Static postural control assessment during pregnancy

  • Ana Silvia Moccellin
  • Fernanda G. S. A. Nora
  • Paula H. L. Costa
  • Patricia Driusso
Keywords: centre of pressure, balance, instability

Abstract

The hormonal and anatomic changes during pregnancy affect the musculoskeletal system and may lead to instability of static postural control and increased risk of falls. The aim of this study was to analyze changes in static postural control during the three trimesters of pregnancy, using variables derived from the center of pressure. This is a descriptive study in which posturographic tests were applied in four still standing positions, for three trials, with a combination of different visual conditions (eyes open - EO/eyes closed - EC) and support base configurations on 20 non-pregnant women (C) and 13 pregnant women during the gestational period (G1, G2 and G3). For static postural control assessment, a force plate (Bertec®) was used, and the variables analyzed were statokinesigram area, displacement amplitude, displacement velocity and sway frequency. The results demonstrate that, early in pregnancy, the woman's body seems to already change postural control, probably due to increased mobility of the sacroiliac joint and pubic symphysis caused by hormonal factors, and during the trimesters there is a decrease in postural stability, observed as an increase in the elliptical areas, amplitudes of center of pressure displacement and velocity of center of pressure displacement.

References

Alvarez, R., Stokes, I.A.F., Asprinio, D.E., Trevino, S., & Braun, T. (1988). Dimensional changes of the feet in pregnancy. The Journal of Bone & Joint Surgery, 70(2), 271-4.

Atalah, S.E., Castillo, L.C., Castro, S.R., & Aldea, P.A. (1997). Propuesta de un nuevo estándar de evaluación nutricional en embarazadas. Revista Médica de Chile, 125, 1429-36.

Butler, E.E., Colón, I., Druzin, M.L., & Rose, J. (2006). Postural equilibrium during pregnancy: decreased stability with an increased reliance on visual cues. American Journal of Obstetrics & Gynecology, 195(4):1104-8.

Charlton, W.P.H., Coslett-Charlton, L.M., & Ciccotti, M.G. (2001). Correlation of estradiol in pregnancy and anterior cruciate ligament laxity. Clinical Orthopaedics and Related Research, 1(387):165-170.

Duarte, M., & Freitas, S.M.S.F. (2010). Revisão sobre posturografia baseada em plataforma de força para avaliação do equilíbrio. Revista Brasileira de Fisioterapia, 14(3):183-92.

Dunning, K., LeMasters, G., Levin, L., Bhattacharya, A., Alterman, T., & Lordo, K. (2003). Falls in workers during pregnancy: risk factors, job hazards, and high risk occupations. American Journal of Industrial Medicine, 44(6):664â€72.

Heckman, J.D., & Sassard, R. (1994). Musculoskeletal considerations in pregnancy. The Journal of Bone & Joint Surgery, 76(11):1720-30.

Ireland, M.L., & Ott, S.M. (2000). The effects of pregnancy on the musculoskeletal system. Clinical Orthopaedics and Related Research, 372:169-79.

Jang, J., Hsiao, K.T., & Hsiaoâ€Wecksler, E.T. (2008). Balance (perceived and actual) and preferred stance width during pregnancy. Clinical Biomechanics, 23(4):468â€76.

Laros, R.K.Jr. (1991). Physiology of normal pregnancy. In: Wilson JR, Carrington ER. Obstetrics & Gynecology, Ed 9. St. Louis: Mosby Year Book; 242p.

MacLennan, A.H. (1991). The role of the hormone relaxin in human reproduction and pelvic girdle relaxation. Scandinavian Journal of Rheumatology, Suppl. 88:7-15.

Marnach, M.L., Ramin, K.D., Ramsey, P.S., Song, S.W., Stensland, J.J., & An, K.N. (2003). Characterization of the relationship between joint laxity and maternal hormones in pregnancy. Obstetrics & Gynecology, 101(2):331-5.

Mochizuki, L., Duarte, M., Amadio, A.C., Zatsiorsky, V.M., & Latash, M.L. (2006). Changes in postural sway and its fractions in conditions of postural instability. Journal of Applied Biomechanics, 22:51-60.

Niska, M., Sofer, D., Porat, A., Howard, C.B., Levi, A., & Meizner, I. (1997). Planter foot pressures in pregnant women. Israel Journal of Medical Sciences, 33(2):139-46.

Oliveira, L.F., Vieira, T.M.M., Macedo, A.R., Simpson, D.M., & Nadal, J. (2009). Postural sway changes during pregnancy: a descriptive study using stabilometry. European Journal of Obstetrics & Gynecology and Reproductive Biology, 147:25-8.

Paul, J.A., Sallé, H., & Frings-Dresen, M.H.W. (1996). Effect of posture on hip joint moment during pregnancy, while performing a standing task. Clinical Biomechanics, 11(2):111-5.

Ribas, S.I., & Guirro, E.C.O. (2007). Análise da pressão plantar e do equilíbrio postural em diferentes fases da gestação. Revista Brasileira de Fisioterapia, 11(5):391-6.

Ritchie, J.R. (2003). Orthopedic considerations during pregnancy. Clinical Obstetrics & Gynecology, 46(2):456-66.

Rossavick, L.K., & Fishburne, J.I. (1989). Conceptional age, menstrual age, and ultrasound age: A second trimester comparison of pregnancies of known conceptional date with pregnancies dated from the last menstrual period. Obstetrics & Gynecology, 73:243-9.

Soames, R.W., & Atha, J. (1982). The spectral characteristics of postural sway behavior. European Journal of Applied Physiology, 49:169-77.

To, W.W.K., & Cheung, W. (1998). The relationship between weight gain in pregnancy, birth-weight and postpartum weight retention. Journal of Obstetrics & Gynaecology Research, 38(2):176-9.

Vullo, V.J., Richardson, J.K., & Hurvitz, E.A. (1996). Hip, knee, and foot pain during pregnancy and the postpartum period. The Journal of Family Practice, 43(1):63-8.

Published
2015-02-23
Section
Research Articles