{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T17:10:03Z","timestamp":1756660203094,"version":"3.44.0"},"reference-count":30,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:00:00Z","timestamp":1752192000000},"content-version":"unspecified","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia, Portugal","award":["2023.14896.PEX"],"award-info":[{"award-number":["2023.14896.PEX"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Sport Exerc Med"],"accepted":{"date-parts":[[2025,6,24]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>Many studies have supported the positive effects of an active lifestyle on the prevention and treatment of pregnancy-related complications, as well as maintaining fitness and functionality. The COVID-19 pandemic has underscored the need for virtual approaches to health interventions; however, few studies have examined the effectiveness of these interventions. The Standard Protocol Items: Recommendations for Interventional Trials 2025 guidelines were followed to describe the protocol of the ACTIVE PREGNANCY trial, an intervention study that delivers a physical exercise programme in-person (IN) and online (ON) to improve maternal physical activity (PA), fitness and healthy lifestyle parameters in pregnant women. Pregnant women will be invited to participate in a multisite, multicomponent exercise programme delivered either IN or ON by qualified exercise physiologists. Both groups will receive an exercise intervention delivered in different real-life environments. Participants will undergo basic fitness field tests and complete questionnaires assessing PA, fitness and lifestyle parameters before starting the exercise programme and after completing 12 weeks of the intervention. Researchers will test whether the intervention is beneficial in maintaining or improving maternal parameters after 12 weeks and will compare the effectiveness of different exercise modes. Subgroups of maternal age and weekly volume of PA will also be analysed.<\/jats:p>\n               <jats:p>Primary outcomes: PA volume and health-related and functional fitness. Secondary outcomes: healthy lifestyle parameters. Additional outcomes: satisfaction with the exercise interventions and resources. This study was approved by the Ethics Committee of Santar\u00e9m Polytechnic University and registered on ClinicalTrials.gov (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06954454\">NCT06954454<\/jats:ext-link>). Findings will be disseminated via publications, conferences and training programmes.<\/jats:p>","DOI":"10.1136\/bmjsem-2025-002767","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T13:50:10Z","timestamp":1752241810000},"page":"e002767","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of in-person versus online supervised multicentre multicomponent prenatal exercise programme on maternal physical activity, fitness and healthy lifestyle: the Active Pregnancy trial SPIRIT 2025-based protocol"],"prefix":"10.1136","volume":"11","clinical-trial-number":[{"clinical-trial-number":"nct06954454","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct06954454","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7188-8383","authenticated-orcid":false,"given":"Rita","family":"Santos-Rocha","sequence":"first","affiliation":[{"name":"ESDRM Sport Sciences School of Rio Maior, Santar\u00e9m Polytechnic University, Rio Maior, Portugal"},{"name":"SPRINT Sport Physical Activity and Health Research and Innovation Center, Rio Maior, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5238-1069","authenticated-orcid":false,"given":"Marco","family":"Branco","sequence":"additional","affiliation":[{"name":"ESDRM Sport Sciences School of Rio Maior, Santar\u00e9m Polytechnic University, Rio Maior, Portugal"},{"name":"SPRINT Sport Physical Activity and Health Research and Innovation Center, Rio Maior, Portugal"}]},{"given":"Joana","family":"Prior de Freitas","sequence":"additional","affiliation":[{"name":"ESDRM Sport Sciences School of Rio Maior, Santar\u00e9m Polytechnic University, Rio Maior, Portugal"},{"name":"SPRINT Sport Physical Activity and Health Research and Innovation Center, Rio Maior, Portugal"}]},{"given":"B\u00e1rbara","family":"Castro","sequence":"additional","affiliation":[{"name":"SPRINT Sport Physical Activity and Health Research and Innovation Center, Rio Maior, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7172-3461","authenticated-orcid":false,"given":"Adelaide Teixeira","family":"Pinto","sequence":"additional","affiliation":[{"name":"SPRINT Sport Physical Activity and Health Research and Innovation Center, Rio Maior, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1625-5932","authenticated-orcid":false,"given":"Sandra","family":"Silva - Santos","sequence":"additional","affiliation":[{"name":"SPRINT Sport Physical Activity and Health Research and Innovation Center, Rio Maior, Portugal"},{"name":"Instituto de Estudos Superiores de Fafe Lda, Braga, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7273-2911","authenticated-orcid":false,"given":"Cristina","family":"Nogueira-Silva","sequence":"additional","affiliation":[{"name":"University of Minho School of Medicine, Braga, Portugal"},{"name":"ICVS Institute of Life and Health Sciences, Braga, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1032-0529","authenticated-orcid":false,"given":"Miguel Angel","family":"Oviedo-Caro","sequence":"additional","affiliation":[{"name":"University of Seville, Seville, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8565-027X","authenticated-orcid":false,"given":"Anna","family":"Szablewska","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3777-5697","authenticated-orcid":false,"given":"Anna","family":"Szumilewicz","sequence":"additional","affiliation":[{"name":"Gdansk University of Physical Education and Sport, Gdansk, Poland"}]}],"member":"239","published-online":{"date-parts":[[2025,7,11]]},"reference":[{"key":"2025083109305088000_11.3.e002767.1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000001941"},{"key":"2025083109305088000_11.3.e002767.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.681"},{"key":"2025083109305088000_11.3.e002767.3","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.pcad.2020.11.003","article-title":"The impact of moving more, physical activity, and cardiorespiratory fitness: Why we should strive to measure and improve fitness","volume":"64","author":"Myers","year":"2021","journal-title":"Prog Cardiovasc Dis"},{"key":"2025083109305088000_11.3.e002767.4","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e318267ad67"},{"key":"2025083109305088000_11.3.e002767.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0229079","article-title":"Association of objectively measured physical fitness during pregnancy with maternal and neonatal outcomes. 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