Medical care providers recommend regular exercise as it is said to be effective for both physical and mental health. Home-based walking, the easiest physical activity, is considered one of the habits in daily life that contribute to the people’s wellbeing, and have been adopted in a number of exercise programs. The safe practice that does not require any special physical skills has been recommended for people of all ages including pregnant women.

Studies conducted between 1996 and 2017 were identified in a search of electronic databases, which include MEDLINE and CINAHL. Selected keywords were ‘home-based walking’, ‘women’, ‘pregnancy’ and ‘mood’.

A search using the keyword of home-based walking found 150 papers from 1996 to 2017, which is reduced to less than 1/3 or 43 papers when the search is limited to women. A search conducted with the keywords of home-based walking and mood found only four papers, while there were 10 papers when searched with walking and pregnancy.

Although medical care providers recommend regular exercise as it is said to be effective for both physical and mental health, there are limited number of papers in this regard focused on women or pregnant women in the last 20 years. Home-based walking is good not only for healthy women but also for breast cancer patients and pregnant women, and nursing intervention has been carried out to improve their mental health as well as alleviating discomfort. In the literature in the 2000s, surveys of walking were conducted taking account of environmental factors for improvement of women’s physical and mental health [1-3]. Home-based walking is an exercise that does not require any expenses or special training and is doable by anyone. One issue to be considered is the adherence to it.

To improve the adherence to home-based walking

Environmental factors that prevent exercise according to WHO include: risk of encountering violence/crimes in the suburbs; busy traffic; air pollution; and insufficient facilities such as parks and walkways [4]. As for walking, it was revealed that the amount of exercise declines without a promenade, even though there is a park nearby [5]. In a study of African-American women, a relation between the environment and their mental health, and a relation between their adherence and mental health became clear, and improvement of the environment as an external factor was proposed [2].

For breast cancer patients, a program is offered that uses a treadmill installed at home so the exercise can be done regardless of the weather. Although this program uses a special apparatus, it successfully eliminates the environmental factor that obstructs home-based walking, and resulted in an adherence rate of 30% even during chemotherapy [6].

Highlighting the matter of adherence, Nies describes the necessity to attract the interest of women who don’t have a habit of exercising [1]. A study of aged people in Japan found that to motivate the participants a reward to all was effective rather than giving it to some of them selected by drawing and that the reward should have a higher cash value [7]. There is no research, however, about the contents that would attract the interest of women.

Concerning pregnant women who do not have the habit of exercise, there is a report that home-based walking is effective for relieving backache during pregnancy [8]. The adherence to home-based walking, however, decreases along with the progress of pregnancy [9,10] and the effect on mental health declines [10]. Pregnant women are encouraged to exercise even after going into labor, but as a large-scale RCT shows that walking around during labor doesn’t hasten delivery [11], it may be difficult for them to see a definite benefit of walking [12].

Attention to stretching as a substitute for home-based walking

In place of walking, stretching is proposed for pregnant women in advanced stages when it becomes difficult to continue walking. With its effects for relaxing, and reducing heart beat and blood pressure, stretching is also good for prevention of preeclampsia [9]. In addition, it is not affected by external environment and does not require any special apparatus such as a treadmill and the implementation rate was higher with stretching than walking [9].

Rather than walking that is affected by external environmental factors, stretching is considered to be more recommendable as a home exercise, although further examination is necessary to review whether stretching is equally effective for improving mental health and reduce discomfort.