Alessander Danna-Dos-Santos1, Alessandra T Magalhães2, Baldomero A Silva3, Biara S Duarte4, Glena L Barros5, Maria De Fátima C Silva6, Cristiano S Silva7, Sambit Mohapatra8, Adriana M Degani9, Vinicius S Cardoso10. 1. Department of Physical Therapy, Western Michigan University, 1903W Michigan Ave., Kalamazoo, MI 49008-5383, USA; Synergy Applied Medical and Research, Missoula, MT, USA. Electronic address: alex.santos@wmich.edu. 2. Biosignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil. Electronic address: alessandra@ufpi.edu.br. 3. Biosignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil. Electronic address: baldomero@ufpi.edu.br. 4. Biosignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil. Electronic address: biara_duarte@hotmail.com. 5. Biosignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil. Electronic address: glenasousa@hotmail.com. 6. Biosignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil. Electronic address: fatinhacosta2008@hotmail.com. 7. Biosignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil. Electronic address: cristiano.silva@ufpi.edu.br. 8. University of Vermont, Burlington, VT, USA. 9. Synergy Applied Medical and Research, Missoula, MT, USA. Electronic address: adriana.degani@umontana.edu. 10. Biosignal Laboratory, School of Physical Therapy, Federal University of Piauí, Parnaíba, Piauí, Brazil. Electronic address: vscfisio@ufpi.edu.br.
Abstract
BACKGROUND: Morphological and physiological changes during pregnancy are considered to interfere with the mechanisms of postural control and potentially increase the risk of falling. A clear understanding of these mechanisms is important to improve pre-natal care and reduce the fall risk in this population. OBJECTIVES: This study focused on investigating how pregnancy affects postural control in each trimester of pregnancy by analyzing pelvic inclination and body sway behavior. Our main hypothesis was that balance control and posture would change during pregnancy. More specifically, pregnancy would increase sway amplitude, anterior pelvic tilt, and body sway regularity in time. STUDY DESIGN: Forty women formed four groups: non-pregnant women (NP) and women at their first, second, and third trimester of pregnancy (P1, P2, and P3, respectively). All participants performed (1) postural evaluation of the pelvic inclination using a digital system of postural analysis and (2) instrumented posturography using a force platform to collect the coordinates of the body's center of pressure (COP) during quiet bipedal stance for 120 s. Kruskal-Wallis H test and post-hoc Mann-Whitney U tests were used to investigate the effects of pregnancy (NP, P1, P2, and P3) on pelvic inclination angle and postural indices computed from the COP signals. RESULTS: Results revealed significant larger body sway accompanied by a more regular medial-lateral pattern of oscillation and a more synchronized anterior-posterior and medial-lateral sway already at the first trimester of pregnancy. The averaged COP migrated posteriorly at third trimester of pregnancy and the anterior pelvic tilt increased at second and third trimesters. CONCLUSIONS: Our results indicate the existence of changes in posture and balance metrics even at early stages of pregnancy. We suggest the use of posturography as one of screening tools for postural instability and fall risk during pregnancy.
BACKGROUND: Morphological and physiological changes during pregnancy are considered to interfere with the mechanisms of postural control and potentially increase the risk of falling. A clear understanding of these mechanisms is important to improve pre-natal care and reduce the fall risk in this population. OBJECTIVES: This study focused on investigating how pregnancy affects postural control in each trimester of pregnancy by analyzing pelvic inclination and body sway behavior. Our main hypothesis was that balance control and posture would change during pregnancy. More specifically, pregnancy would increase sway amplitude, anterior pelvic tilt, and body sway regularity in time. STUDY DESIGN: Forty women formed four groups: non-pregnant women (NP) and women at their first, second, and third trimester of pregnancy (P1, P2, and P3, respectively). All participants performed (1) postural evaluation of the pelvic inclination using a digital system of postural analysis and (2) instrumented posturography using a force platform to collect the coordinates of the body's center of pressure (COP) during quiet bipedal stance for 120 s. Kruskal-Wallis H test and post-hoc Mann-Whitney U tests were used to investigate the effects of pregnancy (NP, P1, P2, and P3) on pelvic inclination angle and postural indices computed from the COP signals. RESULTS: Results revealed significant larger body sway accompanied by a more regular medial-lateral pattern of oscillation and a more synchronized anterior-posterior and medial-lateral sway already at the first trimester of pregnancy. The averaged COP migrated posteriorly at third trimester of pregnancy and the anterior pelvic tilt increased at second and third trimesters. CONCLUSIONS: Our results indicate the existence of changes in posture and balance metrics even at early stages of pregnancy. We suggest the use of posturography as one of screening tools for postural instability and fall risk during pregnancy.