, 4249-015 Porto, Portugal

¹⁷ Laboratory for Integrative and Translational Research in Population Health (ITR), Instituto de Saúde Pública, Universidade do Porto, 4200-450 Porto, Portugal

^*Correspondence: paulaclara@ess.ipp.pt (Paula Clara Santos)
^†These authors contributed equally.

Clin. Exp. Obstet. Gynecol. 2024, 51(3), 70; https://doi.org/10.31083/j.ceog5103070

Submitted: 18 November 2023 | Revised: 30 December 2023 | Accepted: 15 January 2024 | Published: 15 March 2024

This is an open access article under the CC BY 4.0 license.

Abstract

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] $\geq$ 30 kg/m ${}^{2}$ ) 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 ( $\geq$ 35%), loss to follow-up ( $\leq$ 15%), and program fidelity ( $\geq$ 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 $\geq$ 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).

Keywords

pregnancy

exercise

physical activity

obesity

e-health

remote

Funding

UI/BD/151206/2021/Portuguese Foundation for Science and Technology (FCT)

PTDC/DES/116586/2010/Portuguese Foundation for Science and Technology (FCT)

LA/P/0064/2020/Laboratory of Interdisciplinary Research—ITR

Figures

Fig. 1.

Previous article in this issue

Next article in this issue

Clin. Exp. Obstet. Gynecol. Print ISSN 0390-6663 Electronic ISSN 2709-0094