Educational Program on Exercise During Pregnancy

Regular physical activity during pregnancy is associated with multiple maternal and fetal health benefits. However, many pregnant women remain inactive due to lack of knowledge, misconceptions about safety, and low confidence to perform exercise. Educational strategies may help overcome these barriers, yet evidence on brief structured educational interventions in primary care settings remains limited.

This study is designed as a pilot randomized controlled trial to evaluate the feasibility and preliminary effectiveness of an educational intervention on therapeutic exercise during pregnancy.

Pregnant women between 24 and 36 weeks of gestation attending primary care health centers in the Principality of Asturias (Spain) will be invited to participate. Inclusion criteria include age ≥18 years, ability to understand Spanish, and low-risk pregnancy. Women with high-risk pregnancies, medical contraindications to exercise, or inability to complete online questionnaires will be excluded.

After providing informed consent, participants will complete baseline online questionnaires assessing:

Knowledge about exercise during pregnancy (Knowledge of Exercise during Pregnancy Scale - KEPS)

Exercise self-efficacy during pregnancy (adapted Pregnancy Exercise Self-Efficacy Scale)

Physical activity level (Pregnancy Physical Activity Questionnaire - PPAQ, Spanish validated version)

Participants will then be randomly assigned (1:1) to one of two groups:

Control group: Receives standard prenatal information routinely provided during midwife consultations.

Experimental group: Receives standard prenatal care plus a structured educational session delivered by a physiotherapist. The session lasts approximately 60 minutes and includes information on benefits and safety of exercise during pregnancy, recommendations on frequency and intensity, demonstration of adapted therapeutic exercises, and time for questions. The intervention is educational only and does not require mandatory physical exercise practice.

Two weeks after the intervention, all participants will complete the same questionnaires again.

Primary outcomes are changes in knowledge and exercise self-efficacy scores between baseline and follow-up. Secondary outcome is change in physical activity level measured by the PPAQ. As a pilot study, the planned sample size is 30-40 participants.

Data will be collected anonymously using coded identifiers. The study is considered minimal risk, as it involves only educational activities and questionnaire completion, without altering usual medical care.

Findings from this pilot trial will inform the feasibility of implementing structured educational interventions on exercise during pregnancy in primary care and provide preliminary data for future larger-scale studies.

Inclusion criteria

• Pregnant women between 24 and 36 weeks of gestation
• Age 18 years or older
• Ability to understand Spanish
• Low-risk pregnancy

Exclusion criteria

• High-risk pregnancy
• Medical contraindications to exercise during pregnancy
• Inability to complete online questionnaires