A prospective longitudinal comparison of the sacral inclination angle in women between their early and advanced pregnancy and 6-month postpartum follow-up
Treść / Zawartość
The impact of pregnancy on the anterior-posterior sacral orientation and its relation to lumbopelvic pain and weight gain has not been fully recognized. This longitudinal study aimed to compare the sacral inclination angle in women between their early and advanced pregnancy and at 6 months postpartum. The authors also searched for a correlation between the sacral inclination and lumbopelvic pain, BMI and change in body mass. Methods: Thirteen healthy women participated in the study. Data were collected at 8–16 and 35–38 weeks of gestation, and at 27–31.5 postpartum weeks. At each session, the women’s sacral inclination angles were measured using the Saunders digital inclinometer. Data were also collected on lumbopelvic pain, BMI and body mass gain/loss. Results: There was no effect of the evaluation period on the sacral inclination ( p > 0.05); however, various individual values of the sacral inclination in pregnancy and postpartum were noted. In advanced pregnancy, 61.5% of the women had recurrent pain in the lumbopelvic region. The sacral inclination did not correlate with the lumbopelvic pain, BMI and body mass change ( p > 0.05) in the pregnancy and postpartum periods. Conclusions: Advanced pregnancy did not influence sacral inclination. However, individuals varied in their responses. Therefore, we suggest that an individually-based physical therapy approach concerning proper posture during and after pregnancy should be emphasized. The sacral inclination had no impact on the occurrence of recurrent lumbopelvic pain. BMI and changes in body mass did not influence the sacral inclination in advanced pregnancy and at 6 months postpartum.
Bibliogr. 32 poz., rys., tab., wykr.
- Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland, firstname.lastname@example.org
- Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
- Motion Analysis Laboratory, Department of Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
-  BACKHAUSEN M., DAMM P., BENDIX J., TABOR A., HEGAARD H., The prevalence of sick leave: Reasons and associated predictors – A survey among employed pregnant women, Sex Reprod. Healthc., 2018, 15, 54–61.
-  BETSCH M., WEHRLE R., DOR L., RAPP W., JUNGBLUTH P., HAKIMI M., WILD M., Spinal posture and pelvic position during pregnancy: A prospective rasterstereographic pilot study, Eur. Spine J., 2015, 24, 1282–1288.
-  BIVIÁ-ROIG G., LISÓN J.F., SÁNCHEZ-ZURIAGA D., Changes in trunk posture and muscle responses in standing during pregnancy and postpartum, PLoS ONE, 2018, 13 (3), e0194853.
-  COLDRON Y., STOKES M.J., NEWHAM D.J., COOK K., Postpartum characteristics of rectus abdominis on ultrasound imaging, Man. Ther., 2008, 13, 112–121.
-  CZAPROWSKI D., PAWŁOWSKA P., GĘBICKA A., SITARSKI D., KOTWICKI T., Intra- and interobserver repeatability and reliability of the assessment of the anterio-posterior curvatures of the spine using Sanders digital inclinometer, Ortop. Traumatol. Rehabil., 2012, 14, 145–154.
-  FRANKLIN M.E., CONNER-KERR T., An Analysis of Posture and Back Pain in the First and Third Trimesters of Pregnancy, J. Orthop. Sports Phys. Ther., 1998, 28, 133–138.
-  FRIES E.C., HELLEBRANDT F.A., The influence of pregnancy on the location of the center of gravity, postural stability, and body alignment, Am. J. Obstet. Gynecol., 1943, 46, 374–380.
-  GEIGER E.V., MÜLLER O., NIEMEYER T., KLUBA T., Adjustment of pelvispinal parameters preserves the constant gravity line position, Int. Orthop., 2007, 31, 253–258.
-  GUTKE A., OSTGAARD H.C., OBERG B., Predicting persistent pregnancy-related low back pain, Spine, 2008, 20, 386–393.
-  HAWRYLAK A., CHROMIK K., RATAJCZAK B., BARCZYK--PAWELEC K., DEMCZUK-WŁODARCZYK E., Spinal range of motion and plantar pressure in sport climbers, Acta Bioeng. Biomech., 2017, 19, 169–173.
-  JENSEN R.K., DOUCET S., TREITZ T., Changes in segment mass and mass distribution during pregnancy, J. Biomech., 1996, 29, 251–256.
-  KOUHKAN S., RAHIMI A., GHASEMI M., NAIMI S.S., AKBARZADEH BAGHBAN A., Postural changes during first pregnancy, Br. J. Med. Med. Res., 2015, 7, 744–753.
-  MACINTYRE N.J., BENNETT L., BONNYMAN A.M., STRATFORD P.W., Optimizing reliability of digital inclinometer and flexicurve ruler measures of spine curvatures in postmenopausal women with osteoporosis of the spine: An illustration of the use of generalizability theory, ISRN Rheumatol., 2011, ID 571698, 8 pp., DOI:10.5402/2011/571698.
-  MACKENZIE J., MURRAY E., LUSHER J., Women’s experiences of pregnancy related pelvic girdle pain: A systematic review, Midwifery, 2018, 56, 102–111.
-  MENS J.M., POOL-GOUDZWAARD A., STAM H.J., Mobility of the pelvic joints in pregnancy-related lumbopelvic pain: a systematic review, Obstet. Gynecol. Surv., 2009, 64, 200–208.
-  MIESZAŁA W., DEMCZUK-WŁODARCZYK E., CHROMIK K., HAWRYLAK A., MAŁACHOWSKA-SOBIESKA M., Examining relationships of the anterior pelvic tilt angle with the anteriorposterior curvatures and elongation of the spine, Acta Bioeng. Biomech. 2019, 21, 37–44.
-  MOGREN I.M., Low back pain and pelvic pain during pregnancy: Prevalence and risk factors, Spine, 2005, 30, 983–991.
-  MOORE K., DUMAS G.A., REID J.G., Postural changes associated with pregnancy and their relationship with low-back pain, Clin. Biomech., 1990, 5, 169–174.
-  MORINO S., ISHIHARA M., UMEZAKI F., HATANAKA H., IIJIMA H., YAMASHITA M., AOYAMA T., TAKAHASHI M., Low back pain and causative movements in pregnancy: a prospective cohort study, BMC Musculoskelet. Disord., 2017, 18, 416.
-  NAKIPOGLU G.F., KARAGÖZ A., ÖZGIRGIN N., The Biomechanics of the Lumbosacral Region In Acute And Chronic Low Back Pain Patients, Pain Physician, 2008, 11, 505–511.
-  OKANISHI N., KITO N., AKIYAMA M., YAMAMOTO M., Spinal curvature and characteristics of postural change in pregnant women, Acta Obstet. Gynecol. Scand., 2012, 91, 856–861.
-  OPALA-BERDZIK A., BACIK B., CIEŚLIŃSKA-ŚWIDER J., PLEWA M., GAJEWSKA M., The influence of pregnancy on the location of the center of gravity in standing position, J. Hum. Kinet., 2010, 26, 5–11.
-  OPALA-BERDZIK A., BŁASZCZYK J.W., BACIK B., CIEŚLIŃSKA-ŚWIDER J., ŚWIDER D., SOBOTA G., MARKIEWICZ A., Static Postural Stability in Women during and after Pregnancy: A Prospective Longitudinal Study, PLoS ONE, 2015, 10 (6), e0124207.
-  OPALA-BERDZIK A., BŁASZCZYK J.W., ŚWIDER D., CIEŚLIŃSKA-ŚWIDER J., Trunk forward flexion mobility in reference to postural sway in women after delivery: A prospective longitudinal comparison between early pregnancy and 2- and 6-month postpartum follow-ups, Clin. Biomech., 2018, 56, 70–74.
-  OSTGAARD H.C., ANDERSSON G.B., SCHULTZ A.B., MILLER J.A., Influence of some biomechanical factors on low-back pain in pregnancy, Spine, 1993, 18, 61–65.
-  RASMUSSEN K.M., CATALANO P.M., YAKTINE A.L., New guidelines for weight gain during pregnancy: what obstetrician/gynecologists should know, Curr. Opin. Obstet. Gynecol., 2009, 21, 521–526.
-  SCHRÖDER G., KUNDT G., OTTE M., WENDIG D., SCHOBER H.C., Impact of pregnancy on back pain and body posture in women, J. Phys. Ther. Sci., 2016, 28, 1199–1207.
-  TLAPAKOVA E., JELEN K., MINARIKOVA M., The relationship between pelvis inclination, exercise and low back pain (LBP) during pregnancy, Acta Univ. Palacki. Olomuc., Gymn., 2011, 41, 15–21.
-  VAZ G., ROUSSOULY P., BERTHONNAUD E., DIMNET J., Sagittal morphology and equilibrium of pelvis and spine, Eur. Spine J., 2002, 11, 80–87.
-  VERMANI E., MITTAL R., WEEKS A., Pelvic girdle pain and low back pain in pregnancy: A review, Pain Pract., 2010, 10, 60–71.
-  WANG S.M., DEZINNO P., MARANETS I., BERMAN M.R., CALDWELL-ANDREWS A.A., KAIN Z.N., Low back pain during pregnancy: Prevalence, risk factors and outcomes, Obstet. Gynecol., 2004, 104, 65–70.
-  WHITCOME K.K., SHAPIRO L.J., LIEBERMAN D.E., Fetal load and the evolution of lumbar lordosis in bipedal hominis, Nature, 2007, 450, 1075–1078.
This study is a part of a project regarding the longitudinal investigation of postural characteristics of women during and after pregnancy, which was funded by the Polish Ministry of Science and Higher Education grant 2 P05D 05227. The study was supported by statutory funds from the Jerzy Kukuczka Academy of Physical Education in Katowice.
Opracowanie rekordu ze środków MNiSW, umowa Nr 461252 w ramach programu "Społeczna odpowiedzialność nauki" - moduł: Popularyzacja nauki i promocja sportu (2020).