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Wei L, Wang Y, Peng Y, Zhang G, Tan Q, Gu Y, Zhang M. Suitable Heel Height, a Potential Method for Musculoskeletal Problems during the Third Trimester: A Pilot Study. Bioengineering (Basel) 2024; 11:667. [PMID: 39061749 PMCID: PMC11274345 DOI: 10.3390/bioengineering11070667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/17/2024] [Accepted: 06/20/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND The treatment options for third-trimester musculoskeletal issues are limited. This study aims to examine how heel height affects gait biomechanics and provides heel height recommendations for various musculoskeletal problems. METHODS Five third-trimester gravidas were recruited wearing uniform footwear with four heel heights (0 mm, 15 mm, 30 mm, and 45 mm). Lower-limb muscle forces, joint angles, joint torques, joint contact forces, and ground reaction forces (GRF) at specific moments (the first peak, valley, and second peak of GRF) were collected for one-way analysis of variance with repeated measures. RESULTS The soleus, gastrocnemius, tibialis posterior, plantaris, obturator externus, gluteus maximus, gemellus superior, and obturator internus were the smallest at heel heights of 45 mm and 15 mm at the valley of GRF. Hip extension and knee flexion displayed the smallest joint angle and joint torques at a height of 15 mm. Ankle joint contact force decreased with increased heel height. CONCLUSIONS The height of the heel significantly impacts muscle force, joint angles, joint torques, and joint contact force. A heel of 15 mm might be the most suitable heel height to potentially avoid or alleviate musculoskeletal problems during the third trimester.
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Affiliation(s)
- Linjuan Wei
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (L.W.); (G.Z.); (Q.T.)
| | - Yan Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (L.W.); (G.Z.); (Q.T.)
- Shenzhen Research Institute, The Hong Kong Polytechnic University, Shenzhen 518057, China
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Yinghu Peng
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology Chinese Academy of Sciences, Shenzhen 518055, China;
| | - Guoxin Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (L.W.); (G.Z.); (Q.T.)
| | - Qitao Tan
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (L.W.); (G.Z.); (Q.T.)
- Shenzhen Research Institute, The Hong Kong Polytechnic University, Shenzhen 518057, China
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China;
| | - Ming Zhang
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China; (L.W.); (G.Z.); (Q.T.)
- Shenzhen Research Institute, The Hong Kong Polytechnic University, Shenzhen 518057, China
- Research Institute for Sports Science and Technology, The Hong Kong Polytechnic University, Hong Kong 999077, China
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Edwards CM, da Silva D, Puranda JL, Miller É, Semeniuk K, Adamo KB. Are physical fitness, a history of childbirth and injury history related to knee valgus in female Canadian Armed Forces members during a bodyweight overhead squat movement? BMJ Mil Health 2024:e002653. [PMID: 38862249 DOI: 10.1136/military-2023-002653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/04/2024] [Indexed: 06/13/2024]
Abstract
OBJECTIVES A history of childbirth is associated with musculoskeletal injury (MSKi) in female members of the Canadian Armed Forces (CAF). While previous injury and pregnancy impact knee kinematics, it is unclear if a history of childbirth is associated with medial knee displacement (MKD) in an overhead squat movement screen. The aim of this study is to examine the relationship between MKD and (1) MSKi and (2) parity status in female CAF members. METHODS 24 nulliparous and 21 parous female participants employed by the CAF completed a comprehensive physical fitness assessment of muscular flexibility, power, strength, endurance, aerobic capacity and a bodyweight overhead squat movement screen (recorded using two-dimensional video, and hip-knee-ankle angle measured using Kinovea software). Interactions between MKD, parity status and MSKi history were assessed by one-way analysis of variance and two-way analysis of covariance (ANCOVA) (adjusted for age). RESULTS An interaction between parity status and acute injury of the lower extremity was observed (F=4.379, p=0.043, η2 =0.099) in MKD of the right knee. The two-way ANCOVA examining acute injury of the lumbopelvic hip complex (lower back, pelvis, hip) yielded an interaction between acute injury to the lumbopelvic hip complex and parity status (F=4.601, p=0.038, η2=0.103) in MKD asymmetry. DISCUSSION Parous participants with acute injury to the lower extremity had larger MKD than parous without this injury type. Parous participants without acute injury to the lumbopelvic hip complex had greater MKD asymmetry than nulliparous without this injury type. Our findings suggest that researchers and clinicians should consider parity status in conjunction with MSKi history when assessing knee kinematics in female military members.
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Affiliation(s)
| | - D da Silva
- Department of Sports Studies, Bishop's University, Sherbrooke, Quebec, Canada
| | - J L Puranda
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - É Miller
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - K Semeniuk
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - K B Adamo
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Fukano M, Nomura Y, Tsukahara Y. Does the pregnancy-related adaptation of gait biomechanics after childbirth recover to its pre-pregnancy state?: A systematic review. Gait Posture 2024; 110:110-121. [PMID: 38569400 DOI: 10.1016/j.gaitpost.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 03/12/2024] [Accepted: 03/19/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Although changes in the gait biomechanics during pregnancy are known to occur, it is unclear whether they return to their original state after childbirth. RESEARCH QUESTION The objective of the current systematic review is to summarize existing literature reporting the biomechanical characteristics of gait in postpartum women and to identify knowledge gaps that calls for future investigations in this population. METHODS Relevant articles were selected using MEDLINE (PubMed), Scopus (Elsevier), Embase (Elsevier), and Web of Science (Clarivate Analytics). Articles were included if they met the following criteria: They must (1) include postpartum women, (2) report measures related to three-dimensional (3D) kinematics and/or kinetics, (3) have been published after 1990, and (4) have been published in English. RESULTS AND SIGNIFICANCE The current systematic review included a total of 14 articles, five of which compare the data from postpartum women with nulliparous women or pre-pregnancy data. We observed that gait biomechanics changes of postpartum women could persist for more than 5 years after the childbirth. This review provides novel viewpoints on the biomechanics of postpartum women's gait and recommendations for future studies to fully understand these changes and improve postpartum women's physical and mental wellbeing.
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Affiliation(s)
- Mako Fukano
- College of Engineering, Shibaura Institute of Technology, 307 Fukasaku, Minuma-ku, Saitama-shi, Saitama 337-8570, Japan.
| | - Yumi Nomura
- Faculty of Creative Engineering, Chiba Institute of Technology, 2-1-1 Shibazono, Narashino-shi, Chiba 275-0023, Japan
| | - Yuka Tsukahara
- Department of Sports Medicine, Tokyo Women's College of Physical Education, 4-30-1 Fujimidai, Kunitachi-shi, Tokyo 186-8668, Japan
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Bagwell JJ, Avila E, Reynolds N, Smith JA, Valenzuela K, Katsavelis D. Running biomechanics differ during and after pregnancy compared to females who have never been pregnant. Gait Posture 2024; 109:277-283. [PMID: 38377744 DOI: 10.1016/j.gaitpost.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/16/2024] [Accepted: 02/03/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Perinatal running participation has increased recently; however, pregnancy related symptoms can limit activity. Perinatal running biomechanics could inform interventions to help perinatal individuals maintain an active lifestyle. RESEARCH QUESTION Are perinatal running biomaechanics and muscle activation different compared to nulligravida females? METHODS Sixteen pregnant participants completed self-selected velocity running during second trimester (2 T), third trimester (3 T), and postpartum (PP) and 16 matched controls completed these procedures once in this case control study. Kinematic, kinetic, and electromyography (EMG) data were collected using a motion capture system, force plates, and EMG electrodes. Peak trunk, pelvis, hip, knee, and ankle kinematics and hip, knee, and ankle moments during stance phase, and average and peak erector spinae (ES), gluteus maximus (GMax), and gluteus medius (GMed) EMG amplitude and duration of activation during stance and swing phases were calculated. Independent t-tests were used to compare 2 T, 3 T, and PP to control participants (α < 0.05). RESULTS Running velocity was slower during 3 T compared to control participants. At all pregnancy timepoints compared to the control group, peak trunk contralateral rotation was smaller. During 2 T and 3 T peak hip flexor moments were smaller. At 3 T pelvis contralateral rotation was smaller, ES average amplitude was greater during swing, GMax percent duration during stance and GMed percent duration during swing were smaller. At PP trunk flexion was smaller and knee abduction was greater (all p < 0.05). CONCLUSIONS Decreased running velocity may help offset increased demand during pregnancy. During 3 T, greater ES activation, smaller trunk and pelvis motion, and altered gluteal activation could indicate trunk rigidity combined with modified hip stabilizer muscle utilization. During PP, the rigid trunk combined with greater knee abduction may indicate hip and trunk strength deficits. Altered trunk and hip motion and activation could be relevant to pathologies such as perinatal low back, pelvic girdle, or knee pain.
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Affiliation(s)
- Jennifer J Bagwell
- Department of Physical Therapy, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA.
| | - Elizabeth Avila
- Department of Kinesiology, California State University Long Beach, 1250 Bellflower Blvd, Long Beach, CA 90840, USA
| | - Nicholas Reynolds
- Department of Biomechanics, University of Nebraska, Omaha, NE 68182, 6160 University Drive, Omaha, NE 68182, USA
| | - Jo Armour Smith
- Department of Physical Therapy, Chapman University, 9401 Jeronimo Road, Irvine, CA 92618, USA
| | - Kevin Valenzuela
- Department of Kinesiology, California State University Long Beach, 1250 Bellflower Blvd, Long Beach, CA 90840, USA
| | - Dimitrios Katsavelis
- Department of Exercise Science, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
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Edwards CM, da Silva DF, Puranda JL, Souza SCS, Semeniuk K, Adamo KB. Associations Between Rank, Sex, and Parity With Musculoskeletal Injuries Sustained During Annual Military Physical Fitness Test. J Strength Cond Res 2024; 38:367-373. [PMID: 37815270 DOI: 10.1519/jsc.0000000000004606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
ABSTRACT Edwards, CM, da Silva, DF, Puranda, JL, Souza, SCS, Semeniuk, K, and Adamo, KB. Associations between rank, sex, and parity with musculoskeletal injuries sustained during annual military physical fitness test. J Strength Cond Res 38(2): 367-373, 2024-Musculoskeletal injuries pose a significant threat to the well-being of military personnel. Attempts to use physical employment standard test results as predictors of injury are underway, but little is known about injuries sustained during the tests. This study sought to identify body regions most likely to be reported as injured during the annual Canadian Armed Forces (CAF) physical fitness evaluation. In addition, sex, rank, and parity status are explored as possible associated factors for injury. A total of 1,796 actively serving CAF members were categorized by sex (1,030 male participants; 766 female participants), rank (1,142 Non-Commissioned Members [NCM]; 638 Officers), and parity (314 parous female participants; 435 nulliparous female participants). Sex, rank, and parity were associated with body regions reportedly injured during an annual CAF fitness assessment (significance p ≤ 0.05). When compared with male participants, female participants were more likely to be injured {aOR: 1.797 (95% [confidence interval] CI: 1.45-2.23)} and more prone to injury of the wrist (adjusted odds ratio [aOR]: 1.933 [95% CI: 1.20-3.12]), hip (aOR: 3.445 [95% CI: 2.07-5.728]), or lower back (aOR: 1.55 [95% CI: 1.18-2.04]). Non-Commissioned Members were more likely to injure the neck (aOR: 2.14 [95% CI: 1.18-3.88]) or shoulder (aOR: 2.03 [95% CI: 1.31-3.15]), when compared with Officers. Parous female participants reported pelvis/abdomen injury at a higher rate than the nulliparous group (5 vs. 1.7%, p = 0.019). Injuries sustained during an annual CAF fitness assessment differ based on sex, rank, and parity. Canadian Armed Forces female participants, NCM, and parous female participants may require specific physical fitness support in preparation for the annual physical fitness test.
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Affiliation(s)
- Chris Margaret Edwards
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; and
| | - Danilo Fernandes da Silva
- Sports Studies Department, Faculty of Arts and Science, Bishop's University, Sherbrooke, Quebec, Canada
| | - Jessica Laura Puranda
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; and
| | | | - Kevin Semeniuk
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; and
| | - Kristi Bree Adamo
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; and
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Edwards CM, Adamo KB. History of childbirth as a potential risk factor for musculoskeletal injury in military personnel. BMJ Mil Health 2023:e002620. [PMID: 38053284 DOI: 10.1136/military-2023-002620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/20/2023] [Indexed: 12/07/2023]
Affiliation(s)
| | - K B Adamo
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
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Lefranc AS, Klute GK, Neptune RR. The Influence of Multiple Pregnancies on Gait Asymmetry: A Case Study. J Appl Biomech 2023; 39:403-413. [PMID: 37704197 DOI: 10.1123/jab.2023-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 06/15/2023] [Accepted: 07/17/2023] [Indexed: 09/15/2023]
Abstract
Gait asymmetry is a predictor of fall risk and may contribute to increased falls during pregnancy. Previous work indicates that pregnant women experience asymmetric joint laxity and pelvic tilt during standing and asymmetric joint moments and angles during walking. How these changes translate to other measures of gait asymmetry remains unclear. Thus, the purpose of this case study was to determine the relationships between pregnancy progression, subsequent pregnancies, and gait asymmetry. Walking data were collected from an individual during 2 consecutive pregnancies during the second and third trimesters and 6 months postpartum of her first pregnancy and the first, second, and third trimesters and 6 months postpartum of her second pregnancy. Existing asymmetries in step length, anterior-posterior (AP) impulses, AP peak ground reaction forces, lateral impulses, and joint work systematically increased as her pregnancy progressed. These changes in asymmetry may be attributed to pelvic asymmetry, leading to asymmetric hip flexor and extensor length, or due to asymmetric plantar flexor strength, as suggested by her ankle work asymmetry. Relative to her first pregnancy, she had greater asymmetry in step length, step width, braking AP impulse, propulsive AP impulse, and peak braking AP ground reaction force during her second pregnancy, which may have resulted from increased joint laxity.
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Affiliation(s)
- Aude S Lefranc
- Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX,USA
| | - Glenn K Klute
- Department of Veteran Affairs, Center for Limb Loss and MoBility, Seattle, WA,USA
- Department of Mechanical Engineering, University of Washington, Seattle, WA,USA
| | - Richard R Neptune
- Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX,USA
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Edwards CM, Miller É, da Silva DF, Puranda JL, Souza SCS, Semeniuk K, Adamo KB. Does a history of childbirth impact injury prevalence and mental health in female military members? Appl Physiol Nutr Metab 2023; 48:841-850. [PMID: 37429041 DOI: 10.1139/apnm-2023-0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
The effect of parity status on the prevalence and impact of musculoskeletal injury (MSKi) among female Canadian Armed Forces (CAF) members is unknown. This study aims to identify whether a history of childbirth and pregnancy-related complications are associated with MSKi occurrence among female members of the CAF. From September 2020 to February 2021, data were collected via an online questionnaire that assessed MSKi, reproductive health, and barriers to recruitment and retention in the CAF. Actively serving, female members were included in this analysis stratified by parous (n = 313) or nulliparous (n = 435) status. Descriptive analysis and binary logistic regressions were used to identify prevalence and adjusted odds ratios (aOR) of repetitive strain injuries (RSI), acute injuries, and body regions affected. Covariates included in aOR: age, body mass index, and rank. A p value of <0.05 was considered significant and 95% confidence intervals (CI) were reported. Female members with a history of childbirth were more likely to report an RSI (80.9% vs. 69.9%, OR = 1.57, CI: 1.03 to 2.40), and when stratified by body region, were more likely to have an RSI of the wrist (30.0% vs. 20.5%, aOR = 1.62, CI: 1.09 to 2.40), and foot (39.3% vs. 24.1%, aOR = 1.79, CI: 1.24 to 2.59). When compared to the nulliparous group, parity did not influence prevalence of acute injuries. MSKi and mental health perceptions were different for females who experienced postpartum depression, miscarriage, or preterm birth. Childbirth and pregnancy-related complications impact prevalence of some RSI among female CAF members. Thus, specific health and fitness support may be needed for parous female CAF members.
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Affiliation(s)
- Chris M Edwards
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Émilie Miller
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Danilo F da Silva
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
- Faculty of Arts and Science, Sports Studies Department, Bishop's University, Sherbrooke, QC J1M 1Z7, Canada
| | - Jessica L Puranda
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Sara C S Souza
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Kevin Semeniuk
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Kristi B Adamo
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
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Li X, Lu Z, Cen X, Zhou Y, Xuan R, Sun D, Gu Y. Effect of pregnancy on female gait characteristics: a pilot study based on portable gait analyzer and induced acceleration analysis. Front Physiol 2023; 14:1034132. [PMID: 37260595 PMCID: PMC10227621 DOI: 10.3389/fphys.2023.1034132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 04/17/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction: The changes in physical shape and center of mass during pregnancy may increase the risk of falls. However, there were few studies on the effects of maternal muscles on gait characteristics and no studies have attempted to investigate changes in induced acceleration during pregnancy. Further research in this area may help to reveal the causes of gait changes in women during pregnancy and provide ideas for the design of footwear and clothing for pregnant women. The purpose of this study is to compare gait characteristics and induced accelerations between non-pregnant and pregnant women using OpenSim musculoskeletal modeling techniques, and to analyze their impact on pregnancy gait. Methods: Forty healthy participants participated in this study, including 20 healthy non-pregnant and 20 pregnant women (32.25 ± 5.36 weeks). The portable gait analyzer was used to collect participants' conventional gait parameters. The adjusted OpenSim personalized musculoskeletal model analyzed the participants' kinematics, kinetics, and induced acceleration. Independent sample T-test and one-dimensional parameter statistical mapping analysis were used to compare the differences in gait characteristics between pregnant and non-pregnant women. Results: Compared to the control group, pregnancy had a 0.34 m reduction in mean walking speed (p < 0.01), a decrease in mean stride length of 0.19 m (p < 0.01), a decrease in mean stride frequency of 19.06 step/min (p < 0.01), a decrease in mean thigh acceleration of 0.14 m/s2 (p < 0.01), a decrease in mean swing work of 0.23 g (p < 0.01), and a decrease in mean leg falling strength of 0.84 g (p < 0.01). Induced acceleration analysis showed that pregnancy muscle-induced acceleration decreased in late pregnancy (p < 0.01), and the contribution of the gastrocnemius muscle to the hip and joint increased (p < 0.01). Discussion: Compared with non-pregnant women, the gait characteristics, movement amplitude, and joint moment of pregnant women changed significantly. This study observed for the first time that the pregnant women relied more on gluteus than quadriceps to extend their knee joints during walking compared with the control group. This change may be due to an adaptive change in body shape and mass during pregnancy.
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Affiliation(s)
- Xin Li
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Zhenghui Lu
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Xuanzhen Cen
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Yizheng Zhou
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Rongrong Xuan
- The Affiliated Hospital of Medical School, Ningbo University, Ningbo, China
| | - Dong Sun
- Faculty of Sports Science, Ningbo University, Ningbo, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, China
- Research Academy of Medicine Combining Sports, Ningbo No 2 Hospital, Ningbo, China
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Bagwell JJ, Reynolds N, Katsavelis D, Lam K, Walaszek M, Runez H, Kyvelidou A. Center of pressure characteristics differ during single leg stance throughout pregnancy and compared to nulligravida individuals. Gait Posture 2022; 97:43-47. [PMID: 35872482 DOI: 10.1016/j.gaitpost.2022.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/27/2022] [Accepted: 07/09/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Falls are common during pregnancy and present potential for injury to the pregnant individual and the baby. RESEARCH QUESTION Do center of pressure characteristics during single leg stance differ between participants during and after pregnancy and nulligravida participants in the presence and absence of visual input? METHODS Nineteen pregnant participants completed testing during the second trimester, the third trimester, and 4-6 months post-partum. Matched, nulligravida females completed testing once. All participants performed single leg stance on a force platform on each limb for up to 20 s with eyes open and with eyes closed. Center of pressure characteristics were compared between pregnant and nulligravida females using three separate 2 × 2 mixed way ANOVAs, one for each pregnancy time point (second trimester, third trimester, and post-partum) with Bonferroni correction. RESULTS Pregnant females demonstrated smaller single leg stance time with eyes closed during the third trimester. During the second and third trimester, pregnant participants demonstrated smaller sway and sway velocity across eyes open and eyes closed conditions. During the third trimester and post-partum, pregnant participants demonstrated greater median frequency of the center of pressure data. Pregnant participants also demonstrated smaller sample entropy in the anteroposterior direction during the second and third trimesters and in the mediolateral direction during the second trimester. SIGNIFICANCE The decreased total sway and sway velocity observed during pregnancy may reflect rigidity or a protective strategy during single limb stance. Additionally, center of pressure data were less smooth and more repetitive during pregnancy indicating robust differences in postural control strategies and potentially increased fall risk. Because single limb stance is a component of many activities of daily living, the single limb stance task may have clinical utility for testing or training balance in this population with a goal of decreasing falls.
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Affiliation(s)
- Jennifer J Bagwell
- Department of Physical Therapy, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA.
| | - Nicholas Reynolds
- Children's Hospital & Medical Center, 8200 Dodge Street, Omaha, NE 68114, USA
| | - Dimitrios Katsavelis
- Department of Exercise Science, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
| | - Kristina Lam
- Department of Physical Therapy, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
| | - Michelle Walaszek
- Department of Physical Therapy, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
| | - Hannah Runez
- Department of Physical Therapy, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
| | - Anastasia Kyvelidou
- Department of Physical Therapy, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
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11
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Bagwell JJ, Reynolds N, Smith JA, Walaszek M, Runez H, Lam K, Peterson J, Katsavelis D. An exploratory analysis of gait biomechanics and muscle activation in pregnant females with high and low scores for low back or pelvic girdle pain during and after pregnancy. Clin Biomech (Bristol, Avon) 2022; 97:105705. [PMID: 35763890 DOI: 10.1016/j.clinbiomech.2022.105705] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/16/2022] [Accepted: 06/14/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND The purpose of this study was to compare gait kinematics, kinetics, and muscle activation between pregnant females with high and low scores for low back and/or pelvic girdle pain during and after pregnancy. METHODS Twenty participants tested during second trimester, third trimester, and again post-partum. At each session, motion capture, force plates, and surface electromyography data were captured during self-selected velocity over-ground walking. Participants completed the Quebec Back Pain Disability Scale (QBPDS) and were assigned to high (QBPDS ≥15) or low pain groups (QBPDS <15) based on third trimester scores. Two-way mixed model ANOVAs were used to compare high and low pain groups over time. FINDINGS Nine participants met the high pain group criteria and 11 were low pain. During second trimester the high pain group compared to the low pain group demonstrated smaller peak hip flexor moments, total hip work, percent hip contribution to work, and larger percent ankle contribution to work. Pregnant females demonstrated greater hip, knee, and ankle moments, ankle work, and gluteus maximus muscle activation third trimester than second trimester. INTERPRETATION Reduced hip and greater ankle contribution to work in the high pain group during second trimester could indicate decreased hip utilization early in pregnancy and may contribute to disability as pregnancy progresses. It is also possible kinetic differences during second trimester reflect an early strategy to reduce pain by avoiding hip joint loading. Increased moments and work during third trimester indicate a clinical imperative to better prepare pregnant females to accommodate increased joint loading and muscular demand.
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Affiliation(s)
- Jennifer J Bagwell
- Department of Physical Therapy, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA.
| | - Nicholas Reynolds
- Department of Physical Therapy, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
| | - Jo Armour Smith
- Department of Physical Therapy, Chapman University, 9401 Jeronimo Road, Irvine, CA 92618, USA
| | - Michelle Walaszek
- Department of Physical Therapy, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
| | - Hannah Runez
- Department of Physical Therapy, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
| | - Kristina Lam
- Department of Physical Therapy, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
| | - Julie Peterson
- Department of Physical Therapy, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
| | - Dimitrios Katsavelis
- Department of Exercise Science, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
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12
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Femino JD, Nelson SC, Agulnik M, Zuckerman LM. All-Internal Limb Lengthening with Simultaneous Corrective Osteotomy After Internal Hemipelvectomy: A Case Report. JBJS Case Connect 2022; 12:01709767-202206000-00029. [PMID: 36099533 DOI: 10.2106/jbjs.cc.22.00069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CASE A 27-year-old woman with a Grade II chondrosarcoma in the right acetabulum underwent a Type II internal hemipelvectomy with an ischiofemoral fusion. She developed a 7.0-cm functional limb-length discrepancy with adduction of the hip at rest. Four years after surgery, she underwent a corrective osteotomy and limb lengthening with a magnetic lengthening nail. Eleven years after tumor resection and a successful pregnancy, she had symmetric leg lengths and ambulated without an assistive device. CONCLUSIONS A magnetic lengthening nail is a viable option for correcting limb-length discrepancies after hemipelvectomy. If necessary, a simultaneous corrective proximal femoral osteotomy can be performed.
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Affiliation(s)
- Joseph D Femino
- Division of Orthopaedic Surgery, Department of Surgery, City of Hope National Medical Center, Duarte, California
| | - Scott C Nelson
- Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, California
- Department of Surgery, Hopital Adventiste d'Haiti, Port-au-Prince, Haiti
| | - Mark Agulnik
- Department of Medical Oncology and Therapeutics, City of Hope National Medical Center, Duarte, California
| | - Lee M Zuckerman
- Division of Orthopaedic Surgery, Department of Surgery, City of Hope National Medical Center, Duarte, California
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13
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Moore IS, James ML, Brockwell E, Perkins J, Jones AL, Donnelly GM. Multidisciplinary, biopsychosocial factors contributing to return to running and running related stress urinary incontinence in postpartum women. Br J Sports Med 2021; 55:1286-1292. [PMID: 34144950 DOI: 10.1136/bjsports-2021-104168] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To examine contributory factors behind postpartum return-to-running and return to pre-pregnancy running level, in addition to risk factors for postpartum running-related stress urinary incontinence (SUI). METHODS 881 postpartum women completed an online questionnaire. Clinically and empirically derived questions were created relating to running experiences and multidisciplinary, biopsychosocial contributory factors. Logistic regression was used to determine predictors for return-to-running, returning to pre-pregnancy level of running and running-related SUI. RESULTS Median time to first postpartum run was 12 weeks. Running during pregnancy (OR: 2.81 (1.90 to 4.15)), a high weekly running volume (OR: 1.79 (1.22 to 2.63)), lower fear of movement (OR: 0.53 (0.43 to 0.64)) and not suffering vaginal heaviness (OR: 0.52 (0.35-0.76)) increased the odds of return-to-running. Factors that increased the odds of returning to pre-pregnancy running level were a low weekly running volume (OR: 0.38 (0.26 to 0.56)), having more than one child (OR: 2.09 (1.43 to 3.05)), lower fear of movement (OR: 0.78 (0.65 to 0.94)), being younger (OR: 0.79 (0.65 to 0.96)) and shorter time to running after childbirth (OR: 0.74 (0.60 to 0.90)). Risk factors for running-related SUI were having returned to running (OR: 2.70 (1.51 to 4.76)) and suffering running-related SUI pre-pregnancy (OR: 4.01 (2.05 to 7.82)) and during pregnancy (OR: 4.49 (2.86 to 7.06)); having a caesarean delivery decreased the odds (OR: 0.39 (0.23 to 0.65)). CONCLUSION Running during pregnancy may assist women safely return-to-running postpartum. Fear of movement, the sensation of vaginal heaviness and running-related SUI before or during pregnancy should be addressed early by healthcare providers.
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Affiliation(s)
- Isabel S Moore
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Megan L James
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Emma Brockwell
- Private practice, Oxted, UK.,Perinatal Physical Activity Research Group, Canterbury Christchurch University, Canterbury, UK
| | | | - Alex L Jones
- Department of Psychology, Swansea University, Swansea, UK
| | - Gráinne M Donnelly
- Perinatal Physical Activity Research Group, Canterbury Christchurch University, Canterbury, UK.,Private practice, ABSOLUTE.PHYSIO, Maguiresbridge, UK.,University of Ulster, Coleraine, Londonderry, UK
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