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Woodroffe L, Slayman T, Paulson A, Kruse N, Mancuso A, Hall M. Return to Running for Postpartum Elite and Subelite Athletes. Sports Health 2024:19417381241256973. [PMID: 38864285 DOI: 10.1177/19417381241256973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024] Open
Abstract
CONTEXT There is little evidence to guide elite athletes who desire returning to competition after giving birth to a child. Ultimately, this can result in decreased performance and increased risk of injury. This paper addresses aspects that must be considered when building and monitoring a return to running program for a postpartum elite or subelite athlete, including pelvic floor and core stability, progressive reloading of the musculoskeletal system, monitoring of nutritional parameters, and considerations for lactation. EVIDENCE ACQUISITION PubMed and CINAHL (Cumulative Index for Nursing and Allied Health Literature) were searched with the following search strategy: (extreme sports OR elite athletes OR running OR exercise) AND (breastfeeding OR lactation OR bone density OR fetal weight OR gestational weight gain OR postpartum or post-partum OR postnatal OR post-natal OR pregnancy OR childbirth). The following information is based on best available evidence and clinical experience. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 4. RESULTS Due to the interplay between cardiovascular fitness, postpartum nutrition, lactation, and progressive reloading of the muscular and skeletal system, we propose a multimodal, multidisciplinary approach to safely and successfully allow an athlete to return to an elite level of competition. CONCLUSION Return to running in the postpartum period is a highly individualized process that benefits from multidisciplinary, individualized care. This includes monitoring of nutrition, core and pelvic floor function, bone reloading, muscle and tendon reloading, and breastfeeding care when applicable. STRENGH OF RECOMMENDATION TAXONOMY (SORT) C.
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Affiliation(s)
- Lisa Woodroffe
- University of Iowa Institute of Orthopedics Sports Medicine and Rehabilitation, University of Iowa Healthcare, Iowa City, Iowa
| | - Tyler Slayman
- University of Iowa Institute of Orthopedics Sports Medicine and Rehabilitation, University of Iowa Healthcare, Iowa City, Iowa
| | - Amanda Paulson
- University of Iowa Institute of Orthopedics Sports Medicine and Rehabilitation, University of Iowa Healthcare, Iowa City, Iowa
| | - Natalie Kruse
- University of Iowa Healthcare Main Campus, Iowa City, Iowa
| | - Abigail Mancuso
- University of Iowa Healthcare Main Campus, Iowa City, Iowa
- University of Iowa Healthcare West Des Moines Campus, West Des Moines, Iowa
| | - Mederic Hall
- University of Iowa Institute of Orthopedics Sports Medicine and Rehabilitation, University of Iowa Healthcare, Iowa City, Iowa
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Stott B, Driscoll M. Development and evaluation of sex-specific thoracolumbar spine finite element models to study spine biomechanics. Med Biol Eng Comput 2024; 62:1191-1199. [PMID: 38157201 DOI: 10.1007/s11517-023-03003-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/16/2023] [Indexed: 01/03/2024]
Abstract
Musculoskeletal disorders and low back pain (LBP) are common global afflictions, with a higher prevalence observed in females. However, the cause of many LBP cases continues to elude researchers. Current approaches seldom consider differences in male and female spines. Thus, this study aimed to compare the load distribution between male and female spines through finite element modeling. Two finite element models of the spine, one male and one female, were developed, inclusive of sex-specific geometry and material properties. The models consisted of the vertebrae, intervertebral discs (IVD), tendons, surrounding spinal muscles, and thoracolumbar fascia and were subjected to loading conditions simulating flexion and extension. Following extensive validation against published literature, intersegmental rotation, IVD stress, and vertebral body stress were evaluated. The female model demonstrated increased magnitudes for rotation and stresses when compared to the male model. Results suggest that the augmented stresses in the female model indicate an increased load distribution throughout the spine compared to the male model. These findings may corroborate the higher prevalence of LBP in females. This study highlights the importance of using patient- and sex-specific models for patient analyses and care.
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Affiliation(s)
- Brittany Stott
- Musculoskeletal Biomechanics Research Lab, Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W Qc, H3A 0C3, Macdonald Engineering Building, Office #153, Montreal, QC, Canada
- Orthopaedic Research Laboratory, Research Institute MUHC, Montreal General Hospital, Montreal, QC, Canada
| | - Mark Driscoll
- Musculoskeletal Biomechanics Research Lab, Department of Mechanical Engineering, McGill University, 817 Sherbrooke St W Qc, H3A 0C3, Macdonald Engineering Building, Office #153, Montreal, QC, Canada.
- Orthopaedic Research Laboratory, Research Institute MUHC, Montreal General Hospital, Montreal, QC, Canada.
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Morino S, Ishihara M, Umezaki F, Hatanaka H, Yamashita M, Aoyama T. History of pain around the lumbopelvic region during perinatal period: a prospective cohort study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:1440-1446. [PMID: 38427055 DOI: 10.1007/s00586-024-08193-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE Many women experience pain around the low back and pelvic girdle during/after pregnancy. These pains have different risk factors and require independent management strategies. Therefore, an epidemiological database is required to understand when each type of pain occurs, and how serious it could be. Thus, the history of pain in the lumbopelvic region throughout the perinatal period was investigated. METHODS The information of 170 women recruited at the obstetrics and gynecology clinics in Japan was collected at 12, 24, 30, and 36 weeks of pregnancy, in the early days after childbirth, and one month after childbirth. The presence and severity of sacroiliac joint pain, pubic pain, groin pain, and low back pain were assessed using a numerical rating scale. Descriptive statistics were used to determine changes in the prevalence of pain. In addition, the change in the severity of each type of pain was observed through descriptive statistics, by including only those who had pain. RESULTS The sacroiliac joint pain showed a twofold increase from 12 to 24 weeks, while the pubic pain suddenly increased after 24 weeks. The severity of pubic and groin pain increased sharply during pregnancy. Regarding low back pain, the change in the severity was lesser than the other pains. The sacroiliac joint pain was the highest among the four pains during pregnancy. CONCLUSION Each type of pain had a different incidence rate and a different time of onset and aggravation. These results help women and health professionals to manage, and prevent these harmful symptoms.
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Affiliation(s)
- Saori Morino
- Department of Rehabilitation Science, School of Medicine, Osaka Metropolitan University, 3-7-30 Habikino, Habikino-shi, Osaka, 583-8555, Japan.
| | | | | | | | | | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Lan Q, Fu ACL, McKay MJ, Simic M, Castrillon CM, Wei Y, Ferreira P. The association between musculoskeletal pain during pregnancy and pregnancy outcomes: A systematic review and meta-analyses. Eur J Obstet Gynecol Reprod Biol 2024; 294:180-190. [PMID: 38286038 DOI: 10.1016/j.ejogrb.2024.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/16/2024] [Accepted: 01/19/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVE To systematically investigate the association between musculoskeletal pain during pregnancy and birth outcomes including caesarean section, newborn birthweight, newborn birth length, and gestational age at birth. METHODS Medline, Embase, Web of Science, Cinahl and Scopus were systematically searched to identify eligible studies. Odds ratios, mean differences, and confidence intervals were used to describe results. Risk of Bias was assessed using the Newcastle-Ottawa Scale for observational studies. GRADE (The Grading of Recommendation Assessment, Development, and Evaluation) was used to assess the quality of each outcome. RESULTS Seven studies were included with a total population of 85,991 participants. There is low- quality evidence that pregnant women with musculoskeletal pain had 1.59 greater odds to experience delivery by caesarean section compared to those without musculoskeletal pain ([OR] 1.59, 95 % confidence interval [CI] 1.09 to 2.31). Both newborn birth weight (Mean Difference [MD] 77.79 g, 95 % [CI] -23.09 to 178.67) and newborn birth length ([MD] 0.55 cm, 95 % [CI] -0.47 to 1.56) were not affected by musculoskeletal pain, with very low-quality and low-quality evidence, respectively. There was moderate evidence that pregnant women with musculoskeletal pain had shorter gestational age (weeks), although the effect was small and possibly not clinically relevant ([MD] -0.41, 95 % [CI] -0.41 to -0.07). CONCLUSION Pregnant women experiencing musculoskeletal pain are at greater odds of delivering their babies via caesarean than those without musculoskeletal pain, however, musculoskeletal pain during pregnancy does not appear to affect newborn birth weight, length, or gestational age at birth.
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Affiliation(s)
- Qianwen Lan
- Sydney Musculoskeletal Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia; Charles Perkins Centre Musculoskeletal Research Group, The University of Sydney, Australia.
| | - Allan Chak Lun Fu
- Sydney Musculoskeletal Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia; Charles Perkins Centre Musculoskeletal Research Group, The University of Sydney, Australia.
| | - Marnee J McKay
- Sydney Musculoskeletal Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia.
| | - Milena Simic
- Sydney Musculoskeletal Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia.
| | - Carlos Mesa Castrillon
- Sydney Musculoskeletal Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia; Charles Perkins Centre Musculoskeletal Research Group, The University of Sydney, Australia.
| | - Yuanye Wei
- Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, China.
| | - Paulo Ferreira
- Sydney Musculoskeletal Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia; Charles Perkins Centre Musculoskeletal Research Group, The University of Sydney, Australia.
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Martin LC, Routzong MR, Moalli PA, Rostaminia G, Abramowitch SD. Sacrum and Coccyx Shape Changes During Pregnancy and After Delivery. Ann Biomed Eng 2024; 52:292-301. [PMID: 37828266 DOI: 10.1007/s10439-023-03375-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/22/2023] [Indexed: 10/14/2023]
Abstract
Remodeling of the sacrum and coccyx to accommodate pregnancy and delivery has been hypothesized but not directly quantified. This study aimed to quantify the remodeling of the sacrum and coccyx by comparing midsagittal lengths, angles, curvature, and shape between nulliparous, pregnant, and parous women using both 2 and 3 dimensional measures. Ninety pelvic magnetic resonance images of the pelvis were retrospectively collected and segmented. Twelve length, angle, and curvature measurements were made using definitions from previous literature on the midsagittal plane to define the sacrum, coccyx, and combined sacrum-coccyx shape. These measures were followed by a statistical shape analysis, which returned modes of variation and principal component scores. A separate MANCOVA analysis was conducted for both the 2D and 3D measures. The 2D and 3D analyses agreed that pregnant women had a significantly straighter coccyx and combined sacrum/coccyx than nulliparous (9.1% and 5.6%, respectively) and parous (7.5% and 2.7%, respectively) subjects. All comparisons showed that, on average, a pregnant woman's sacrum and coccyx were significantly straighter than their nulliparous counterparts. Then after delivery, the sacrum/coccyx returned, but not completely back to a more curved configuration.
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Affiliation(s)
- Liam C Martin
- Translational Biomechanics Laboratory, Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Benedum Hall, Office 406, 3700 O'Hara Street, Pittsburgh, PA, 15260, USA
| | - Megan R Routzong
- Translational Biomechanics Laboratory, Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Benedum Hall, Office 406, 3700 O'Hara Street, Pittsburgh, PA, 15260, USA
| | - Pamela A Moalli
- Department of Obstetrics, Gynecology & Reproductive Surgery, University of Pittsburgh, Pittsburgh, PA, USA
- Magee-Womens Research Institute, Pittsburgh, PA, USA
| | - Ghazaleh Rostaminia
- Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Division of Urogynecology, University of Chicago, Northshore University HealthSystem, Skokie, IL, USA
| | - Steven D Abramowitch
- Translational Biomechanics Laboratory, Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Benedum Hall, Office 406, 3700 O'Hara Street, Pittsburgh, PA, 15260, USA.
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Jiang LQ, Zhang RD, Musonye HA, Zhao HY, He YS, Zhao CN, He T, Tian T, Gao ZX, Fang Y, Wang P, Ni J, Pan HF. Hormonal and reproductive factors in relation to the risk of rheumatoid arthritis in women: a prospective cohort study with 223 526 participants. RMD Open 2024; 10:e003338. [PMID: 38195516 PMCID: PMC10826586 DOI: 10.1136/rmdopen-2023-003338] [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: 05/24/2023] [Accepted: 09/11/2023] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVE This study aimed to examine rheumatoid arthritis (RA) risk associated with hormonal and reproductive factors in women from the large cohort of the UK Biobank. METHODS Data on hormonal and reproductive factors in women were collected from a prospective cohort of 223 526 UK Biobank participants. The potential relationship between reproductive factors and RA risk was assessed using restricted cubic spline. Hazard ratios (HR) were estimated using Cox proportional hazard regressions. RESULTS During a median follow-up of 12.39 years, 3313 women with RA were identified. Age at menarche >14 years was associated with a greater RA risk (HR 1.13, 95% CI 1.02 to 1.26) compared with menarche at 13. The multiple adjusted HR for RA in women with menopause at <45 years was 1.46. Reproductive years <33 increased the risk of RA (HR 1.39, 95% CI 1.21 to 1.59). Compared with those with 2 children, women with ≥4 children were associated with a higher risk of RA (HR 1.18, 95% CI 1.04 to 1.34). Women who had a hysterectomy (HR 1.40, 95% CI 1.25 to 1.56) or oophorectomy (HR 1.21, 95% CI 1.08 to 1.35) had a higher risk of RA than those without a hysterectomy or oophorectomy. Both hormone replacement therapy (HRT) use (HR 1.46, 95% CI 1.35 to 1.57) and HRT duration (HR 1.02, 95% CI 1.01 to 1.03) were associated with a higher risk of RA. CONCLUSIONS Some hormonal and reproductive factors were associated with a higher risk of RA. Hormonal and reproductive factors should be considered in risk assessment and formulating management plans in female patients with RA.
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Affiliation(s)
- Ling-Qiong Jiang
- Department of Epidemiology and Biostatistics, Anhui Medical University School of Public Health, Hefei, Anhui, China
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Ruo-Di Zhang
- Department of Epidemiology and Biostatistics, Anhui Medical University School of Public Health, Hefei, Anhui, China
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Harry Asena Musonye
- Department of Epidemiology and Biostatistics, Anhui Medical University School of Public Health, Hefei, Anhui, China
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Hao-Yun Zhao
- Department of Clinical Medicine, Anhui Medical University, Hefei, China
| | - Yi-Sheng He
- Department of Epidemiology and Biostatistics, Anhui Medical University School of Public Health, Hefei, Anhui, China
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Chan-Na Zhao
- Department of Epidemiology and Biostatistics, Anhui Medical University School of Public Health, Hefei, Anhui, China
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Tian He
- Department of Epidemiology and Biostatistics, Anhui Medical University School of Public Health, Hefei, Anhui, China
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Tian Tian
- Department of Epidemiology and Biostatistics, Anhui Medical University School of Public Health, Hefei, Anhui, China
| | - Zhao-Xing Gao
- Department of Epidemiology and Biostatistics, Anhui Medical University School of Public Health, Hefei, Anhui, China
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yang Fang
- Department of Epidemiology and Biostatistics, Anhui Medical University School of Public Health, Hefei, Anhui, China
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Peng Wang
- Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei, China
| | - Jing Ni
- Department of Epidemiology and Biostatistics, Anhui Medical University School of Public Health, Hefei, Anhui, China
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, Anhui Medical University School of Public Health, Hefei, Anhui, China
- Institute of Kidney Disease, Inflammation & Immunity Mediated Diseases, Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
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Kim JW, Cha SH, Lee MK, Ko J, Kwon YR. Effects of infant care posture and weight on static postural balance. Technol Health Care 2024; 32:361-369. [PMID: 38759061 PMCID: PMC11191505 DOI: 10.3233/thc-248032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
BACKGROUND Studies investigating postural balance during various infant care postures have not been reported yet. OBJECTIVE The aim of this study was to measure static postural balance when holding an infant dummy in-arms and carrying an infant dummy on back according to different infant dummy weights. METHODS Sixteen healthy young subjects participated in a balance test. Infant dummies with weights of 4.6 kg (1-month) and 9.8 kg (12-month) were used in this study. All subjects were asked to naturally stand on a force platform in two infant care postures (holding an infant in-arms and carrying an infant on one's back). Center of pressure (COP) was measured from the force platform. Quantitative variables were derived from the COP. Two-way repeated measure analysis of variance (ANOVA) was performed to determine main effects of infant care postures, infant weight, and their interactions on COP variables. RESULTS Back carrying a 12-month infant dummy had the greatest amplitude in all COP variables. Back carrying posture showed significantly greater mean distance and peak power, faster mean velocity, and wider COP area compared to holding posture (P< 0.05). There were significant weight effects of most COP variables mainly in AP direction (P< 0.01). CONCLUSIONS Our results could contribute to the prevention of musculoskeletal diseases or prevention of fall due to various infant care activities by developing an assisting device to improve postural balance.
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Affiliation(s)
- Ji-Won Kim
- Department of Biomedical Engineering, Konkuk University, Chungju, Korea
- Institute of Biomedical Engineering, Konkuk University, Chungju, Korea
| | - Sang-Ho Cha
- Department of Biomedical Engineering, Konkuk University, Chungju, Korea
| | - Min-Kyun Lee
- Department of Biomedical Engineering, Konkuk University, Chungju, Korea
| | - Junghyuk Ko
- Division of Mechanical Engineering, College of Engineering, Korea Maritime and Ocean University, Busan, Korea
| | - Yu-Ri Kwon
- Department of Biomedical Engineering, Konkuk University, Chungju, Korea
- Institute of Biomedical Engineering, Konkuk University, Chungju, Korea
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Zhou L, Feng X, Zheng R, Wang Y, Sun M, Liu Y. The correlation between pregnancy-related low back pain and physical fitness evaluated by an index system of maternal physical fitness test. PLoS One 2023; 18:e0294781. [PMID: 38127938 PMCID: PMC10734947 DOI: 10.1371/journal.pone.0294781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/08/2023] [Indexed: 12/23/2023] Open
Abstract
To investigate incidence of pregnancy-related low back pain (LBP), evaluate physical fitness objectively during pregnancy and analyze the correlation between LBP and physical fitness of pregnant women, 180 pregnant women including 101 in mid-gestation (14-28 gestational weeks) and 79 in late-gestation (28-37 gestational weeks) were recruited and self-reported their LBP. The aerobic ability such as cardiorespiratory fitness and anaerobic ability including strength, endurance, speed, flexibility, and balance were evaluated by a novel materal physical fitness test system. The correlation between LBP and each component in physical fitness test system was analyzed in SPSS. As the results, 135 out of 180 participants (75% of total) had pregnancy-related LBP. Physical fitness of participants in late-gestation was significantly weaker including weaker back strength (p<0.05), less resistance band pullbacks in 30s (p<0.01), less stretching in sit-and-reach test (p<0.001), shorter duration in left legged blind balance test (p<0.05) and weaker bird dog balance(p<0.05) than those in mid-gestation. Correlation analysis indicated that LBP was negatively associated with standing heel raises in 20s (p<0.01) and standing glute kickbacks in 30s (left p<0.01, right p<0.05). Thus, it is concluded that LBP is in high prevalence throughout the entire pregnant course. The pregnant women are prone to have weakened strength of core muscle groups and poorer flexibility and balance along the pregnancy. In addition, their LBP was negatively correlated to strength of back muscle groups of lower limbs.
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Affiliation(s)
- Longfeng Zhou
- Institute of Physical Education and Training, Capital University of Physical Education and Sports, Beijing, China
| | - Xiaoyi Feng
- Institute of Physical Education and Training, Capital University of Physical Education and Sports, Beijing, China
| | - Ruimin Zheng
- National Center for Women and Children’s Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuhan Wang
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Mengyun Sun
- National Center for Women and Children’s Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yan Liu
- Institute of Physical Education and Training, Capital University of Physical Education and Sports, Beijing, China
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Ojukwu CP, Okpoko CG, Okemuo AJ, Ede SS, Ilo IJ. Breastfeeding-related neck pain: prevalence and correlates among Nigerian lactating mothers. Int Health 2023; 15:383-388. [PMID: 35871267 PMCID: PMC10318971 DOI: 10.1093/inthealth/ihac050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/22/2022] [Accepted: 07/04/2022] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Breastfeeding (BF) is a physically demanding task and is predominantly performed in a head-down position as the mother attempts to maintain eye contact with the infant. There are possibilities of BF-related neck pain (BFRNP) that have not been widely studied. This study investigated the prevalence and correlates of BFRNP in Nigerian lactating mothers. METHODS A cross-sectional descriptive survey was conducted among 310 lactating mothers selected from post-natal clinics in Enugu, Nigeria. Information on their BF profile was sought as well as the prevalence and characteristics of BFRNP using a self-structured questionnaire. RESULTS It was found that cradle hold was the commonly adopted BF position (94.0%) and the majority breastfed ≥10 times daily (55.2%) for <30 min per session (49.1%). BFRNP was seen in 51.7% of women, of which 55.0% reported moderate pain intensity and 60.0% experienced this pain during BF. None of the maternal characteristics and breastfeeding profiles were significantly associated with the prevalence of BFRNP (p>0.05). CONCLUSIONS There is a high prevalence of BFRNP among nursing mothers. Although maternal characteristics and BF positions were not associated with reported BFRNP, the results suggest that changing BF positions reduces neck pain during nursing sessions. Therefore this study recommends that nursing mothers should regularly change their BF positions to increase relaxation and comfort.
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Affiliation(s)
| | | | - Adaora Justina Okemuo
- Department of Medical Rehabilitation, College of Medicine, University of Nigeria Enugu, Nigeria
| | - Stephen Sunday Ede
- Department of Medical Rehabilitation, College of Medicine, University of Nigeria Enugu, Nigeria
- Department of Physiotherapy, College of Allied Health Sciences, Gregory University, Uturu, Nigeria
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Walsh CM. Enhancing Ergonomics in Pediatric Endoscopy Training and Practice. Gastrointest Endosc Clin N Am 2023; 33:235-251. [PMID: 36948744 DOI: 10.1016/j.giec.2022.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
Pediatric endoscopists are at risk of work-related injuries from overuse and repetitive motions during endoscopy. Recently, there has been increasing appreciation for the importance of ergonomics education and training to help build long-term habits that prevent injury. This article reviews the epidemiology of endoscopy-related injuries in pediatric practice, describes methods for controlling exposures in the workplace, discusses key ergonomic principles that can be used to mitigate injury risk, and outlines tips for integrating education on endoscopy ergonomics during training.
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Affiliation(s)
- Catharine M Walsh
- Division of Gastroenterology, Hepatology and Nutrition and the SickKids Research and Learning Institutes, The Hospital for Sick Children, Department of Paediatrics and The Wilson Centre, Temerty Faculty of Medicine, University of Toronto, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
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Filippini C, Saran S, Chari B. Musculoskeletal steroid injections in pregnancy: a review. Skeletal Radiol 2023:10.1007/s00256-023-04320-9. [PMID: 36917270 DOI: 10.1007/s00256-023-04320-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/06/2023] [Accepted: 03/06/2023] [Indexed: 03/16/2023]
Abstract
Pregnant women experience a wide range of musculoskeletal pain disorders, which include general ailments occurring during pregnancy, exacerbation of pre-existing conditions, or pregnancy-specific pain/inflammatory conditions. There are significant concerns and knowledge gaps surrounding the safety, dosage, and potential long-term effects of several drugs used during pregnancy. Our article reviews the use of focal steroid injections during pregnancy. A mixture of case studies, meta-analyses, and randomised controlled trials have shown at least there is no adverse side effect to the mother or baby from maternal use of non-systemic injection during pregnancy and a significant improvement in symptoms of pain or paraesthesia can be achieved in patients that do not respond to more conservative measures. As with all patients, the use of steroid injection should be judged on a case-by-case basis to ensure that it is the most appropriate treatment choice. However, being pregnant should not be considered a contraindication to a single dose of non-systemic steroid administration, as these women can achieve significant symptomatic relief that reduces reliance on systemic medication and can significantly improve their quality of life.
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Affiliation(s)
- Claire Filippini
- Oxford University Hospitals NHS Foundation Trust, Windmill Rd, Oxford, OX3 7LD, UK
| | - Sonal Saran
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Basavaraj Chari
- Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Windmill Rd, Oxford, OX3 7LD, UK.
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Makkiyah FA, Sinaga TA, Khairunnisa N. A Study from a Highly Populated Country : Risk Factors Associated with Lower Back Pain in Middle-Aged Adults. J Korean Neurosurg Soc 2023; 66:190-198. [PMID: 35880345 PMCID: PMC10009244 DOI: 10.3340/jkns.2021.0278] [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: 11/24/2021] [Revised: 05/01/2022] [Accepted: 07/06/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Low back pain (LBP) is a global health problem that affects the productivity of the patients. Several factors such as individual, occupational, and psychosocial factors increase the risk of LBP. However, only a few studies investigated those factors, especially in middle adulthood in Indonesia. Indonesia is a country with a young population that has been rapidly developing in recent years. This study was conducted to find out the factors associated with LBP in middle adulthood. METHODS This study is a cross-sectional observational analytic study using a convenience sampling method with a total sample of 3005 respondents. Data were collected using a questionnaire which was then analyzed using the chi-square test, Kolmogorovsmirnov, Spearman's Rank, and logistic regression test. RESULTS From the result of this study, it was found that the 12-month prevalence of LBP in middle-aged adults was 44,29%. Female (odds ratio [OR], 1.3; 95% confidence interval [Cl], 1.098-1.545; p=0.002), lack of physical exercises (OR, 0.87; 95% Cl, 0.794-0.959; p=0.005), high body mass index (OR, 1.09; 95% Cl, 1.009-1.187; p=0.002), stress level (OR, 1.26; 95% Cl, 1.088-1.458; p=0.002), and years of work experience (OR, 1.1; 95% Cl, 1.001-1.225; p=0.047) were determined as risk factors that significantly associated with LBP. CONCLUSION LBP is quite common among middle-aged adults in Indonesia. Female gender, higher body mass index, lack of physical activity, stress level, and years of work experience were all potential risk factors for LBP in middle-aged adults. Middle-aged adults in Indonesia should be aware of LBP and avoid disabilities by identifying risk factors that may worsen LBP in the future.
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Affiliation(s)
- Feda Anisah Makkiyah
- Department of Neurosurgery, Faculty of Medicine UPN Veteran Jakarta, Jakarta, Indonesia
| | | | - Namira Khairunnisa
- Undergraduate Program, Faculty of Medicine UPN Veteran Jakarta, Jakarta, Indonesia
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Lee KA, Lee SY, Kim SH, Kim HS, Kim HR, Lee SH. Computed tomography-based assessment of radiographic progression in spine and sacroiliac joints after pregnancy in women with radiographic axial spondyloarthritis. Front Med (Lausanne) 2022; 9:970546. [PMID: 36590955 PMCID: PMC9800050 DOI: 10.3389/fmed.2022.970546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/28/2022] [Indexed: 12/16/2022] Open
Abstract
Background Mechanical stress are one of the pathogenesis of axial spondyloarthritis (axSpA). During pregnancy, the mechanical overload on the spine and pelvis increases due to gravid uterus. We aimed to investigate whether pregnancy affects radiographic progression in patients with radiographic axSpA (r-axSpA) based on computed tomography (CT) evaluations. Materials and methods This retrospective study included women with r-axSpA aged 19-49 years who underwent at least two CT evaluations of the whole spine and/or sacroiliac joints (SIJs) at intervals of 2-4 years. To compare radiographic progression after delivery, we classified the patients into two groups: delivery group and controls. The delivery group was restricted to women who had the first CT ∼2 years before delivery and the second CT ∼2 years after delivery. The CT Syndesmophyte Score (CTSS) (0-522) and SIJ scores (0-40) were used to evaluate spinal syndesmophytes and erosion, joint space narrowing, and sclerosis of the SIJs. Results A total of 21 women in the delivery group and 38 women in the control group were included. The median (Q1-Q3) CTSS at baseline in the delivery group and controls was 19 (16-23) and 20 (13.25-27.75), and the median progression was 1 (0-3) and 0 (0-1) during the median 2.9-year follow-up, respectively. The median (Q1-Q3) SIJ score at baseline in the delivery group and controls was 13 (8-22) and 11 (6-22), and the median progression was 1.5 (0-3) and 1 (0-2), respectively. Using cut-off 0.5, 52.9, and 61.9% of r-axSpA patients and 39.3 and 44.4% of controls showed progression of whole spine and SIJs, respectively. However, no difference in proportion of spinal and SIJ progression and absolute score changes per time point was observed between two groups. Moreover, the SIJ score changes were comparable according to the delivery method. Conclusion Pregnancy and delivery do not affect the radiographic progression of the spine and SIJs in women with r-axSpA assessed by CT.
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Affiliation(s)
- Kyung-Ann Lee
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, School of Medicine, Soonchunhyang University, Seoul, Republic of Korea
| | - So Yun Lee
- Department of Rheumatology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Se Hee Kim
- Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Research Institute of Medical Science, School of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Hyun-Sook Kim
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, School of Medicine, Soonchunhyang University, Seoul, Republic of Korea
| | - Hae-Rim Kim
- Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Research Institute of Medical Science, School of Medicine, Konkuk University, Seoul, Republic of Korea
| | - Sang-Hoon Lee
- Department of Rheumatology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
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Fiat F, Merghes PE, Scurtu AD, Almajan Guta B, Dehelean CA, Varan N, Bernad E. The Main Changes in Pregnancy—Therapeutic Approach to Musculoskeletal Pain. Medicina (B Aires) 2022; 58:medicina58081115. [PMID: 36013582 PMCID: PMC9414568 DOI: 10.3390/medicina58081115] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/27/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background and Objectives: During pregnancy, women undergo various physiological and anatomical changes that are accentuated as the pregnancy progresses, but return to their previous state a few weeks/months after the pregnancy. However, a targeted therapeutic approach is needed. Most of the time, during this period, these changes precipitate the appearance of pain, musculoskeletal pain being the most common. Pregnant women should avoid treating musculoskeletal pain with medication and should choose alternative and complementary methods. Exercise along with rest is the basis for treating chronic musculoskeletal pain. Side effects of physical therapy are rare and, in addition, it is not contraindicated in pregnant women. The benefits of this type of treatment in combating pain far outweigh the risks, being an easy way to improve quality of life. The objective of this article is to discuss the management of musculoskeletal pain during pregnancy, to identify the main musculoskeletal pain encountered in pregnant women along with drug treatment, and to expose the beneficial effects of alternative and complementary methods in combating pain. Materials and Methods: A literature search was conducted using medical databases, including PubMed, Google Scholar, and ScienceDirect, using the keywords “changes of pregnancy”, “musculoskeletal pain”, “pregnancy pain”, “pain management”, “pharmacological approach”, “alternative and complementary treatment” and specific sites. Information was collected from studies whose target population included pregnant women who complained of musculoskeletal pain during the 9 months of pregnancy; pregnant women with other pathologies that could increase their pain were not included in this review. Results: The articles related to the most common non-obstetric musculoskeletal pain in pregnancy along with pharmacological treatment options and alternative and complementary methods for musculoskeletal pain management during pregnancy were selected. Conclusions: The results were used to guide information towards the safest methods of therapy but also to raise awareness of the treatment criteria in order to compare the effectiveness of existing methods. Treatment must consider the implications for the mother and fetus, optimizing non-pharmacological therapeutic options.
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Affiliation(s)
- Felicia Fiat
- Department of Obstetrics-Gynecology II, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Petru Eugen Merghes
- Department of Physical Education and Sport, Banat’s University of Agricultural Sciences and Veterinary Medicine “King Mihai I of Romania” from Timisoara, Calea Aradului 119, 300645 Timisoara, Romania
| | - Alexandra Denisa Scurtu
- Department of Toxicology and Drug Industry, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Research Centre for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Correspondence: (A.D.S.); (B.A.G.)
| | - Bogdan Almajan Guta
- Department of Physical Therapy and Special Motor Skills, Faculty of Physical Education and Sport, West University of Timisoara, Vasile Parvan Boulevard, No. 4, 300223 Timisoara, Romania
- Correspondence: (A.D.S.); (B.A.G.)
| | - Cristina Adriana Dehelean
- Department of Toxicology and Drug Industry, Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Research Centre for Pharmaco-Toxicological Evaluation, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Narcis Varan
- Department of Physical Education and Sport, Banat’s University of Agricultural Sciences and Veterinary Medicine “King Mihai I of Romania” from Timisoara, Calea Aradului 119, 300645 Timisoara, Romania
| | - Elena Bernad
- Department of Obstetrics-Gynecology II, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
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Zewudie BT, Temere BC, Eniyew MA, Mesfin Y, Tenaw SG. Low back pain and associated factors among obstetrics care providers in public hospitals of Amhara Regional State, Ethiopia: a cross-sectional study. BMJ Open 2022; 12:e055749. [PMID: 35676008 PMCID: PMC9185416 DOI: 10.1136/bmjopen-2021-055749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Although the study of low back pain (LBP) among healthcare workers in Ethiopia is becoming common, it mainly focused on nurses leaving obstetrics care providers aside. The objective of this study was to assess the prevalence and associated factors of LBP among obstetrics care providers in public hospitals in Amhara Regional State, Ethiopia. DESIGN An institution-based cross-sectional study. SETTINGS The study settings were nine public hospitals in Amhara Region. PARTICIPANTS Randomly selected 416 obstetrics care providers working in public hospitals in Amhara Region, Ethiopia. OUTCOMES The outcomes of this study were the prevalence of LBP in the last 12 months among obstetrics care providers and its associated factors. RESULTS Overall, the prevalence of LBP was 65.6% (95% CI 61.5% to 70.2%) among obstetrics care providers in the last 12 months.Female gender (AOR 2.33, 95% CI 1.344 to 4.038), not having regular physical exercise habits (AOR 8.26, 95% CI 4.36 to 15.66), job stress (AOR 2.21, 95% CI 1.24 to 3.92), standing longer while doing procedures (AOR 2.04, 95% CI 1.14 to 3.66) and working more than 40 hours a week (AOR 2.20, 95% CI 1.09 to 4.45) were significantly associated with LBP. CONCLUSION About two-thirds of obstetrics care providers working in public hospitals in the Amhara region reported LBP. The prevalence of LBP was higher among those who did not have regular physical exercise habits, had job stress, stood longer than 1 hour while doing procedures, worked more than 40 hours a week and female obstetrics care providers. Providing resting periods, decreasing the working hours of obstetrics care providers in a week, and counselling on the importance of doing regular physical exercise help to reduce the prevalence of LBP.
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Elliott-Sale KJ, Bostock EL, Jackson T, Wardle SL, O'Leary TJ, Greeves JP, Sale C. Investigating the Efficacy of an 18-Week Postpartum Rehabilitation and Physical Development Intervention on Occupational Physical Performance and Musculoskeletal Health in UK Servicewomen: Protocol for an Independent Group Study Design. JMIR Res Protoc 2022; 11:e32315. [PMID: 35648463 PMCID: PMC9201705 DOI: 10.2196/32315] [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: 07/23/2021] [Revised: 03/08/2022] [Accepted: 03/18/2022] [Indexed: 11/20/2022] Open
Abstract
Background Postpartum women are at an increased risk of pelvic floor dysfunction, musculoskeletal injury, and poor psychological health and have reduced physical fitness compared to before pregnancy. There is no formal, evidence-based rehabilitation and physical development program for returning UK servicewomen to work following childbirth. Objective This study aims to examine the efficacy of a rehabilitation and physical development intervention for returning postpartum UK servicewomen to occupational fitness. Methods Eligible servicewomen will be assigned to a training or control group in a nonrandomized controlled trial 6 weeks after childbirth. Group allocation will be based on the location of standard pregnancy and postpartum care. The control group will receive standard care, with no prescribed intervention. The training group will start an 18-week core and pelvic health rehabilitation program 6 weeks post partum and a 12-week resistance and high-intensity interval training program 12 weeks post partum. All participants will attend 4 testing sessions at 6, 12, 18, and 24 weeks post partum for the assessment of occupational physical performance, pelvic health, psychological well-being, quality of life, and musculoskeletal health outcomes. Occupational physical performance tests will include vertical jump, mid-thigh pull, seated medicine ball throw, and a timed 2-km run. Pelvic health tests will include the Pelvic Organ Prolapse Quantification system, the PERFECT (power, endurance, repetitions, fast, every contraction timed) scheme for pelvic floor strength, musculoskeletal physiotherapy assessment, the Pelvic Floor Distress Inventory–20 questionnaire, and the International Consultation on Incontinence Questionnaire–Vaginal Symptoms. Psychological well-being and quality of life tests will include the World Health Organization Quality of Life questionnaire and the Edinburgh Postnatal Depression Scale. Musculoskeletal health outcomes will include body composition; whole-body areal bone mineral density; tibial volumetric bone mineral density, geometry, and microarchitecture; patella tendon properties; muscle architecture; muscle protein and collagen turnover; and muscle mass and muscle breakdown. Data will be analyzed using linear mixed-effects models, with participants included as random effects, and group and time as fixed effects to assess within- and between-group differences over time. Results This study received ethical approval in April 2019 and recruitment started in July 2019. The study was paused in March 2020 owing to the COVID-19 pandemic. Recruitment restarted in May 2021. The results are expected in September 2022. Conclusions This study will inform the best practice for the safe and optimal return of postpartum servicewomen to physically and mentally demanding jobs. Trial Registration ClinicalTrials.gov NCT04332757; https://clinicaltrials.gov/ct2/show/NCT04332757 International Registered Report Identifier (IRRID) DERR1-10.2196/32315
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Affiliation(s)
- Kirsty Jayne Elliott-Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom.,Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
| | - Emma Louise Bostock
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Thea Jackson
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Sophie Louise Wardle
- Army Health and Performance Research, Army Headquarters, Andover, United Kingdom
| | - Thomas James O'Leary
- Army Health and Performance Research, Army Headquarters, Andover, United Kingdom
| | | | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom.,Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
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Ojukwu CP, Okpoko CG, Ikele IT, Ilo IJ, Ede SS, Anekwu NE, Okemuo AJ, Anekwu EM, Ugwu SU, Ikele CN. Neck Muscles' Responses to Cradle, Cross-cradle and Football Breastfeeding Hold Positions in Nursing Mothers: A Preliminary Study. Niger J Clin Pract 2022; 25:563-568. [PMID: 35593596 DOI: 10.4103/njcp.njcp_630_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Breastfeeding-related Neck Pain (BFNP) is prevalent in nursing mothers and cuts across the utilization of different breastfeeding (BF) hold positions. Biomechanical considerations to highlight ergonomically safe BF positions for the prevention of BFNP have not been previously studied. Aim This study was designed to compare the electrical activities of selected neck muscles across three breastfeeding hold positions [cradle (C1), cross-cradle (C2), and football (FB)]. Materials and Method Surface electromyographic analyses of four neck muscles (right and left components of each trapezius and sternocleidomastoid) were performed respectively during three BF trials with different BF hold positions (C1, C2, and FB) in 22 nursing mothers. For all the trials, the mothers nursed from the left breast. Results Across the three BF trials, the electrical activities of each of the neck muscles did not vary significantly (P > 0.05). Furthermore, the left muscular components showed predominantly higher activities, as compared to their right components. Conclusion The breastfeeding hold position adopted during BF tasks may not be a determinant of BFNP in nursing mothers. Further studies to ascertain the biomechanical implications of the utilized BF holds are recommended.
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Affiliation(s)
- C P Ojukwu
- Department of Medical Rehabilitation, University of Nigeria, Enugu Campus, Nigeria
| | - C G Okpoko
- Department of Medical Rehabilitation, University of Nigeria, Enugu Campus, Nigeria
| | - I T Ikele
- Department of Anatomy, University of Nigeria, Enugu Campus, Nigeria
| | - I J Ilo
- Department of Nursing Sciences, University of Nigeria, Enugu Campus, Nigeria
| | - S S Ede
- Department of Medical Rehabilitation, University of Nigeria, Enugu Campus, Nigeria
| | - N E Anekwu
- Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - A J Okemuo
- Department of Medical Rehabilitation, University of Nigeria, Enugu Campus, Nigeria
| | - E M Anekwu
- Department of Physiotherapy, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
| | - S U Ugwu
- Department of Medical Physiology in College of Medicine, University of Nigeria, Enugu Campus, Nigeria
| | - C N Ikele
- Department of Medical Rehabilitation, University of Nigeria, Enugu Campus, Nigeria
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Kim JW, Eom GM, Kwon YR. Analysis of maximum joint moment during infant lifting-up motion. Technol Health Care 2022; 30:441-450. [PMID: 35124618 PMCID: PMC9028669 DOI: 10.3233/thc-thc228040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Infant care activities can induce musculoskeletal disease. However, little is known about the biomechanical joint load during lifting-up of an infant. OBJECTIVE: The aim of this study was to investigate normalized maximum moment during lifting-up of infant dummies weighing 4.6 kg, 7.6 kg, and 9.8 kg. METHODS: Six healthy young subjects participated in our study. All subjects performed lifting-up activities of dummies to shoulder height with their feet apart and natural postures in their comfortable speed. Three-dimensional reflective marker trajectories and ground reaction forces were used as input to calculate joint moments using a full body musculoskeletal model. Joint moments were normalized by each subject’s body mass. Friedman’s test was performed to compare mean differences of normalized joint moments for lifting up three dummy weights. RESULTS: Lumbar joint had the greatest normalized joint moment. Lumbar and hip extension moments were significantly increased with dummy weight (P< 0.05). In contrast, knee extension and ankle plantarflexion moment were not significantly affected by dummy weight (P> 0.05). CONCLUSIONS: These results indicate that the lumbar joint plays the most important role in infant lifting-up motion and that the load of lumbar and hip joint should be reduced when lifting a heavier infant. These results could contribute to the development of an effective lifting strategy and an assisting device for lifting an infant.
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Affiliation(s)
- Ji-Won Kim
- BK21 Plus Research Institute of Biomedical Engineering, Konkuk University, Chungju, Korea
- Department of Biomedical Engineering, Konkuk University, Chungju, Korea
| | - Gwang-Moon Eom
- BK21 Plus Research Institute of Biomedical Engineering, Konkuk University, Chungju, Korea
- Department of Biomedical Engineering, Konkuk University, Chungju, Korea
- BK21 Plus Research Institute of Biomedical Engineering, Konkuk University, Chungju, Korea
| | - Yu-Ri Kwon
- BK21 Plus Research Institute of Biomedical Engineering, Konkuk University, Chungju, Korea
- Department of Biomedical Engineering, Konkuk University, Chungju, Korea
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Parker EA, Meyer AM, Goetz JE, Willey MC, Westermann RW. Do Relaxin Levels Impact Hip Injury Incidence in Women? A Scoping Review. Front Endocrinol (Lausanne) 2022; 13:827512. [PMID: 35185802 PMCID: PMC8855110 DOI: 10.3389/fendo.2022.827512] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/05/2022] [Indexed: 01/10/2023] Open
Abstract
PURPOSE The aim of this review is to assess the current evidence regarding the impact of relaxin on incidence of soft tissue hip injuries in women. METHODS A trained research librarian assisted with searches of PubMed, Embase, CINAHL, and SPORTDiscus, with a preset English language filter. The review was completed per the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis methodology. Included studies required assessment of relaxin effects on musculoskeletal health, pelvic girdle stability, or hip joint structures in human subjects. Letters, texts, and opinion papers were excluded. RESULTS Our screen yielded 82 studies. Molecularly, relaxin activates matrix metalloproteinases (MMPs) including collagenases MMP-1/-13 and gelatinases MMP-2/-9 to loosen pelvic ligaments for parturition. However, relaxin receptors have also been detected in female periarticular tissues, such as the anterior cruciate ligament, which tears significantly more often during the menstrual cycle peak of relaxin. Recently, high concentrations of relaxin-activated MMP-9 receptors have been found on the acetabular labrum; their expression upregulated by estrogen. CONCLUSIONS Menstrual cycle peaks of relaxin activate MMPs, which locally degrade collagen and gelatine. Women have relaxin receptors in multiple joints including the hip and knee, and increased relaxin correlates with increased musculoskeletal injuries. Relaxin has paracrine effects in the female pelvis on ligaments adjacent to hip structures, such as acetabular labral cells which express high levels of relaxin-targeted MMPs. Therefore, it is imperative to investigate the effect of relaxin on the hip to determine if increased levels of relaxin are associated with an increased risk of acetabular labral tears.
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Affiliation(s)
- Emily A. Parker
- Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
- *Correspondence: Emily A. Parker,
| | - Alex M. Meyer
- Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Jessica E. Goetz
- Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
- Orthopedic Biomechanics Laboratories, Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Michael C. Willey
- Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Robert W. Westermann
- Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
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20
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Pany‐Kucera D, Spannagl‐Steiner M, Desideri J, Rebay‐Salisbury K. Indicators of motherhood? Sacral preauricular extensions and notches in identified skeletal collections. INTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY 2022; 32:64-74. [PMID: 35874189 PMCID: PMC9293283 DOI: 10.1002/oa.3044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 08/30/2021] [Accepted: 09/23/2021] [Indexed: 06/15/2023]
Abstract
The sacral preauricular extension (SPE) and sacral preauricular notch (SPN) are morphological changes at the ventral apex of the sacrum. We recently specified their shapes and appearances and suggested a scoring system based on prehistoric Austrian skeletal assemblages. We hypothesized that these specific pelvic changes relate to past pregnancies and parturitions, a hypothesis that we now tested on a subsample of individuals from the Simon Identified Skeletal collection in Geneva (n = 62) and the Christ Church, Spitalfields collection in London (n = 27) linked to historical information on deliveries. We found SPE and SPN in low frequencies and only in female individuals with at least two children in both collections, and a significant association between the emergence of SPE and first births by 25 years. SPN was found only in two females in the Simon collection, but both with a very high number of recorded parturitions including twin births. Based on these results, we are confident in our assumption that at least SPE, and possibly also SPN, result from increased compression forces at the sacroiliac joint, and especially at the ventrosuperior margin, in recurring (complicated) birth events, the interaction of enhanced pelvic joint mobility that is highest up to age 25, and postural changes related to weight gain during pregnancy. Pelvic shape, dimensions, body proportions, biomechanical issues and hormonal levels may also play a role in their emergence.
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Affiliation(s)
- Doris Pany‐Kucera
- Austrian Archaeological InstituteAustrian Academy of SciencesViennaAustria
- Department of AnthropologyNatural History MuseumViennaAustria
| | - Michaela Spannagl‐Steiner
- Austrian Archaeological InstituteAustrian Academy of SciencesViennaAustria
- Department of AnthropologyNatural History MuseumViennaAustria
| | - Jocelyne Desideri
- Department F.‐A. Forel for Environmental and Aquatic Sciences, Laboratory of Prehistoric Archaeology and AnthropologyUniversity of GenevaGenevaSwitzerland
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Long G, Fang ZY, Xiang-Sheng T, Feng Y, Hao-Ning M, Qing-Ying H, Ping Y, Ming-Sheng T. Symmetry in Paraspinal Muscles as a Predictor of the Development of Pregnancy-Related Low Back and Pelvic Pain: A Prospective Study. Orthop Surg 2021; 13:2255-2262. [PMID: 34668324 PMCID: PMC8654660 DOI: 10.1111/os.13126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 05/12/2021] [Accepted: 06/04/2021] [Indexed: 12/01/2022] Open
Abstract
Objective To determine the asymmetry in the paraspinal muscle before pregnancy and evaluate its association with pregnancy‐associated lumbopelvic pain (LPP). Methods This was a prospective case–control study conducted from January 2017 and December 2018. A total of 171 subjects (mean age ± SD, 27.4 ± 5.8 years) were finally divided into the LBP group, PGP group, and no LPP group. Each subject was asked to follow a standardized clinical imaging protocol before the pregnancy. The area of muscles (multifidus, erector spinae, and psoas muscles) on the axial slice at mid‐disc of L4–L5 and L5–S1 were segmented and then the cross‐sectional area (CSA) of a particular muscle was measured by outlining the innermost fascial border surrounding each muscle. The mean value of F‐CSA's ratio to T‐CSA (F/T CSA) was used to determine whether the bilateral paraspinal muscle was asymmetrical. Total muscle CSA (T‐CSA) represents the sum of CSA of interested three muscles. The signal intensity can distinguish fat and muscle tissue in a different range. Based on this, functional CSA (F‐CSA), represented by fat‐free area, was evaluated quantitively by excluding the signal of the deposits of intramuscular fat. Total muscle CSA (T‐CSA), functional CSA (F‐CSA), and the ratio of F‐CSA to T‐CSA (F/T CSA) were measured unilaterally and compared between groups. Logistic regression was performed to determine the risk factors for pregnancy‐associated LPP. The Pearson correlation coefficient was performed to test the relationship between asymmetry in F/T‐CSA and pain rating. Results A total of 124 subjects (72.5%) (28.5 ± 5.2 years) had LPP during pregnancy. Forty‐eight (38.7%) individuals had low back pain (LBP) and 76 (61.3%) had pelvic girdle pain (PGP). Seventy‐six women (44.4%) were determined to have asymmetry in paraspinal muscle according to the definition in this methods section. The duration of follow‐up was 24 months postpartum. A total of 39 (31.5%) women unrecovered from LPP. F/T‐CSA was significantly decreased for LBP in the PGP group than in the and control group (0.03 ± 0.02 vs 0.05 ± 0.03 vs 0.12 ± 0.05, P < 0.001). Meanwhile, significant differences were detected in both groups (all P < 0.001). In patients with LBP, the level of paraspinal asymmetry, represented by the difference in F/T‐CSA, was positively correlated with pain scores (r = 0.52, P < 0.01). However, no statistically significant correlation between pain scores and paraspinal asymmetry was found in PGP (r = 0.42, P > 0.05). Asymmetry in the paraspinal muscle (adjusted OR = 1.5), LBP (adjusted OR = 1.6), LPP in a previous pregnancy (adjusted OR = 1.4), sick leave ≥90 days (adjusted OR = 1.2), and heavy labor (adjusted OR = 1.2) were risk factors for the unrecovered LPP during pregnancy. Conclusions Asymmetrical muscular compositions could lead to abnormal biomechanics for the segmental motions. Lateral‐directed physical training and stretching may help decrease the occurrence and severity of this condition.
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Affiliation(s)
- Gong Long
- Department of Orthopaedic, China-Japan Friendship Hospital, Beijing, China.,Peking Union Medical College, Chinese Academy of Medical College, Beijing, China
| | - Zhi-Yuan Fang
- Department of Orthopaedic, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Tang Xiang-Sheng
- Department of Orthopaedic, China-Japan Friendship Hospital, Beijing, China
| | - Yang Feng
- Department of Orthopaedic, China-Japan Friendship Hospital, Beijing, China
| | - Ma Hao-Ning
- Department of Orthopaedic, China-Japan Friendship Hospital, Beijing, China
| | - Hao Qing-Ying
- Department of Orthopaedic, China-Japan Friendship Hospital, Beijing, China
| | - Yi Ping
- Department of Orthopaedic, China-Japan Friendship Hospital, Beijing, China.,Peking Union Medical College, Chinese Academy of Medical College, Beijing, China
| | - Tan Ming-Sheng
- Department of Orthopaedic, China-Japan Friendship Hospital, Beijing, China.,Peking Union Medical College, Chinese Academy of Medical College, Beijing, China
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Iuamoto L, Ferreira V, Hsing W. Multidisciplinary management of musculoskeletal pain during pregnancy: A review of literature. THE JOURNAL OF THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE 2021. [DOI: 10.4103/jisprm-000099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Huang S, Fan Q, Xiong J, Liao K, Hua F, Xiang J, Li C, Jin H. The effectiveness of acupuncture and moxibustion for treating tenosynovitis: A systematic review and meta-analysis protocol. Medicine (Baltimore) 2020; 99:e22372. [PMID: 33285669 PMCID: PMC7717726 DOI: 10.1097/md.0000000000022372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND De Quervain's tenosynovitis is an overuse disease that involves a thickening of the abductor pollicis longus and extensor pollicis brevis tendons. Evidence shows that acupuncture and moxibustion (AM) could remarkably relieve the pain of De Quervain's tenosynovitis patients. The aim of this protocol is to determine the efficacy and safety of AM for treating De Quervain's tenosynovitis. METHODS Several online databases including PubMed, Cochrane Library, Embase, Chinese Biomedical Literatures Database, China National Knowledge Infrastructure, WangFang Database, Chinese Scientific Journal Database will be searched from their establishment to July 1, 2020. We will include all randomized controlled trials using AM as the method for treating De Quervain's tenosynovitis, regardless of blinding or publication types. The selection of studies, data extraction and the assessment of the studies quality will be conducted by 2 reviewers separately. When there is sufficient available data for meta-analysis, we will use the RevMan V.5.3 statistical software for data synthesis. The total effective rate, range of motion of wrist ulnar deviation will be the primary outcomes, and the secondary outcomes contain Visual Analog Scale, Coney Wrist Score and side effects. We will express the result by using Risk ratio for dichotomous data and mean differences with a 95% confidence interval for continuous data. RESULTS The results of this study be presented in corresponding journal or conferences. CONCLUSIONS This study is designed to provide sufficient evidence to assess the exact effectiveness of AM on De Quervain's tenosynovitis. PROSPERO REGISTRATION NUMBER CRD42020158764.
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Affiliation(s)
- Shouqiang Huang
- Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Qian Fan
- Changshu Hospital of Traditional Chinese Medicine, Changshu
| | - Jun Xiong
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Kai Liao
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Fanghui Hua
- Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Jie Xiang
- Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Changsheng Li
- Jiangxi University of Traditional Chinese Medicine, Nanchang
| | - Hangyu Jin
- Jiangxi University of Traditional Chinese Medicine, Nanchang
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Vitor de Sousa Oliveira G, Dibai Filho AV, Dibai DB, de Maria Araujo Mendonça Silva F, da Cunha Araújo Firmo W, Amorim de Sousa Garcia R, Rebelo Ferreira de Carvalho ST, Gonçalves MC, Abreu Barbosa JM, Rêgo AS. Correlation between baropodometric variables, disability, and intensity of low back pain in pregnant women in the third trimester. J Bodyw Mov Ther 2020; 25:24-27. [PMID: 33714502 DOI: 10.1016/j.jbmt.2020.11.009] [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: 05/17/2020] [Revised: 10/08/2020] [Accepted: 11/04/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Growth of uterus, enlargement of breasts and weight gain result from the development and growth of the fetus during pregnancy. The posture and the displacement of the center of gravity change. OBJECTIVE Correlate baropodometric variables with low back pain in pregnant women in the third trimester of pregnancy. METHODS This is a cross-sectional analytical study conducted in São Luís (MA, Brazil). For data collection, we used a form containing sociodemographic and clinical data, Oswestry Disability Questionnaire for disability evaluation of the lumbar spine, Numerical Rating Scale to measure pain intensity, and baropodometric evaluation. RESULTS Twenty-five pregnant women took part in the study. There was a significant and positive correlation (r = 0.404, p = 0.045) between functional disability and hindfoot pressure and a significant and negative correlation (r = -0.404, p = 0.045) between functional disability and plantar pressure in the forefoot of the right foot. In addition, there was a positive and significant correlation between the intensity of pain and the contact area on the left (r = 0.504, p = 0.010) and right (r = 0.509, p = 0.009) foot. CONCLUSION There is a relation between disability and plantar pressure and between pain intensity and area of contact of feet in pregnant women.
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Affiliation(s)
- Gabriel Vitor de Sousa Oliveira
- Integrated Multiprofessional Residence in Health University Hospital of Federal University of Maranhão, São Luís, Maranhão, Brazil.
| | - Almir Vieira Dibai Filho
- Postgraduate Program in Physical Education Federal University of Maranhão, São Luís, Maranhão, Brazil.
| | - Daniela Bassi Dibai
- Postgraduate Program in Management of Health Programs and Services Ceuma University, São Luís, Maranhão, Brazil.
| | | | | | | | | | | | | | - Adriana Sousa Rêgo
- Postgraduate Program in Environment, Postgraduate Program in Management of Health Programs and Services, Ceuma University, São Luís, Maranhão, Brazil.
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Vesentini G, Prior J, Ferreira PH, Hodges PW, Rudge M, Ferreira ML. Pelvic floor muscle training for women with lumbopelvic pain: A systematic review and meta-analysis. Eur J Pain 2020; 24:1865-1879. [PMID: 32735717 DOI: 10.1002/ejp.1636] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVE It has been suggested that pelvic floor dysfunction may contribute to the development of lumbopelvic pain as a result of changes in trunk muscle control. However, there is limited evidence that pelvic floor muscle training (PFMT) can improve clinical outcomes in women with lumbopelvic pain. DATABASES AND DATA TREATMENT Six databases were searched for randomized controlled trials (RCTs) comparing the effectiveness of PFMT to other conservative interventions (usual physiotherapy care or minimal intervention), no treatment or placebo interventions on pain and disability in women with lumbopelvic pain. RESULTS We included eight RCTs totalling 469 participants. PFMT was more effective than minimal intervention for lumbopelvic pain [mean difference (MD) 15.9/100 (95% confidential interval (CI), 8.2 to 23.6; p = 0.00; I2 = 3.92%)] and disability [standardized mean difference (SMD) 0.5 (95% CI 0.1-0.9; p = 0.00; I2 = 0%)] during pregnancy. PFMT was more effective than usual physiotherapy care for pain (MD 11.7/100 [95% CI 7.5-15.9; p = 0.00; I2 = 94.14%]) and disability (SMD 0.3 (95% CI 0.0-0.6; p = 0.01; I2 = 82.54%]) in non-pregnant women. Effect sizes were in general of arguable clinical relevance. CONCLUSIONS Overall, the certainty of the evidence was very low to low. There is no conclusive evidence that the addition of PFMT to usual physiotherapy care or minimal intervention is superior to minimal intervention and usual care alone given the small number of studies and high levels of heterogeneity of included studies. Further well-designed trials are needed to establish the effectiveness of PFMT for lumbopelvic pain in women.
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Affiliation(s)
- Giovana Vesentini
- Department of Gynaecology and Obstetrics, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil.,Institute of Bone and Joint Research, The Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Joanna Prior
- Institute of Bone and Joint Research, The Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Paulo H Ferreira
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Paul W Hodges
- Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Marilza Rudge
- Department of Gynaecology and Obstetrics, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, The Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Mijena GF, Geda B, Dheresa M, Fage SG. Low Back Pain Among Nurses Working at Public Hospitals in Eastern Ethiopia. J Pain Res 2020; 13:1349-1357. [PMID: 32606901 PMCID: PMC7292259 DOI: 10.2147/jpr.s255254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 05/23/2020] [Indexed: 11/23/2022] Open
Abstract
Objective This study assessed the prevalence of low back pain and factors associated with it among nurses working at public hospitals in eastern Ethiopia. Materials and Methods Institutional-based cross-sectional study was conducted from February 1 to March 20, 2018 among randomly selected 404 nurses working in public hospitals of Harari region and Dire Dawa city administration. Six trained nurses collected the data through a self-administered data collection technique. All variables that yield p< 0.25 in bivariable logistic regression were subjects for multivariable logistic regression analysis. The direction and strength of statistical association were measured by odds ratio with the corresponding 95% confidence interval (CI). Finally, statistical significance was declared at p < 0.05. Results The 12-month prevalence of low back pain was 38.1% [95% CI: 32.7-42.7%]. It was more prevalent among females (65%). More than 5 years of work experience [adjusted odds ratio (AOR) =3.135; 95% CI (1.292-7.605)], manual lifting of weight >10kg [AOR=5.260; 95% CI (1.869-14.805)] and working in awkward posture [AOR=3.93; 95% CI (1.109-13.924)] were variables significantly associated with low back pain among nurses. Conclusion About two in five nurses working at public hospitals in Harari region and Dire Dawa city administration were suffering from low back pain. So, tailored intervention is needed to prevent nurses from further injury and retain experienced nurses.
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Affiliation(s)
- Gelana Fekadu Mijena
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biftu Geda
- Department of Nursing, College of Health and Medical Sciences, Meda Welabu University, Bale-Robe, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Sagni Girma Fage
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Ezeukwu OA, Ojukwu CP, Okemuo AJ, Anih CF, Ikele IT, Chukwu SC. Biomechanical analysis of the three recommended breastfeeding positions. Work 2020; 66:183-191. [DOI: 10.3233/wor-203162] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | | | - Adaora Justina Okemuo
- Department of Medical Rehabilitation, University of Nigeria, Enugu Campus, Enugu State, Nigeria
| | - Chinagozim Faith Anih
- Department of Medical Rehabilitation, University of Nigeria, Enugu Campus, Enugu State, Nigeria
| | | | - Sylvester Caesar Chukwu
- Department of Medical Rehabilitation, University of Nigeria, Enugu Campus, Enugu State, Nigeria
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Traumatic Pelvic Ring Injury following Childbirth with Complete Pubic Symphysis Diastasis. Case Rep Orthop 2019; 2019:1785167. [PMID: 31827958 PMCID: PMC6881751 DOI: 10.1155/2019/1785167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/08/2019] [Indexed: 11/18/2022] Open
Abstract
Case Traumatic pelvic ring injury following childbirth is a rare but debilitating condition. We present a case of a 28-year-old female who sustained a traumatic pelvic ring injury following childbirth with a complete pubic symphysis separation of 5.6 cm treated successfully with nonoperative management. Conclusion Operative and nonoperative treatments for traumatic pelvic ring injuries following childbirth have been described without universal adoption of a uniform treatment modality. We hope this case study adds to the collection of data to help guide medical decision-making in the future as surgeons encounter patients with similar orthopedic injuries.
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Morino S, Ishihara M, Umezaki F, Hatanaka H, Yamashita M, Aoyama T. Pelvic alignment changes during the perinatal period. PLoS One 2019; 14:e0223776. [PMID: 31600310 PMCID: PMC6799872 DOI: 10.1371/journal.pone.0223776] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 09/29/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The function of the pelvic bones is to transfer load generated by body weight. Proper function of the pelvic bones can be disturbed by alignment changes that occur during pregnancy. Further, misalignment of the pelvic bones can lead to pain, urinary incontinence, and other complications. An understanding of the timing and nature of pelvic alignment changes during pregnancy may aid in preventing and treating these complications. OBJECTIVE To investigate the changes in pelvic alignment during pregnancy and one month after childbirth. METHODS This is a prospective, longitudinal cohort study. Pelvic measurements were obtained for 201 women at 12, 24, 30, and 36 weeks of pregnancy, and 1 month after childbirth. The anterior and posterior width of the pelvis (the distance between the bilateral anterior superior iliac spines and the bilateral posterior superior iliac spines), the anterior pelvic tilt, and pelvic asymmetry (the mean left and right pelvic tilt degrees and the bilateral difference of the anterior pelvic tilt) were measured. For the change in pelvic alignment, a Friedman test was conducted to determine any significant difference in the measurements over time. RESULTS The anterior and posterior width of the pelvis became significantly wider with pregnancy progress and the anterior width of the pelvis at 1 month after childbirth remained wider than that at 12 weeks of pregnancy (p < 0.001). The anterior pelvic tilt increased during pregnancy and decreased after childbirth (p < 0.05). CONCLUSION Some changes in pelvic alignment occur continuously during the perinatal period. Changes in the anterior width of the pelvis are not recovered at one month post-childbirth. Understanding these perinatal changes may help clinicians avert complications due to pelvic misalignment.
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Affiliation(s)
- Saori Morino
- Department of Physical Therapy, Faculty of Comprehensive Rehabilitation, Osaka Prefecture University, Osaka, Japan
| | | | | | | | | | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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The effects of pelvic belt use on pelvic alignment during and after pregnancy: a prospective longitudinal cohort study. BMC Pregnancy Childbirth 2019; 19:305. [PMID: 31438891 PMCID: PMC6704663 DOI: 10.1186/s12884-019-2457-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 08/13/2019] [Indexed: 11/27/2022] Open
Abstract
Background Pelvic alignment changes during pregnancy and post-childbirth. Pelvic belts exert external forces that compress and stabilize the joints, and therefore, could influence pelvic alignment. However, limited information is available regarding this potential effect. Therefore, the purpose of this study is to investigate the influence of pelvic belt use on pelvic alignment during and after pregnancy. Methods Data of 201 pregnant women in late pregnancy and 1 month after childbirth were used. Pelvic alignment measurements, including anterior and posterior pelvic width, pelvic asymmetry, and pelvic belt use during and after pregnancy were investigated. Participants were divided into four groups according to pelvic belt use: before and after childbirth (BAC), before childbirth only (BC), after childbirth only (AC), and non-use (NU). Then, an initial one-way ANOVA was conducted to compare the amount of change in pelvic alignment from late pregnancy to post-childbirth between the groups. After the initial analysis, a multivariate regression analysis was performed to determine the statistically significant differences between the groups to consider other factors that influenced pelvic alignment such as age, BMI, number of previous childbirths, vaginal delivery and pelvic asymmetry in late pregnancy. Next, a cutoff point for subgroup stratification based on the weekly duration of pelvic belt use and inter-group changes in pelvic alignment were compared. Results As the result of the initial one-way ANOVA, the decrease in pelvic asymmetry from during pregnancy to postpartum for BAC was greater than that for AC. Moreover, multiple regression analysis showed that the effect of pelvic belt that was revealed in the initial analysis was statistical significance even after adjustment for other factors. Moreover, pelvic asymmetry in the BAC group decreased, compared to being increased or unchanged in the NU and AC groups when the group cutoff time was 7 h per week. Conclusions Continuous and extended use of pelvic belts during and after pregnancy might be related to modifications of pelvic asymmetry in the perinatal period. Therefore, the instruction of correct and comfortable usage and the recommendation of continuous use of pelvic belt especially during pregnancy are required for prevention of some discomforts related to pelvic malalignment. Electronic supplementary material The online version of this article (10.1186/s12884-019-2457-6) contains supplementary material, which is available to authorized users.
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Austin K, Schoenberger H, Saha S. Special situations: Performance of endoscopy while pregnant. TECHNIQUES IN GASTROINTESTINAL ENDOSCOPY 2019. [DOI: 10.1016/j.tgie.2019.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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YETİŞGİN A, CİNAKLI A, ARPA N, KUL M, SATIŞ S. Risk Factors For Pregnancy Related Low Back Pain. KONURALP TIP DERGISI 2019. [DOI: 10.18521/ktd.526531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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The Association of Variations in Hip and Pelvic Geometry With Pregnancy-Related Sacroiliac Joint Pain Based on a Longitudinal Analysis. Spine (Phila Pa 1976) 2019; 44:E67-E73. [PMID: 29979361 DOI: 10.1097/brs.0000000000002774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-sectional study using radiological measurements and longitudinal data analysis. OBJECTIVE We aim to explore hip/pelvic geometry on anteroposterior radiographs and examine if such parameters are associated with clinical symptoms. SUMMARY OF BACKGROUND DATA Pregnancy-related sacroiliac joint pain is a common disease and is responsible to the disability of daily activities. The etiology is likely to be correlated with the biomechanical factors which are determined by trunk load and hip/pelvic geometry. Previous studies have already found the association between symptoms and weight increase during pregnancy. However, the relationship between bony anatomy and pregnancy-related sacroiliac joint pain remains unknown. METHODS In total, 72 women were included in the final analysis. In pregnant women with self-reported sacroiliac joint pain, pain scores at 12, 24, 30, and 36 weeks of pregnancy were recorded and included in a mixed-effect linear regression model as dependent variables. The radiological measurements were included as independent variables. Furthermore, to investigate the relationship between hip/pelvic geometry and the activity-specific nociceptive phenomenon, the radiological measurements between patients with and without activity-induced pain were compared using a binominal logistic regression model. RESULTS The relative bilateral is chial tuberosity distance (betta coefficient: 0.078; P = 0.015) and the relative bilateral femoral head length (betta coefficient: 0.011; P = 0.028) showed significant interactions with the slope of pain scores. Moreover, women whose pain exacerbate during prolonged walking had a higher odds in hip/pelvic geometry of the bilateral ischial tuberosity distance (odds ratio [OR]: 1.12; P = 0.050) and the bilateral femoral head length (OR: 1.16; P = 0.076) with approximately significant P-value. CONCLUSION These data indicate hip/pelvic anatomical variations are associated with the degree of pain increasing and the activity-specific pain during pregnancy, which may help to have further understanding on the biomechanical factor in developing pregnancy-related sacroiliac joint pain. LEVEL OF EVIDENCE 3.
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Lira SOR, Sousa VPSD, Medeiros CNA, Viana EDSR. Impact of lumbopelvic pain on postural balance during sit-to-stand activity in pregnant women: a cross-sectional study. FISIOTERAPIA EM MOVIMENTO 2019. [DOI: 10.1590/1980-5918.032.ao21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
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.
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Myrex P, Harper L, Gould S. Corticosteroid Injection for an Orthopedic Complaint in a Female with Gestational Diabetes. SPORTS MEDICINE - OPEN 2018; 4:3. [PMID: 29305780 PMCID: PMC5756231 DOI: 10.1186/s40798-017-0115-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 12/07/2017] [Indexed: 11/10/2022]
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Kesikburun S, Güzelküçük Ü, Fidan U, Demir Y, Ergün A, Tan AK. Musculoskeletal pain and symptoms in pregnancy: a descriptive study. Ther Adv Musculoskelet Dis 2018; 10:229-234. [PMID: 30515249 PMCID: PMC6262502 DOI: 10.1177/1759720x18812449] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 10/04/2018] [Indexed: 11/16/2022] Open
Abstract
Background Pregnancy-induced hormonal and physiologic changes increase the risk of musculoskeletal problems in pregnancy. The purpose of this report is to provide a comprehensive look at the musculoskeletal pain and symptoms experienced during pregnancy. Methods A total of 184 women (mean age 30.9 ± 5.0 years) who gave birth in the obstetrics clinic of a tertiary hospital were included in the study. The participants who had given birth at 37-42 weeks of pregnancy (term pregnancy) and aged over 18 years were selected for participation. Basic demographic and clinical characteristics of the participants including age, body mass index, weight gained during pregnancy, education level, occupation, parity, sex of baby, and exercise habits were collected from the medical chart and face-to-face interviews. Musculoskeletal pain sites were defined as hand-wrist, elbow, shoulder, neck, back, low back, hip, knee, and ankle-foot in a diagram of the human body. The interviews with participants were performed to assess their musculoskeletal pain separately at each trimester follow-up visit. Results The most frequent musculoskeletal complaints during pregnancy were low back pain (n = 130, 70.7%), back pain (n = 80, 43.5%), hand-wrist (n = 61, 33.2%) and hip pain (n = 59, 32.1%). The participants experienced musculoskeletal pain most in the third trimester except for elbow, shoulder and neck pain compared with the first and second trimesters (p < 0.05). Conclusions The results of the study suggest that numerous musculoskeletal problems may complicate pregnancy especially in the third trimester.
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Affiliation(s)
- Serdar Kesikburun
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gülhane School of Medicine, Gaziler Physical Therapy and Rehabilitation Research and Training Hospital, Gaziler Fizik Tedavi ve Rehabilitasyon Eğitim Araştırma Hastanesi 06800 Bilkent-Ankara, Turkey
| | - Ümüt Güzelküçük
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gülhane School of Medicine, Gaziler Physical Therapy and Rehabilitation Research and Training Hospital, Ankara, Turkey
| | - Ulaş Fidan
- Department of Gynecology and Obstetrics, University of Health Sciences, Gulhane School of Medicine, Ankara, Turkey
| | - Yasin Demir
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gülhane School of Medicine, Gaziler Physical Therapy and Rehabilitation Research and Training Hospital, Ankara, Turkey
| | - Ali Ergün
- Department of Gynecology and Obstetrics, University of Health Sciences, Gulhane School of Medicine, Ankara, Turkey
| | - Arif Kenan Tan
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gülhane School of Medicine, Gaziler Physical Therapy and Rehabilitation Research and Training Hospital, Ankara, Turkey
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Fernandes JG. Occupational Therapists' Role in Perinatal Care: A Health Promotion Approach. Am J Occup Ther 2018; 72:7205347010p1-7205347010p4. [PMID: 30157021 DOI: 10.5014/ajot.2018.028126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This article establishes and examines occupational therapists' role in perinatal care and proposes a health promotion approach for new and expectant mothers. The author demonstrates the importance of maintaining meaningful occupational engagement during this critical life stage by incorporating evidence from orthopedic, rehabilitation, and hand therapy research. New and expectant mothers are at high risk for upper extremity (UE) conditions such as carpal tunnel syndrome, De Quervain's tenosynovitis, and tendinosis of the UE. Occupational therapists with basic knowledge of hand therapy are well prepared to manage these conditions conservatively. An occupation-based model and framework are presented to ensure a holistic view of the target population. Topics pertinent to this population include postural techniques, repetitive tasks, patient education, and strengthening related to the perinatal period.
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Affiliation(s)
- Julie Grobbelaar Fernandes
- Julie Grobbelaar Fernandes, OTD, OT/L, CHT, is Senior Occupational Therapist, New York University Langone Orthopedic Center, New York, NY;
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Vico Pardo FJ, López del Amo A, Pardo Rios M, Gijon-Nogueron G, Yuste CC. Changes in foot posture during pregnancy and their relation with musculoskeletal pain: A longitudinal cohort study. Women Birth 2018; 31:e84-e88. [DOI: 10.1016/j.wombi.2017.08.114] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 08/07/2017] [Accepted: 08/10/2017] [Indexed: 11/28/2022]
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Low back pain and causative movements in pregnancy: a prospective cohort study. BMC Musculoskelet Disord 2017; 18:416. [PMID: 29037184 PMCID: PMC5644197 DOI: 10.1186/s12891-017-1776-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 10/10/2017] [Indexed: 11/10/2022] Open
Abstract
Background Low back pain (LBP) during pregnancy might be strongly related to posture and movements of the body, and its management is a clinically important issue. The purpose of this study was to investigate the activities related to LBP during pregnancy. Methods Participants included 275 women before 12 weeks of pregnancy. The women were evaluated at 12, 24, 30, and 36 weeks of pregnancy. The intensity of LBP was assessed using the Numerical Rating Scale (NRS). Movements related to LBP were investigated by free descriptive answers. Descriptive statistics were used to compile the movements that pregnant women thought induced LBP at each evaluation. Subsequently, a linear regression analysis was performed to evaluate the degree of association of certain movements with LBP using the data of participants who had LBP. The intensity of LBP (NRS score) was specified as the dependent variable, the movements that were related to pain were specified as the independent variables at the analysis. A significance threshold was set at 0.05. Results The final sample used in the analyses was 254, 249, 258, and 245 women at 12, 24, 30, and 36 weeks of pregnancy, respectively. There were 16 kinds of movements that induced LBP and all of them were daily activities rather than special movements that require extra task or effort. As pregnancy progressed, less number of participants attributed pain to a specific movement. At all evaluations, movements, especially sitting up, standing up from a chair, and tossing and turning were thought to be related to LBP. Furthermore, standing up from a chair and tossing and turning were significantly related to LBP throughout the pregnancy. In contrast, lying down and sitting up were significantly related to LBP but the relationship did not continue till late pregnancy. Conclusions Daily routine activity is related to LBP during pregnancy. These results suggest that recommendations for pregnant women about basic physical movements, such as ways of standing up that reduce the load on the body might be useful in the management of LBP.
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Estimating Co-Contraction Activation of Trunk Muscles Using a Novel Musculoskeletal Model for Pregnant Women. APPLIED SCIENCES-BASEL 2017. [DOI: 10.3390/app7101067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Colla C, Paiva LL, Thomaz RP. Therapeutic exercise for pregnancy low back and pelvic pain: a systematic review. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.002.ar03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Abstract Introduction: During pregnancy, a woman’s body goes through many changes, and lower back and pelvic pain are common and may persist after pregnancy. Although the literature point physical therapy as an effective therapeutic tool, there are few studies on the effects of physical therapy intervention through exercises for this purpose. Objective: To perform a systematic review on the use of Physiotherapy, through therapeutic exercises, for the prevention and treatment of pregnancy low back and pelvic pain. Methods: A systematic search for randomized trials (RCTs) was conducted on the databases PubMed, PEDro, Cochrane, EMBASE, LILACS and Periódicos Capes. There was no date or language restriction. The terms included in the search were: “pregnancy”, “low back pain”, “pelvic pain”, “exercise therapy” and their descriptors in Portuguese. Methodological quality was assessed using the PEDro scale and a descriptive analysis of the studies was performed. Results: Eight studies, including 1781 pregnant women, were selected. Among them, one study addressed the issue of low back pain, two focused on pelvic pain and five on low back and/or pelvic pain. Seven studies presented high methodological quality, and only one study had low methodological quality. Limited evidence on low back pain was found, and conflicting evidence on pelvic pain, and low and/or pelvic pain. Conclusion: RCTs on the subject are scarce and heterogeneous, making it impossible to reach a consensus or any conclusions about which protocol of therapeutic exercise is more effective in the use of physiotherapy for pregnancy low back and pelvic pain.
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Affiliation(s)
- Cássia Colla
- Universidade Federal do Rio Grande do Sul, Brazil
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Physical exercise and pelvic girdle pain in pregnancy: A nested case–control study within the Danish National Birth Cohort. SEXUAL & REPRODUCTIVE HEALTHCARE 2015; 6:198-203. [DOI: 10.1016/j.srhc.2015.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 04/06/2015] [Accepted: 04/22/2015] [Indexed: 01/13/2023]
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Shah S, Banh ET, Koury K, Bhatia G, Nandi R, Gulur P. Pain Management in Pregnancy: Multimodal Approaches. PAIN RESEARCH AND TREATMENT 2015; 2015:987483. [PMID: 26448875 PMCID: PMC4584042 DOI: 10.1155/2015/987483] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 08/13/2015] [Indexed: 11/17/2022]
Abstract
Nonobstetrical causes of pain during pregnancy are very common and can be incapacitating if not treated appropriately. Recent reports in the literature show that a significant percentage of pregnant women are treated with opioids during pregnancy. To address common pain conditions that present during pregnancy and the available pharmacological and nonpharmacological treatment options, for each of the pain conditions identified, a search using MEDLINE, PubMed, Embase, and Cochrane databases was performed. The quality of the evidence was evaluated in the context of study design. This paper is a narrative summary of the results obtained from individual reviews. There were significant disparities in the studies in terms of design, research and methodology, and outcomes analyzed. There is reasonable evidence available for pharmacological approaches; however, these are also associated with adverse events. Evidence for nonpharmacological approaches is limited and hence their efficacy is unclear, although they do appear to be primarily safe. A multimodal approach using a combination of nonpharmacological and pharmacological options to treat these pain conditions is likely to have the most benefit while limiting risk. Research trials with sound methodology and analysis of outcome data are needed.
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Affiliation(s)
- Shalini Shah
- Department of Anesthesiology & Perioperative Care, University of California, Irvine, 333 The City Boulevard West, Suite 2150, Orange, CA 92868, USA
| | - Esther T. Banh
- Department of Anesthesiology & Perioperative Care, University of California, Irvine, 333 The City Boulevard West, Suite 2150, Orange, CA 92868, USA
| | - Katharine Koury
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Gray-Bigelow 444, Boston, MA 02114, USA
| | - Gaurav Bhatia
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Gray-Bigelow 444, Boston, MA 02114, USA
| | - Roneeta Nandi
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Gray-Bigelow 444, Boston, MA 02114, USA
| | - Padma Gulur
- Department of Anesthesiology & Perioperative Care, University of California, Irvine, 333 The City Boulevard West, Suite 2150, Orange, CA 92868, USA
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Tenforde AS, Toth KES, Langen E, Fredericson M, Sainani KL. Running habits of competitive runners during pregnancy and breastfeeding. Sports Health 2015; 7:172-6. [PMID: 25984264 PMCID: PMC4332642 DOI: 10.1177/1941738114549542] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Running is a popular sport that may be performed safely during pregnancy. Few studies have characterized running behavior of competitive female runners during pregnancy and breastfeeding. Hypothesis: Women modify their running behavior during pregnancy and breastfeeding. Study Design: Observational, cross-sectional study. Level of evidence: Level 2. Methods: One hundred ten female long-distance runners who ran competitively prior to pregnancy completed an online survey characterizing training attitudes and behaviors during pregnancy and postpartum. Results: Seventy percent of runners ran some time during their pregnancy (or pregnancies), but only 31% ran during their third trimester. On average, women reduced training during pregnancy, including cutting their intensity to about half of their nonpregnant running effort. Only 3.9% reported sustaining a running injury while pregnant. Fewer than one third (29.9%) selected fetal health as a reason to continue running during pregnancy. Of the women who breastfed, 84.1% reported running during breastfeeding. Most felt that running had no effect on their ability to breastfeed. Women who ran during breastfeeding were less likely to report postpartum depression than those who did not run (6.7% vs 23.5%, P = 0.051), but we did not detect the same association of running during pregnancy (6.5% vs 15.2%, P = 0.16). Conclusion: Women runners reported a reduction in total training while pregnant, and few sustained running injuries during pregnancy. The effect of running on postpartum depression was not clear from our findings. Clinical Relevance: We characterized running behaviors during pregnancy and breastfeeding in competitive runners. Most continue to run during pregnancy but reduce total training effort. Top reasons for running during pregnancy were fitness, health, and maintaining routine; the most common reason for not running was not feeling well. Most competitive runners run during breastfeeding with little perceived impact.
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Affiliation(s)
- Adam S Tenforde
- Division of Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, Stanford University, Stanford, California
| | - Kierann E S Toth
- Mid-Hudson Family Medicine Residency Program, Institute for Family Health, Kingston, New York
| | - Elizabeth Langen
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Michael Fredericson
- Division of Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, Stanford University, Stanford, California
| | - Kristin L Sainani
- Division of Epidemiology, Department of Health Research and Policy, Stanford University, Stanford, California
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Abstract
de Quervain's tenosynovitis is an overuse disease that involves a thickening of the extensor retinaculum, which covers the first dorsal compartment. A case study approach was utilized in this article to demonstrate many of the available medical and occupational therapy modalities to treat this condition. A 34-year-old right hand-dominant female who works in a daycare facility presents with radial side wrist pain during lifting activity for the past 4-6 weeks. The patient was diagnosed with de Quervain's tenosynovitis and conservative care was initiated. Conservative care involved anti-inflammatory medication and corticosteroid injections as well as occupational therapy to include splinting, activity modification, modalities, manual treatment, and therapeutic exercise. Although conservative care assisted the patient with her symptoms initially, she returned with increased pain and discomfort after 2 months time. At that point, surgery was discussed and performed to release the first dorsal compartment as well as the sub-compartment. The patient was provided with a splint postoperatively and initiated occupational therapy for edema and scar management, therapeutic exercise, and desensitization. Ultimately, the patient was able to return to work pain free.
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Chin EG, Vincent C, Wilkie D. A Comprehensive Description of Postpartum Pain after Cesarean Delivery. J Obstet Gynecol Neonatal Nurs 2014; 43:729-41. [DOI: 10.1111/1552-6909.12483] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Björkenstam E, Narusyte J, Alexanderson K, Ropponen A, Kjeldgård L, Svedberg P. Associations between childbirth, hospitalization and disability pension: a cohort study of female twins. PLoS One 2014; 9:e101566. [PMID: 24999632 PMCID: PMC4084814 DOI: 10.1371/journal.pone.0101566] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 06/04/2014] [Indexed: 11/19/2022] Open
Abstract
Background As the literature on long-term effects of childbirth on risk of morbidity or permanent work incapacity (DP) is limited, we aimed to study associations of childbirth with hospitalization and DP, adjusting for familial factors. Methods This cohort study included female twins, i.e. women with twin sister, born 1959–1990 in Sweden (n = 5 118). At least one in the twin pair had their first childbirth 1994–2009. Women were followed regarding all-cause and cause-specific (mental or musculoskeletal diagnoses) DP during year 2–5 after first delivery or equivalent. Associations between childbirth, hospitalization and DP were calculated as hazard ratios (HR) with 95% confidence intervals (CI). Results Women who did not give birth had markedly higher number of DP days/year compared to those giving birth. Hospitalization after first childbirth was associated with a higher HR of DP. Those hospitalized at least once after their first childbirth had a three-fold DP risk (HR: 3.2; 95% CI 1.1–9.6), DP due to mental diagnoses (HR: 3.2; 1.2–8.8), and of DP due to musculoskeletal diagnoses (HR: 6.1; 1.6–22.9). Lower HRs in the discordant twin pair analyses indicated that familial factors may influence the studied associations. Conclusions Women who did not give birth had a much higher risk for DP than those who did. Among those who gave birth, the risk for DP was markedly higher among those with a previous hospitalization, and especially in women with repeated hospitalizations. The results indicate a health selection into giving birth as well as the importance of morbidity for DP.
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Affiliation(s)
- Emma Björkenstam
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Jurgita Narusyte
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kristina Alexanderson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Linnea Kjeldgård
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Pia Svedberg
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
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Gijon-Nogueron GA, Gavilan-Diaz M, Valle-Funes V, Jimenez-Cebrian AM, Cervera-Marin JA, Morales-Asencio JM. Anthropometric foot changes during pregnancy: a pilot study. J Am Podiatr Med Assoc 2014; 103:314-21. [PMID: 23878384 DOI: 10.7547/1030314] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Women's feet change during pregnancy owing to hormonal and anatomical changes, thus having a strong influence on the decrease in their quality of life during pregnancy. This preliminary study aimed to value the anthropometric and positional changes that affect their feet. METHODS Ten pregnant women were measured during their gestational period to analyze the anthropometric changes in their feet from the 12th week of pregnancy. We examined the changes that occured in foot length, forefoot width, arch of the foot height, and the fixed position of the foot by using the Foot Posture Index, and we analyzed three intervals corresponding to pregnancy weeks 12, 24, and 34. RESULTS The most significant finding, with a reliability rate of 95%, is the decrease in internal arch height, which descends 0.65 mm (0.0394 inches) on average at the final stage of the pregnancy period. This change happened in 18 of the feet analyzed, tending toward pronation according to the measure provided by the Foot Posture Index, with a change of 3.78 points on this scale. CONCLUSIONS The foot of the pregnant woman tends to flatten during gestational weeks 12 to 34, taking a more pronated posture, and the anthropometric changes in late pregnancy result in increases in foot length and forefoot width, changes that seem to be moderate.
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Affiliation(s)
- Gabriel A Gijon-Nogueron
- Department of Nursing and Podiatry, Faculty of Health Science, University of Málaga, Málaga, Spain.
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Angelo RDCDO, Silva DCD, Zambaldi CF, Cantilino A, Sougey EB. Influence of body posture on the association between postpartum depression and pain. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2014; 36:32-9. [PMID: 27000546 DOI: 10.1590/2237-6089-2013-0029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 11/20/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To determine the association between postpartum depression (PPD), intensification of back pain and exacerbation of changes in postural alignment intrinsic to puerperium. METHODS Eighty women at 2 to 30 weeks postpartum were included in the study according to the following criteria: literate mothers, gestation of 34 to 42 weeks, and healthy live-born infants. All mothers agreed to participate in the study. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Pain was assessed using a visual analogue scale (VAS) and the Nordic Musculoskeletal Questionnaire (NMQ), and posture, using real time naturalistic observation. RESULTS There was a statistically significant association between PPD and pain intensity (p = 0.002). The upper back was the most frequent pain site among depressed women, both before (p = 0.04) and after delivery (p = 0.01). There were no associations between PPD and type of posture (p = 0.328). However, pain intensity was greater among depressed women in the swayback group (p < 0.001). CONCLUSION The intensification of puerperal pain is closely associated with PPD. Our results suggest that back pain may be both a risk factor and a comorbidity of PPD among puerperal women and that pain and type of posture are interdependent.
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Chang HY, Lai YH, Jensen MP, Shun SC, Hsiao FH, Lee CN, Yang YL. Factors associated with low back pain changes during the third trimester of pregnancy. J Adv Nurs 2013; 70:1054-64. [DOI: 10.1111/jan.12258] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2013] [Indexed: 01/06/2023]
Affiliation(s)
- Hao-Yuan Chang
- School of Nursing; College of Medicine; National Taiwan University; Taipei Taiwan
| | - Yeur-Hur Lai
- School of Nursing; College of Medicine; National Taiwan University; Taipei Taiwan
| | - Mark P. Jensen
- Department of Rehabilitation Medicine; University of Washington; Seattle Washington USA
| | - Shiow-Ching Shun
- School of Nursing; College of Medicine; National Taiwan University; Taipei Taiwan
| | - Fei-Hsiu Hsiao
- School of Nursing; College of Medicine; National Taiwan University; Taipei Taiwan
| | - Chen-Nan Lee
- Department of Gynecology and Obstetrics; National Taiwan University Hospital; Taipei Taiwan
| | - Ya-Ling Yang
- School of Nursing; College of Medicine; National Taiwan University; Taipei Taiwan
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