Biomechanics of rising from a chair and walking in pregnant women

Evaluating Desk-Assisted Standing Techniques for Simulated Pregnant Conditions: An Experimental Study Using a Maternity-Simulation Jacket

Lower back pain, a common issue among pregnant women, often complicates daily activities like standing up from a chair. Therefore, research into the standing motion of pregnant women is important, and many research studies have already been conducted. However, many of these studies were conducted in highly controlled environments, overlooking everyday scenarios such as using a desk for support when standing up, and their effects have not been adequately tested. To address this gap, we measured multimodal signals for a sit-to-stand (STS) movement with hand assistance and verified the changes using a t-test. To avoid imposing strain on pregnant women, we used 10 non-diseased young adults who wore jackets designed to simulate pregnancy conditions, thus allowing for more comprehensive and rigorous experimentation. We attached surface electromyography (sEMG) sensors to the erector spinae muscles of participants and measured changes in muscle activity, skeletal positioning, and center of pressure both before and after wearing a Maternity-Simulation Jacket. Our analysis showed that the jacket successfully mimicked key aspects of the movement patterns typical in pregnant women. These results highlight the possibility of developing practical strategies that more accurately mirror the real-life scenarios met by pregnant women, enriching the current research on their STS movement.

Elderly-friendly indoor vertical dimensional layout method based on joint mobility

INTRODUCTION

The vertical dimensional arrangement of space is primarily influenced by the reachable range of human fingertips. Currently, this dimensional layout analysis concentrates solely on static body dimensions based on Farley's principle. However, the joint mobility of the elderly population has diminished, necessitating the identification of the factors influencing the age-friendly spatial vertical dimension layout through experimentation.

METHODS

A random sample of 62 adults and 62 elderly individuals were selected to measure the joint mobility of 8 groups with varying comfort levels. The measurement results were analyzed using an independent sample t-test with SPSS software.

RESULTS

The joint mobility of the elderly group exhibited a notable difference from that of the adult group across distinct comfort gradients. A significant reduction in the range of motion of all joints in the elderly was observed. The findings suggest that the reachable range of the upper limbs of the elderly should be considered in conjunction with joint mobility. We propose a vertical dimensional layout method for residential spaces that accommodates the joint mobility of elderly users.

CONCLUSION

The joint mobility of the elderly is significantly deteriorating, and the traditional vertical spatial layout method cannot adequately support the daily life of the elderly. It is essential to integrate the joint mobility factor into the vertical dimensional layout design process. In this paper, we propose an elderly-friendly vertical spatial dimension layout method. It offers a reference for subsequent planning of elderly-friendly vertical dimension layout.

Therapeutic exercise versus other modalities for prevention and treatment of low back, pelvic girdle, and lumbopelvic pain during pregnancy: A review protocol

Background

The female body changes during pregnancy to create a favorable environment for fetal development which may result in musculoskeletal disorder and painful symptoms in the lumbopelvic region.

Objective

To analyze the evidence of therapeutic exercise versus other modalities to prevent and treat LBP, LGP, and LPP during pregnancy.

Methods

Full text randomized controlled trials (RCT) evaluating interventions to prevent or treat LBP, PGP, and LPP during pregnancy (any gestational age) that comparing therapeutic exercises with usual care or other modalities to reduce the incidence or severity of LBP or PGP or both during pregnancy will be included. 5 electronic databases will be searched to identify studies. Assess risk of bias in each study using the Cochrane Handbook for Systematic Reviews of Interventions and quality of overall body of evidence for all primary outcomes will be assessed for all comparisons using the approach outlined in GRADE Handbook.

Analysis of sagittal thoracolumbar spine and hip joint movements during sit-to-stand using a 2D image analysis freeware

[Purpose] This study aimed to verify the utility of an image analysis freeware in the evaluation of thoracolumbar spine and hip joint movements during sit-to-stand movement and show the importance of separately analyzing the movements of the thoracolumbar spine and the hip joint. [Participants and Methods] We used a two-dimensional image analysis freeware to analyze the kinematics of the thoracolumbar spine and the hip joint during sit-to-stand movements in seven healthy young males. We further examined the usefulness of the freeware by verifying the concordance of its angle measurements with those of a three-dimensional motion analysis device. Moreover, we evaluated joint coordination of the thoracolumbar spine with hip joint movements in pregnant female before and after delivery by measuring the relative phase angle. [Results] The trunk angle and relative phase angle between the thoracolumbar spine and the hip joint obtained using the two different analytical methods were fairly consistent. In the analysis of the pregnant female, the degree of thoracolumbar flexion prior to hip flexion tended to decrease. Similarly, the degree of hip extension tended to decrease during pregnancy. [Conclusion] This study shows that a two-dimensional image analysis freeware could be useful and meaningful in the calculation of thoracolumbar spine and hip joint movements and in the detection of synergistic patterns of these entities during sit-to-stand movement.

Pilates for low risk pregnant women: Study protocol for a randomized controlled trial

BACKGROUND

Pilates has growing appeal to pregnant women, as a form of exercise and relaxation. It is purported to benefit lumbo-pelvic stability, as well as motor control, strength and endurance. Some suggest that modified Pilates exercises may assist low risk pregnant women to enjoy a healthier pregnancy and prepare for the physical demands of labour and birth. The feasibility and safety of Pilates during pregnancy is poorly understood. We describe the protocol for a feasibility study designed to compare a midwife-led 6-week community-based Pilates intervention with standard antenatal care.

METHODS

A convenience sample of 30 low-risk pregnant women will be recruited from private obstetric clinics in Melbourne, Australia. Participants shall be randomly allocated to a six-week, 1-h weekly Pilates exercises group session or to usual care. The Pilates exercise class will have a warm-up phase, Pilates exercises, breathing exercises, and a cool down phase. Exercises have been designed to prepare for active birth. The primary outcome will be feasibility of implementation, determined by recruitment, retention, adherence and safety. Secondary outcomes include women's health (quality of life, pain, mobility for daily activities, lower extremity performance, abdominal separation, continence) and labour and birth outcomes (duration of first stage and second stage labour, analgesia used, mode of birth). Validated questionnaires will include the Quality of life 12-item short form survey; Pregnancy Mobility Index, and International Consultation on Incontinence Questionnaire. Lower extremity performance and abdominal separation will also be measured.

DISCUSSION

This trial will provide preliminary data regarding the feasibility and safety of Pilates exercise in healthy pregnant women. It will also provide preliminary outcome data used to inform the design of a future large scale, multi-centre RCT.

TRIAL REGISTRATION

This clinical trial has been registered with the Australian and New Zealand Clinical Trials Registry 2016 (ACTRN12616000809437).

The Biomechanics of Pregnancy: A Systematic Review

During pregnancy, a number of biomechanical and hormonal changes occur that can alter spinal curvature, balance, and gait patterns by affecting key areas of the human body. This can greatly impact quality of life (QOL) by increasing back pain and the risk of falls. These effects are likely to be the ultimate result of a number of hormonal and biomechanical changes that occur during pregnancy. Research Question and Methodology: Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, this systematic review sets out to analyse all available literature relating to the biomechanics factors caused by pregnancy and assess how this might reduce QOL. Fifty papers were deemed eligible for inclusion in this review based on the PUBMED and SCOPUS databases. Results: Angles of lordosis and kyphosis of the spine are significantly increased by pregnancy, but not consistently across all studies. Back pain is significantly increased in pregnant women, although this is not significantly correlated with spinal changes. Increased movements of centre of pressure (COP) and increased stability indexes indicate postural control is reduced in pregnancy. Trunk range of motion, hip flexion, and extension are reduced, as well as decreased stride length, decreased gait velocity, and increased step width; again, not consistently. It is likely that each woman adopts unique techniques to minimise the effects, for example increasing step width to improve balance. Further research should focus on how altered limb kinematics during gait might affect QOL by influencing the human body, as well as assessing parameters in all planes to develop a wider understanding of pregnant biomechanical alterations.

Stand-to-sit kinematic changes during pregnancy correspond with reduced sagittal plane hip motion

BACKGROUND

The stand-to-sit motion has been linked to falls during pregnancy. It is also used in the clinical evaluation of functional performance. The physical and physiological changes during pregnancy may necessitate a change in stand-to-sit kinematic performance. Therefore, this study was conducted to evaluate the longitudinal changes to stand-to-sit kinematics during pregnancy.

METHODS

Fifteen pregnant women were tested in 4-week intervals from 16 weeks to 36 weeks gestational age. They performed a 60-second trial of semi-continuous stand-to-sit motion. Sagittal plane motions at the ankle, knee, spine, and shoulders were measured. Additionally, three-dimensional hip motion was measured. Discrete variables (e.g. range of motion) and joint coordinations (through vector coding) were analyzed over time through a linear mixed model analysis.

FINDINGS

The results indicate a shift away from sagittal hip motion throughout pregnancy. Hip range of motion and standing angle changed in favor of spine motion. Joint coordination shifted from hip dominant to spine- and shoulder-dominate coordination just before the start of sitting motion. Hip-knee joint coordination just before seat contact shifted from hip to a knee-dominant motion during pregnancy.

INTERPRETATION

Discrete variable changes in the entire stand-to-sit motion seem to be driven by initial standing posture related to an increase in gestational lordosis. Likewise, standing joint coordination shift to upper body motion can be attributed to gestational lordosis limiting functional ability around the hip. The shift in motion away from the hip may provide insight into why both fall rates and low back pain rates increase during stand-to-sit during pregnancy.

Does the first trimester of pregnancy induce alterations in the walking pattern?

Introduction

From among many studies observing the walking pattern throughout pregnancy, only two items monitor the influence of pregnancy on the movement system during gait considering the period before gestation.

Research question

Does the women’s gait pattern at the end of the first trimester undergo changes in comparison to body movement pattern before pregnancy?

Methods

All subjects who met the inclusion criteria gave signed and informed consent before the study. Two experimental sessions were arranged according to the same protocol: (P0) before pregnancy and (P1) at the end of the first trimester of pregnancy (12^th week of gestation). At first the anthropometric measures were taken. Then, walking trials at a self-selected speed along a walkway were registered with Vicon 250 (Oxford Metrics Ltd.; Oxford, UK) and FreeMED force platform (Sensor Medica, Italy).

Results

An analysis of anthropometric parameters in 12^th pregnancy week demonstrated significant changes in mean values of waist circumference and waist to hip ratio as well as waist to height ratio indexes compared to the results before pregnancy. No significant differences were found in the basic kinematic gait parameters between experimental conditions. Significant increase of mean inter—ankle distance during double support phase occurred during the first trimester of pregnancy. Also, the ratio of the ankle separation width to the pelvic width was noticeably higher in gestation. Then, angular changes of the pelvis in coronal and transverse planes throughout gait cycle during pregnancy demonstrated significant differences compared to those measured before pregnancy. At the same time in the first trimester of pregnancy no adaptive changes in the pattern of feet loading take place.

Significance

Since our study is of longitudinal character, in the course of pregnancy we expect compensatory mechanisms more clearly demonstrated. Therefore, we hope to identify a strategy of the gravid body progression in space.

Impact of lumbopelvic pain on postural balance during sit-to-stand activity in pregnant women: a cross-sectional study

Abstract Introduction: The emergence of painful pathologies during gestation, such as lumbopelvic pain (LPP), can influence in the achievement of functional activities, such as sit-to-stand, throughout the gestational period. Objective: To compare the variables of static and dynamic postural balance (sit-to-stand activity) among pregnant women with and whitout lumbopelvic pain and the outcome variables between the gestational trimesters. Method: A total of 100 pregnant women participated in this study allocated as follows: 51 in the LPP group and 49 in the group without LPP. All participants were subjected to an evaluation protocol: filling an identification form, Analogic Visual Scale (AVS) and Oswestry Disability Index (ODI). Evaluation of postural balance was subsequently performed using the Balance Master System®. Results: 64.7% of women during the third trimester of pregnancy reported LPP. No statistically significant differences were found between LBP presence or absence in postural balance variables (p>0.05). However, gestational age influenced the VFEC variable (p=0.001). Conclusion: Women during the third gestational trimester presented complaints of lumbopelvic pain. However, the data acquired suggest that women with LPP do not have alterations in postural balance during sit-to-stand movement when compared to pregnant women without pain.

Gait assessment of the expectant mothers - Systematic review

INTRODUCTION

Since pregnant women may have potentially greater difficulty maintaining balance, their stability has been investigated by some researchers. However, there is no consensus considering the results. The purpose of our investigation was to compare all the experimental studies focusing on the analysis of gait that have been conducted over the last years to assess their methodological issues and changes induced by pregnancy.

METHODS

The PRISMA Guidelines incorporating a risk of bias and strength of recommendations were used as a methodological template for this review. Literature searches were conducted using the following databases: PubMed, Embase, SPORTDiscus, Scopus. After limiting the search to meet the inclusion criteria, 25 articles remained in the final analysis.

RESULTS

Some authors emphasised that adaptations due to pregnancy are recognised to provide safety and stability. Thus, they consistently reported reduced walking velocity as a result of lower frequency and smaller length of the steps. Longer contact times were reflected by the shortened peak forces. Plantar loads were redistributed from the rearfoot (decrease) to the midfoot and forefoot (increase) throughout pregnancy. Another adjustment was an increase of base of support to improve lateral gait stability which allows to compensate increased medio-lateral ground reaction force. During the course of pregnancy the increase of anterior body mass and hormonal changes enhance some realignments of the pelvis and lumbar spine. Methodological approaches varied across the included studies. The critical appraisal identified some areas of weaknesses that should be considered for designing the future investigations.

CONCLUSIONS

Since many gait parameters are interrelated, in order to understand the cause-and-effect relationships an integrative and complete analysis of multiple factors is required.

Estimation of inertial parameters of the lower trunk in pregnant Japanese women: A longitudinal comparative study and application to motion analysis

We aimed to quantify the inertial parameters of the lower trunk segment in pregnant Japanese women and compare kinetic data during tasks calculated with parameters estimated in this study to data calculated with standard parameters. Eight pregnant women and seven nulliparous women participated. Twenty-four infrared reflective markers were attached to the lower trunk, and the standing position was captured by eight infrared cameras. The lower trunk was divided into parts, and inertial parameters were calculated. Pregnant women performed a movement task that involved standing from a chair, picking up plates, and walking forward after turning to the right. Kinetic analysis was performed using standard inertial parameters and the newly calculated parameters. There were more significant differences between methods in the kinetic data at the latter stages of pregnancy. The inertial parameters calculated in this study should be used to ensure the validity of biomechanical studies of pregnant Japanese women.

Differences in trunk control between early and late pregnancy during gait

The aim of this study was to compare gait characteristics, including the functional ability of the trunk, between women before and during the third trimester of pregnancy. Gait measurements were performed on 27 pregnant women, who were divided into two groups using the threshold of 28 gestational weeks. The subjects were instructed to walk at their preferred speed. In addition to stride-time coefficient of variation, root mean square (RMS) and autocorrelation coefficient, coefficient of attenuation (CoA) of acceleration was computed as an index to assess the functional ability of the trunk. Differences of gait characteristics between the groups were determined by the Mann-Whitney U test. Gait characteristics that showed a significant difference between the groups were further analyzed with adjustment by age, height, weight and gait velocity by using multiple regression analysis. Women during the third trimester of pregnancy showed significantly smaller RMS in the anteroposterior direction at the lower trunk than those before the third trimester of pregnancy, even after adjusting for age, height, weight and gait velocity [β=0.47; 95% confidence interval (CI) 0.07-0.25]. CoA in the anteroposterior direction was also significantly lower in women during the third trimester of pregnancy than in those before the third trimester of pregnancy after adjustment by age, height, weight and gait velocity (β=0.44; 95% CI 0.39-18.52). The present cross-sectional study suggests the possibility that the functional ability of the trunk during gait declines in late pregnancy.