‘World Joural of Spor Seiences 3 (S): 942-946, 2010 ISSN 2078-4724 ‘© IDOSI Publications, 2010 Effect of Walking Intervention Program on Varicose Veins among Pregnant Women Maysa M, Rabea Department of Athletics, Faculty of Physical Education for Girls, Helwan University, Egypt [Abstracts The main purpose of this tody was to examine the eileets of walking onthe strength oflegs mules ‘and velocity of blood flaw in legs veing and their diameters to prevent varicose veins in pregnant women. “The research sample was divided into to groups, an experimental group consisting of 8 pregnant women and ‘control group consisting of 7 pregnant women using the pre-and post tests, Homogeneity and equality were ‘considered for both groups in age, tallness, weight, muscular strength, diameters of legs veins velocity of ‘blood flow in leg veins. The program bas been applied to the experimental group for 3 months with the rate (of training units weekly with # tial of 36 taining units. The researcher used the ecto -Doppler Instrument {0 examine blood vessels and the Dynamometer instrument to measure muscular strength, Results showed improvement ia both of legs muscular strength and velocity of bloed flow in legs veins and did not show an ‘enlargement in the diameters of legs veins and the protection of them in the experimental group comparing ‘with the control group. The researcher reconimends following systematic sport activity to activate blood circulation, such as walking to prevent vulnerability of pregnant women 1o varicose wens risk Key words: Walking program Primary varcoge 6 Pregnant women INTRODUCTION nosebleeds, voice changes and/or a sensation of fllness in the ears. You may also notice swelling of veins in ‘The body's veins are responsible for ensuring blood flows back to the heart, To assist this process veins are designed with a series of valves, which close between heartbeats 10 prevent the blood flowing venous outflow from the legs. rectum (hemorrbid), in logs (varicose veins) or vulva (vulvar varicosities). In addition, a pressure of the fetal headin the pelvis ean compress iliac veins and obstruct backwards [1]. When you stand up, gravity pulls blood down to your feet. Support hose squeeze the legs and hhelp to prevent blood fiom pooling in veins and distending them (2) Vericase veins are among the most common chronic ‘conditions seen by physicians today. A varicose vein, ‘sometimes called varicosty, occur when a valve weakens, putting more pressure on other valves and causing blood to stagnate [3] Women in general are more susceptible to vein ‘problems than men are, but & pregnant woman's risk is increased dramatically. This risk can be attributed 10 ‘sever! theories regarding the appearance of varicose ‘eis in pregnant women, Firstly, many boronal changes occur in the bodies that have @ profound effect on the veins. Increases in progesterone production during pregnancy cause the ‘vein walls to dilate and become less elastic. Moreover, Blood volume increases between 40 to 50% [4, 5] ‘This increase can cause nasal and sinus. stuTiness, ‘As the baby grows, the uterus enlarges end applies pressure on important veins that retum blood to the heart. This pressure can cause 2 slowing of the blood flow and valve damage, resulting in swelling, leg iscomfort and even varicose veins So, Prognancy plays ‘role in the development of varieose veins. Reports have estimated that up to 73% of females have varicose veins. In addition, 30% of women pregnant forthe frst time and 8% of women who have had two or more full tem pregnancies develop varicose veins Tn 70% to 80% of women who develop problems with varicose veins during pregnancy, the symptoms appear uring the firs imoster (Fst three months of pregnancy), often within wo to three weeks of a women becoming pregnant. ‘Varicose veins are preventable. Maintaining healthy body weight and doing exercises help lessen their cmergenee - appropriate exercises can be the best preventative and defensive strategy against varicose veins 3) ‘Corresponding Author: Maysa ML Rabea, Departmen of Atledes, Faculy of Physical Education for Gi oa elvan University, Egyptorld 3. Sport Se 3 (5): 942-840, 2010 ‘The most important part of nonmedical treatment for varicose veins is exercise, In fact, tis a vitel part of rrainecining a heclihy and balanced body. Any progrem ‘of rgular exercize stimulaies circulation, improves muscle ‘ona and helps pravert varicosities, However, highimpsct serahiss, jogging, strenuous cycling or ary intense ‘activity may increase blood pressure in the legs and ‘accentuate vancose veins. Walking is great exercise for the lower leg area - either aut in the open or on & treadmill ‘expecially wih the incline level rose, Simple interventions like leg elevation, water immersion and exercise should be studied, Further stdies should ensure adequate sample size sid flow up to ensure reasonable ‘conclusions are drawn to guide practice [6,7]. ‘The purpose of ths stdy was to examine the effect ‘of walking ee = prevention program on the surength of logs muscles and velocity of sland flaw in lags veins and their dameters in pregnant women MATERIALS AND METHODS Experimental Approach to the Problem: Two gicups (expetmental and contre), perfommed 2 pre and pest tusining designed intervanticn in which: strength of leg rmuscles (SL) by dynamometor, quickness of wains blood flow in great sapherout vein of left leg (QVAFG- Lyquickness of veins blood flaw in great saphenous vein Of right Ieg (QVBFG-R), quickness of veins blood flow small saphenous vein of eft leg(QVBFS¢L). quickness Of ves blood flow small saphenous vein of right leg (QVBFS-R), vein dames in great sepienous vein of left leg (VDGS-L), vein diameters in great saphencus vein of right leg (VDGS-R), vein diamcters in small saphenous ‘vein of lef log (VDSS-L) end vein diameters in sinall saphenous vein of ight leg (VDSS-R) by Echo- Doppler ‘wore recorded. The experimental group (EG) (Rpregnant) trained (18 50) perday 3 imesa week on walking taining for (12) weeks. One subject dida’t complete the walking program; the control group (7 pregnant) cortinued thei? rhonal lie style without practicing any fm of exercises, while the experimertal gicup completed walking taining program to sce whether this type of traning modality ‘would have a positive or negative or no effect on (SL) (QVBEG-L)(QVBFG-R) (QVBFS-L) (QVBFS.R) (VDGS-L) (VDGS-R) (VDS8-L) and (VDSS.R). Research Sample:'The sample corsisiad of 18 pregnant ‘women age ranged between 27-30 years old, volunteered in this study. They were sedentary, not practiced any sponsor exercises before and have had wo or more full term pregnancies and suffered from primary varicose ‘veins, Subjects were required to read and complete a health questionnaire and informed consent document there was no history of coronary heart disease, diabetes, hhighpressure, blood diseases or recent surgery, ‘Training Protocol: A | Joveck in-season taining program, Tad intersity ranged from (S010 75 %) from the maxiraurn tate of pulse with the gradual increase in intensity in pregnancy from 2 month to ancther and in & cantinucus regular rhythm and wit increasing length of walking ‘weekly with a rate of 200m an an increase of 2 minutes ‘weckly. During he first month, easy light and comfortable ‘valking pattem was used with short breaks during walks and kooping systematic bresthing and the xenon of @ light effor and starting using the walking spor and ‘maining the body organs on walking in systematic rate, During the second month of pregnancy, walking pattern ‘was to keep the exerted effort ight wih full fling of | comfort during prectcing the taining unit. During the third month, walking pattern in a systematic rate was used with keeping the systematic rate of walking with tuying net 1 take breaks with feeling of relaxation, forganzing the breath daring walking in sdythm and comfortable way 10 taking breath (inhalation process) ‘every vo seps during the Sst month, In addition, rate fof three stape dating the sacond month, Moreover, Your seps during the third month, With cominuoue following up the pemmited pulse rate Stop walking Immediately and call healthcare provider if subject have any of the following symptoms: vagind bleeding, difficulty breathing, cizziess, exerese,chest pain, muscle ‘weakness, calf pain or swelling, preterm labor, decreased fetal movement, or contactions. The waking taining program is described in Table | ‘Testing Procedures: Subjects were assessed before and after (2nwook trining program Teste followed « genera light warmup, ‘Statistical Analysis: All statstcal analyses were caleulated by the SPSS statistical package, The results ‘vere report as means and standard devietions (SD). Wilcoxon signed-rank test (no-parsinetic statistic Ihypethesis test) was usod to determine the differences, 1pr0.0$ was considered es statistically significant RESULTS AND DISCUSSION The main findings fom this study were the signifcart improvement in muscular suength and velocity of veins blood, which proved the walking waining efficacy, There ate a nuinber of potential explanations forthese findings.Morld 5 Sport Sei. 3 (9): 942-946, 2010 Mena Aine Te Tas Walng dees =m ie igniting Tae = “x10 a Tee Swconl Woop with eplospend 2638 2 10-180 om Aerts This Waking ralarepaat 3880 2 300-260 1529 — Takes ets of mk andrei) (QVGA) (QVC (QUIS) (QVIES (DESL) (VDGS-8) (VDSS and (VOSS. bemsen sca forthe Experimenta andor ous Tpeinenal gap Consign einai pap Gomnlgra x Ma 0 @ 00400 mam) BST WSL es —a00 ND) TST) QvsoL 426 02% km 28m 2H WDGSR ast coo DTT D2 QVEGR 429 0 G77 4m 28237 WOSSL 231 «00 28D 3H 2 QveSL 47s 0 © 340 400 20257 WDSSR 250 coo OU 40 0028 ee ee ee PP PE a EE Fig, l: Significance clear positive diferences in muscular strength and velocity of veins blood, In addition, no significant ference in veins diameters forthe post tests in the experimental group Baa. a_i. PP PP SF a oS Fig. 2: No significant positive difernces in muscular strength and velocity of veins blood but there was 4 negative significance difference in veins diameters in the contr group. I variables Fig. 3: Superiority ofthe experimental group tothe control group inWorld 1 Sport Set, 3 (5: 942.946, 2010 Fintly, natural of walking program which adequate for pregnant women, this doesnt mean that you have to spend hours sweating away at the gym however or even that you need fo purchase any type of expensive bome exertise equipment. Instead, the no-fills exercise of ‘walking ean provide you with the necessary extra mobility [8]. The Centers for Disease Control and Prevention (CDC) aad the American College of Sports Medicine (ACSMD recommend that more intense physical activity performed in 20-1 60-min sessions on 3-5 days per week will result in higher levels of physical Fitness [8]. The American College of Obsteties and Gynecology (ACOG) thas presented additional recommendations that pregnant ‘women should exerise with similar safeguards as non pregnant women provided that there are no medical or obstetric complications during the pregnancy. And the pumping action of leg muscles during walking exerts Such a strong force to empty of veins. And activation of the two typical strong pumps identified inthe vein block in foot metatarsus and the muscle pump in leg block. Consequently, walking is the best means 10 strengthen legs, Blood cireulation (10, 11]. [According to Wornea's Health, a website ofthe US. Office on Women's Health, explains that low-impact exercise, such as walking, promotes better ciculation in your legs and helps you build muscle strength, which fean contribute to better vein health [12]. Exercise gots the blood flowing normally that helps greatly with blood circulation, Besides aerobic exercise, walking has also been noted as another important aspect of exerise that can be used to trea varicose veins. During walking, legs muscles performance ooeurs in the tone and strength that helps controlling primary veins varicose symptoms through the mechenical movement of walking Without the occurrence of contractions, there is no use of the existing valves in veins. During muscular contraction, muscles size increases, presses the deep veins, squeezes them and ‘causes valves io meet [13, 14], Any exercise that involves ‘both legs is good to prevent varicose veins, the best and most effective is to tin the muscles of the lower calf ‘Walking is more effective fr ealf muscle strength, According to Jacobs et al. [15}, lez volume was caleulated from a formula using four circumference ‘measurements prio to treatment (ime I). Measurements ‘were then taken again immediately afler 30 minutes of ‘treatment (time 2) and again after 10 minutes of walking Gime 3), Data from time 3 measurements, that is, ater walking, are provided in this review. The study neither concer with what women felt about the treatment nor whether they felt any benefit from the reduction in leg volume. Another explanation is fiom hormonal view, considering walking an excellent therapy. Because it help restore the hormones balance, especially estrogen hormone. Previous studies demonstmted that and Founded correlated between walking and estrogen bormone [16]. ‘When walking, the leg muscles contract, squeezing the veins, thus help to force the blood to move forward fon its way back to the hear. And excrete the female hormone (estrogen and progesterone) which reduced the pressure on leg veins Moreover, decreased the volume of blood, follow that increased of blood speed ‘and maintained the veins diameter (11) CONCLUSION ‘Walking exercises are an essential prevention should be practice for pregnant women, REFERENCES Bamigboye, A.A. and R, Smyth, 2010. Interventions for varicose veins and leg oedema in pregnancy. ‘Cochrane Database Syst Rev, Issue 1 2 Gabe, M, 2005. Fitness and Zinellypothermia and Frostbite ‘yw. daniskin.com public! Ezine0|3008 him. 3. Car, S.C, 2006. Current Management of Varicose ‘Veins. Clinical Obsevics and Gynecol, 49: 414-426. 4. Stansby, G., 2000. Women, pregnancy and vaticose veins, Lancet, 355: 1117-1118, Rhabi, Y., C. Charras-Artapignetic, IC. Gris, J Ayoub, JE. Brun, FM. Lopez, C. Janbon, P. Marés ‘and M. 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