Trunk motion and gait characteristics of pregnant women when walking: report of a longitudinal study with a control group

BMC Pregnancy and Childbirth

Wendy L Gilleard¹ 

[1]School of Health and Human Sciences, Southern Cross University, PO Box 157, Lismore, NSW, 2480, Australia

关键词: Walking;    Trunk;    Thorax;    Temporospatial;    Stride length;    Step width;    Pregnancy;    Post-birth;    Pelvis;    Kinematics;   

Others  :  1138139
DOI  :  10.1186/1471-2393-13-71

 received in 2012-11-11, accepted in 2013-03-15,  发布年份 2013

【 摘 要 】

Background

A longitudinal repeated measures design over pregnancy and post-birth, with a control group would provide insight into the mechanical adaptations of the body under conditions of changing load during a common female human lifespan condition, while minimizing the influences of inter human differences. The objective was to investigate systematic changes in the range of motion for the pelvic and thoracic segments of the spine, the motion between these segments (thoracolumbar spine) and temporospatial characteristics of step width, stride length and velocity during walking as pregnancy progresses and post-birth.

Methods

Nine pregnant women were investigated when walking along a walkway at a self-selected velocity using an 8 camera motion analysis system on four occasions throughout pregnancy and once post birth. A control group of twelve non-pregnant nulliparous women were tested on three occasions over the same time period. The existence of linear trends for change was investigated.

Results

As pregnancy progresses there was a significant linear trend for increase in step width (p = 0.05) and a significant linear trend for decrease in stride length (p = 0.05). Concurrently there was a significant linear trend for decrease in the range of motion of the pelvic segment (p = 0.03) and thoracolumbar spine (p = 0.01) about a vertical axis (side to side rotation), and the pelvic segment (p = 0.04) range of motion around an anterio-posterior axis (side tilt). Post-birth, step width readapted whereas pelvic (p = 0.02) and thoracic (p < 0.001) segment flexion-extension range of motion decreased and increased respectively. The magnitude of all changes was greater than that accounted for with natural variability with re testing.

Conclusions

As pregnancy progressed and post-birth there were significant linear trends seen in biomechanical changes when walking at a self-determined natural speed that were greater than that accounted for by natural variability with repeated testing. Not all adaptations were resolved by eight weeks post birth.

【 授权许可】

   
2013 Gilleard; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Maturi MS, Afshary P, Abedi P: Effect of physical activity intervention based on a pedometer on physical activity level and anthropometric measures after childbirth: a randomized controlled trial. BMC Pregnancy Childbirth 2011, 11:103. BioMed Central Full Text
• [2]Jensen RK, Doucet S, Treitz T: Changes in segment mass and mass distribution during pregnancy. J Biomech 1996, 29:251-256.
• [3]Bullock-Saxton JE: Changes in posture associated with pregnancy and the early post-natal period measured in standing. Physiother Theory Pract 1991, 7:103-109.
• [4]Dumas GA, Reid JG, Wolfe LA, Griffin MP, McGrath MJ: Exercise, posture, and back pain during pregnancy. Clin Biomech 1995, 10:98-103.
• [5]Franklin ME, Conner-Kerr T: An analysis of posture and back pain in the first and third trimester of pregnancy. J Orthop Sports Phys Ther 1998, 28:133-138.
• [6]Fries EC, Hellebrandt FA: The influence of pregnancy on the location of the centre of gravity, postural stability and body alignment. Am J Obstet Gynecol 1946, 46:374-380.
• [7]Gilleard W, Crosbie J, Smith R: Static trunk posture in sitting and standing during pregnancy and early post-birth. Arch Phys Med Rehabil 2002, 83:1739-1744.
• [8]Lee YH, Her LL, Tsuang YH: A comparison of sitting posture adaptations of pregnant and non-pregnant females. Int J Ind Ergon 1999, 23:391-396.
• [9]Moore K, Dumas G, Reid J: Postural changes associated with pregnancy and their relationship with low-back pain. Clin Biomech 1990, 5:169-174.
• [10]Foti T, Davids J, Bagley A: A biomechanical analysis of gait during pregnancy. J Bone Joint Surg Br 2000, 82-A:625-632.
• [11]Wu W, Meijer OG, Lamoth CJC, Uegaki K, Van Dieën JH, Wuisman PIJM, De Vries JIP, Beek PJ: Gait coordination in pregnancy: transverse pelvic and thoracic rotations and their relative phase. Clin Biomech 2004, 19:480-488.
• [12]Huang Y, Meijer OG, Lin J, Bruijn SM, Wu W, Lin X, Hu H, Huang C, Shi L, van Dieën JH: The effects of stride length and stride frequency on trunk coordination in human walking. Gait Posture 2010, 31:444-449.
• [13]Hurt CP, Rosenblatt N, Crenshaw JR, Grabiner MD: Variation in trunk kinematics influences variation in step width during treadmill walking by older and younger adults. Gait Posture 2010, 31:461-464.
• [14]Bird AR, Menz HB, Hyde CC: The effect of pregnancy on footprint parameters: a prospective investigation. J Am Podiatr Med Assoc 1999, 89:405-409.
• [15]Golomer E, Ducher D, Arfi GS, Sud R: Etude de la locomotion simple et lors du transport de charge chez la femme enceinte. J Gynecol Obstet Biol Reprod (Paris) 1991, 20:406-412.
• [16]Lymbery J, Gilleard W: The stance phase of walking during late pregnancy. J Am Podiatr Med Assoc 2005, 95:247-253.
• [17]Taves C, Charteris J, Wall JC: The kinematics of treadmill walking during pregnancy. Physiother Can 1982, 34:321-324.
• [18]Crosbie J, Vachalathiti R, Smith R: Patterns of spinal motion during walking. Gait Posture 1997, 5:6-12.
• [19]Leardini A, Biagi F, Merlo A, Belvedere C, Benedetti MG: Multi-segment trunk kinematics during locomotion and elementary exercises. Clin Biomech 2011, 26:562-571.
• [20]Chung CY, Park MS, Lee SH, Kong SJ, Lee KM: Kinematic aspects of trunk motion and gender effect in normal adults. J Neuroeng Rehabil 2010, 15:9.
• [21]Leardini A, Biagi F, Belvedere C, Benedetti MG: Quantitative comparison of current models for trunk motion in human movement analysis. Clin Biomech 2009, 24:542-550.
• [22]Thorstensson A, Carlson H, Zomlefer M, Nilsson J: Lumbar back muscle activity in relation to trunk movements during locomotion in man. Acta Physiol Scand 1982, 116:13-20.
• [23]Gilleard WL, Brown JMM: Structure and function of the abdominal muscles in prim gravid subjects during pregnancy and the immediate post birth period. Phys Ther 1996, 76:750-762.
• [24]Dumas G, Adams M, Dolan P: Fatigability of back extensors after pregnancy. J Biomech 1998, 31(Supplement 1):33.
• [25]McCrory JL, Chambers AJ, Daftary A, Redfern MS: Ground reaction forces during gait in pregnant fallers and non-fallers. Gait Posture 2011, 34:524-528.
• [26]Nicholls JA, Grieve DW: Performance of physical tasks in pregnancy. Ergonomics 1992, 35:301-311.