Miguel Sánchez-Polán

Introduction The complex process of pregnancy and childbirth significantly influences the well‐being of both mother and child. Today all pregnant women without medical contraindications are recommended to start or continue regular aerobic and strength training for at least 150 min per week to prevent pregnancy‐related diseases and conditions. Urinary incontinence in pregnancy, episiotomy and third‐ or fourth‐degree perineal tear during labor can greatly impact womens’ health, quality of life and ability to be physically active. The aim of this study was to examine the efficacy of pelvic floor muscle training (PFMT) during pregnancy in the prevention of urinary incontinence, episiotomy, and third‐ or fourth‐degree perineal tear. Material and methods A systematic review and meta‐analysis (CRD42022370600) was performed. Only randomized clinical trials published between 2010 and 2023 were included. The following databases were examined: EBSCO (including Academic Search Premier, Education Resources Information Center, MEDLINE, SPORTDiscus and OpenDissertations databases), Clinicaltrials.gov , Web of Science, Scopus, Cochrane Database of Systematic Reviews and Physiotherapy Evidence Database (PEDro). Three meta‐analyses to investigate the effect of PFMT exclusively or implemented as a section within a physical activity program during pregnancy on urinary incontinence, episiotomy, and third‐ or fourth‐degree perineal tear were conducted. Results Thirty studies were analyzed ( N = 6691). An effective preventive action of PFMT was found for urinary incontinence ( z = 3.46; p < 0.0005; relative risk [RR] = 0.72, 95% confidence interval [CI]: 0.59, 0.87, I 2 = 59%) and third‐ or fourth‐degree perineal tear ( z = 2.89; p = 0.004; RR = 0.50, 95% CI: 0.31, 0.80, I 2 = 48%) but not for episiotomy ( z = 0.80; p = 0.42; RR = 0.95, 95% CI: 0.85, 1.07, I 2 = 75%). Conclusions PFMT during pregnancy proves to be an effective preventive intervention for reducing the risk of urinary incontinence and the occurrence of third‐ or fourth‐degree perineal tears. These findings highlight the importance of incorporating PFMT into antenatal care and training programs to improve maternal well‐being and overall childbirth outcomes.

Patients with lung cancer may experience deterioration in quality of life due to adverse effects caused by their disease and its treatment. Although exercise programs have been shown to improve quality of life in certain stages of the disease, the overall impact on this population is unknown. The objective of this research was to evaluate the effect of physical activity on the self-perception of quality of life, physical wellbeing and dyspnea in lung cancer patients. Thirteen articles were included. Five meta-analyses were performed using the standardized mean difference (SMD) with 95% confidence intervals (CI) to evaluate the target outcomes. Results showed significant differences in quality of life (p = 0.01; SMD = 0.43, 95% CI = 0.10, 0.75), physical functioning (p = 0.01; SMD = 0.27, 95% CI = 0.06, 0.49) and physical wellbeing (p = 0.01; SMD = 0.37, 95% CI = 0.08, 0.67) in favour of participants who have undergone the programme compared to those who have not, without significant differences between the two groups in dyspnea. This study shows how physical activity interventions could have positive effects on physical functioning and physical wellbeing but could also be effective for improving quality of life in patients with lung cancer.

Cesarean delivery may increase the need for anesthesia administration, thereby causing potential risks to both maternal and fetal health. This article aimed to investigate the effect of physical activity during pregnancy on the type of delivery, the duration of labor, and the use of epidurals (registration No.: CRD42022370646). Furthermore, 57 RCTs (n = 15301) were included showing that physical activity could decrease the risk of cesarean section (z = 3.22, p = 0.001; RR = 0.87, 95% CI = 0.79, 0.95, I2 = 37%, Pheterogeneity = 0.004), and 32 RCTs (n = 9468) showed significant decreases in instrumental delivery through performing physical activity (z = 3.48, p < 0.001; RR = 0.84, 95% CI = 0.76, 0.93, I2 = 0%, Pheterogeneity = 0.63). A significant decrease in the 15 RCTs’ (n = 4797) duration of first stage labor was found in physically active pregnant women (z = 2.09, p = 0.04; MD = −62.26, 95% CI = −120.66, −3.85, I2 = 93%, Pheterogeneity < 0.001) compared to those not active. Prenatal physical activity could decrease the risk of cesarean section and instrumental delivery and the duration of first stage labor.