Exercise Benefits and Barriers in Pregnancy

Developed by Amiri-Farahani et al. (2021) to evaluate barriers to physical activity among pregnant women. The scale consists of 29 items and four subdimensions, with each item scored on a 5-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree). Higher scores indicate greater barriers to physical activity (Amiri-Farahani et al., 2021). The validity and reliability of the Turkish version were confirmed by Ataman Bor and Hanligil, with Cronbach's alpha coefficients reported as follows: total scale, 0.91; pregnancy-related personal barriers, 0.88; non-pregnancy-related personal barriers, 0.89; interpersonal barriers, 0.87; environmental barriers, 0.80 (Bor \& Hanligil, 2024).

Developed by Chasan-Taber et al. (2004), this semi-quantitative questionnaire asks participants to report the amount of time spent on 32 different activities. These include household/caregiving activities (13 items), occupational activities (5 items), sports/exercise (8 items), transportation (3 items), and inactivity (3 items). For each activity, participants indicate the amount of time they typically spend per day or week during their current trimester. Time intervals range from 0 to 6 or more hours per day and 0 to 3 or more hours per week. An open-ended section at the end allows participants to list other activities not included in the questionnaire. Weekly total energy expenditure is calculated as MET-hours/week (Chasan-Taber et al., 2004). The Turkish validity and reliability study was conducted by Çırak et al. (2015).

Physical activity levels will be assessed using the Turkish version of the IPAQ-SF, which has demonstrated validity and reliability (Saglam et al., 2010). The questionnaire consists of seven items evaluating time spent in walking, moderate-intensity, and vigorous-intensity activities, as well as one separate question assessing time spent sitting. Scoring involves calculating total minutes and days for walking, moderate, and vigorous activities. MET-minutes are computed by multiplying the minutes spent in each activity by its MET value (vigorous activity = 8 METs, moderate activity = 4 METs, walking = 3.3 METs). Participants are classified into three categories based on total MET-minutes: "inactive," "minimally active," and "highly active" (Saglam et al., 2010).

This 10-item questionnaire assesses pregnant women's perceived ability and motivation to engage in physical activity under various circumstances. Adapted from the Exercise Self-Efficacy Scale, it was developed by Brand et al. to explain and predict changes in exercise behavior. A 5-point Likert scale is used (1 = strongly disagree to 5 = strongly agree), with total scores ranging from 10 to 50. Scores are categorized as follows: low self-efficacy, 10-17 points; moderate self-efficacy, 18-34 points; high self-efficacy, 35-50 points (Brand et al., 2013). The Turkish validity and reliability study was conducted by Üzelpasaci et al. (2023), with a Cronbach's alpha of 0.889.

The severity of kinesiophobia among pregnant participants will be assessed using a vertical 0-10 cm Visual Analog Scale through the following question:

• "I am afraid that exercising during pregnancy might harm my baby" (0 = not afraid at all, 10 = extremely afraid)

Participants will be asked to mark a point on the VAS, and the distance from 0 will be measured with a ruler.