ORIGINAL ARTICLE

Effect of Circuit Training on Calcium Level and Physical Fitness in Pregnant Women with Hypocalcemia: A randomized controlled trial

Authors

Shorouk Wahb 1 Abeer ElDeeb 2 ✉ Hossam Kamel 3 Manal El-Shafei 4

Affiliations

  1. 1 Department of Physical Therapy, Quesna Hospital, Monfia, Ministry of Health, Egypt
  2. 2 Department of Physical Therapy for Women’s Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
  3. 3 Department of Obstetrics and Gynecology, Faculty of Medicine, Al Azhar University, Cairo, Egypt
  4. 4 Department of Physical Therapy for Women’s Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
Phys Act Rev. 2024;12(1):22-31.DOI: 10.16926/par.2024.12.03

Abstract

Background:

Hypocalcemia is a common problem during pregnancy that affects maternal and fetal outcomes. So, preventive and treatment measures are warranted to prevent complications and promote health and well-being in pregnant women with calcium deficiency.

Purpose:

This study aimed to investigate the effect of circuit training (CT) on calcium levels and physical fitness in pregnant women with hypocalcemia.

Methods:

Forty-four pregnant women in their 2nd trimester having hypocalcemia participated in the study; their ages ranged from 20 to 35 years old, and their body mass index (BMI) was 35.00 to 39.99kg/m2. They were randomly divided into two equal groups. The control group received daily calcium supplements (1.5 – 2 g), while the CT group received the same tablets and performed the CT program for 60 minutes, three sessions per week for 12 weeks. Serum-free and ionized calcium levels were measured, and sit and reach flexibility test, wall squat test, chair stand test, and modified push-up test assessed the physical fitness before and after treatment.

Results:

The control and CT groups showed statistically significant increases (p<0.0001) in free and ionized calcium levels and a non-significant difference (p>0.05) between groups after treatment. Compared to the control group, the CT group showed statistically significant increases (p<0.0001) in the scores of sit and reach flexibility test, wall squat test, chair stand test, and modified push-up test after treatment. However, the control group showed a non-significant difference (p>0.05) in all test scores.

Conclusion:

Adding CT to calcium supplements is a safe and effective method that maintains calcium and improves physical fitness in pregnant women with hypocalcemia, which should be a part of the antenatal exercises program for gravid women.

Keywords

  • pregnancy
  • hypocalcemia
  • circuit training
  • calcium
  • physical fitness

References

1 Almaghamsi A, Almalki MH, Buhary BM. Hypocalcemia in pregnancy: A clinical Review Update. Oman Med J. 2018; 33: 453–462. doi: 10.5001/omj.2018.85
2 Vasanwala RF, Gani L, Ang, SB. It starts from the womb: maximizing bone health: maximizing bone health. Climacteric. 2022; 25: 11–21. doi: 10.1080/13697137.2021.2011197
3 Cormick G, Betran A, IB R, Lombardo C, Gülmezoglu A, Ciapponi A, Belizán JM. Global inequities in dietary calcium intake during pregnancy: a systematic review and meta-analysis. BJOG An Int J Obstet Gynaecol. 2018; 3: 1–13. doi: 10.1111/1471-0528.15512
4 Kumar A, Agarwal K, Devi SG, Gupta RK, Batra S. Hypocalcemia in pregnant women. Biol Trace Elem Res. 2010; 136: 26–32. doi: 10.1007/s12011-009-8523-6
5 Benali A, Demmouche A. Calcium deficiency among pregnant women and their newborns in Sidi Bel Abbes Region, Algeria. J Nutr Food Sci 2014; 4: 6. 10.4172/2155-9600.1000318
6 Abdel Aty AS, Youssef MA, Mohamed YK. Prevalence of hypocalcemia in asymptomatic pregnant females in Upper. EGMR 2022; 3: 28–40
7 Ladipo OA. Nutrition in pregnancy: mineral and vitamin supplements. Am J Clin Nutr. 2000;72(1)(Suppl):280S-290S . doi: 10.1093/ajcn/72.1.280S
8 Hogler , W. Complications of vitamin D deficiency from the fetus to the infant: one cause, one prevention, but who’s responsibility?. Best Pract Res Clin Endocrinol Metab. 2015; 29: 385–398. doi: 10.1016/j.beem.2015.03.003
9 Hofmeyr GJ, Lawrie TA, Atallah AN, Torloni M. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems, Cochrane Database Syst Rev. 2018; 10:CD001059. doi: 10.1002/14651858
10 Troy KL, Mancuso ME, Butler TA, Johnson JE. Exercise Early and Often: Effects of Physical activity and exercise on women’s bone health. Int J Environ Res Public Health. 2018; 15: 878. doi: 10.3390/ijerph15050878
11 Li Y, deBakker CMJ, Lai X, Zhao H, Parajuli A, Tseng W, Pie S, Meng T, Chung R, Wang L, Liu X. Maternal bone adaption to mechanical loading during pregnancy, lactation, and post-weaning recovery. Bone. 2021; 151: 116–123. doi: 10.1016/j.bone.2021.116031
12 Gustafsson MK, Romundstad PR, Stafne SN, Helvik AS, Stunes AK, Mørkved S, Salvesen KÅ, Thorsby PM, Mosti MP, Syversen U. The effect of an exercise program in pregnancy on vitamin D status among healthy, pregnant Norwegian women: a randomized controlled trial. BMC Pregnancy Childbirth. 2019; 19: 76. doi: 10.1186/s12884-019-2220-z.
13 Skidmore BL, Jones MT, Belegen M, Mtthews TD. Acute effects of three different circuit weight training protocols on blood lactate,heart rate, and rating of perceived exertion in recreationally active women. J Sports Sci Med. 2012; 11: 660–668. eCollection 2012.
14 Ramos-Campo DJ, Andreu-Caravaca L, Carrasco-Poyatos M, Benito PJ, Rubio-Arias JÁ. (2021). Effects of circuit resistance training on body composition, strength, and cardiorespiratory fitness in middle-aged and older women: A systematic review and meta-analysis. J Aging Phys Act; 2021: 30, 725-738. doi: 10.1123/japa.2021-0204
15 Susanto, Siswantoyo, Prasetyo Y, Putranta H. The Effect of Circuit Training on Physical Fitness and Archery Accuracy in Novice Athletes. Phys Act Rev 2021; 9(1): 100–108. doi: 10.16926/par.2021.09.12
16 Anderson J, Pudwell J, McAuslan C, Barr L, Kehoe J, Davies GA. Acute fetal response to high-intensity interval training in the second and third trimesters of pregnancy. Appl Physiol Nutr Metab. 2021; 46: 1552–1558. doi: 10.1139/apnm-2020-1086
17 Wieliczko M, Dylewska M. Hypocacemia. Wiad Lek. 2013; 66: 303–306.
18 El Kinany K, Garcia-Larsen V, Khalis M, Deoula MMS, Benslimane A, Ibrahim A, Benjelloun MC, El Rhazi K. Adaptation and validation of a food frequency questionnaire (FFQ) to assess dietary intake in Moroccan adults. Nutr J. 2018; 17: 61. doi: 10.1186/s12937-018-0368-4
19 Lin J, Idee JM, Port M, Diai A, Berthommier C, Robert M, Raynal I, Devoldere L, Corot C. Interference of magnetic resonance imaging contrast agents with the serum calcium measurement technique using colorimetric reagents. J Pharm Biomed Anal. 1999; 21: 931–943. doi: 10.1016/s0731-7085(99)00188-0.
20 Mayorga-Vega D, Merino-Marban R, Viciana J. Criterion-Related Validity of Sit-and-Reach Tests for Estimating Hamstring and Lumbar Extensibility: a Meta-Analysis. J Sports Sci Med. 2014; 13: 1–14.
21 Blazevich AJ, Gill N, Newton, RU. Reliability and validity of two isometric squat tests. J Strength Cond Res. 2002; 16: 298–304
22 Gilleard W, Crosbie J, Smith R. A longitudinal study of the effect of pregnancy on rising to stand from a chair. J Biomech; 2008; 41: 779–787. doi: 10.1016/j.jbiomech.2007.11.015
23 American College of Sports Medicine. ACSM's Guidelines for Exercise Testing and Prescription. 10th ed. Philadelphia, PA: Wolters Kluwer, 2018
24 Moyer C, Livingston J, Fang X, May LE. Influence of exercise mode on pregnancy outcomes: Enhanced by Mom project. BMC Pregnancy and Childbirth. 2015; 15: 133. doi: 10.1186/s12884-015-0556-6
25 Elsisi HF, Mousa GS, El desoky, MT. Electromagnetic field versus circuit weight training on bone mineral density in elderly women. Clin Interv Aging. 2015; 10: 539–548. doi: 10.2147/CIA.S78485
26 Evenson KR, Hesketh KR. Monitoring physical activity intensity during pregnancy. Am J Lifestyle Med. 2023; 17: 18–31. doi: 10.1177/15598276211052277
27 American College of Obstetricians and Gynecologists. Physical activity and exercise during pregnancy and the postpartum period. Obstet Gynecol. 2020; 135: e178–e188. doi: 10.1097/AOG.000000000000377
28 Kovacs, CS. Calcium and bone metabolism disorders during pregnancy and lactation. Endocrinol Metab Clin North Am. 2014; 43: 625–634. doi: 10.1016/j.ecl.2011.08.002
29 Perales M, Santos-Lozano A, Ruiz JR, Lucia A, Barakat R. Benefits of aerobic or resistance training during pregnancy on maternal health and perinatal outcomes: A systematic review. Early Hum Dev. 2016; 94: 43–48. doi: 10.1016/j.earlhumdev.2016.01.004
30 Maïmoun L, Sultan C. (2011). Effects of physical activity on bone remodeling. Metabolism. 2011; 60: 373–388. doi: 10.1016/j.metabol.2010.03.001
31 Isacco L, Duché P, Boisseau N. Influence of hormonal status on substrate utilization at rest and during exercise in the female population. Sports Med; 2012; 42: 327–342. doi: 10.2165/11598900-000000000-00000
32 Hannachi M, Ouerghi N, Abassi W, Ouergui I, Bouassida A. Effects of high-vs. moderate-intensity intermittent training on parathyroid hormone concentration in overweight/obese females. Sci Sports. Available online 2023. https://www.sciencedirect.com/science/article/abs/pii/S0765159723000370
33 Ashisawa N, Fujimura R, Tokuyama K. A bout of resistance exercises increases urinary calcium independently of osteoclastic activation in men. J Appl Physiol. 1997; 83: 1159–1163. doi: 10.1152/jappl.1997.83.4.1159
34 Su, CH, Peng HY, Tien, CW, Huang, WC. Effects of a 12-week pilates program on functional physical fitness and basal metabolic rate in community-dwelling middle-aged women: A quasi-experimental study. Int J Environ Res Public Health. 2022; 19: 16157. doi: 10.3390/ijerph192316157
35 Kerksick CM, Roberts MD, Campbell BI, Galbreath MM, Taylor LW, Wilborn CD, Lee A, Dove J, Bunn JW, Rasmussen CJ, Kreider RB. Differential impact of calcium and vitamin D on body composition changes in post-menopausal women following a restricted energy diet and exercise program. Nutrients. 2020; 12: 713. doi: 10.3390/nu12030713
36 Frontera WR, Meredith CN, O'Reilly KP, Evans WJ. Strength training and determinants of VO2max in older men. J Appl Physiol (1985). 1990; 68: 329–333. doi: 10.1152/jappl.1990.68.1.329
37 Kawamori N, Haff GG. The optimal training load for the development of muscular power. J Strength Cond Res. 2004; 18: 675–684. doi: 10.1519/15334287
38 Brewer CB, Booher BM, Lawton N. Comparison of acute energy expenditure and rating of perceived exertion in equivalent bouts of circuit training and treadmill running. J Strength Cond Res. 2021; 35: 680–687. doi: 10.1519/JSC.0000000000002731.PMID: 29995689

Article information

Published

2024-01-03

Issue

Vol. 12 No. 1 (2024)

Article type

ORIGINAL ARTICLE

License

Copyright (c) 2024 The authors

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Phys Act Rev. 2024;12(1):22-31.DOI: 10.16926/par.2024.12.03

How to Cite

Wahb, S., ElDeeb, A., Kamel, H., & El-Shafei, M. (2024). Effect of Circuit Training on Calcium Level and Physical Fitness in Pregnant Women with Hypocalcemia: A randomized controlled trial. Physical Activity Review, 12(1), 22-31. https://doi.org/10.16926/par.2024.12.03