Does the first trimester of pregnancy induce alterations in the walking pattern?

Abstract

IntroductionFrom among many studies observing the walking pattern throughout pregnancy, only two items monitor the influence of pregnancy on the movement system during gait considering the period before gestation.Research questionDoes the women’s gait pattern at the end of the first trimester undergo changes in comparison to body movement pattern before pregnancy?MethodsAll subjects who met the inclusion criteria gave signed and informed consent before the study. Two experimental sessions were arranged according to the same protocol: (P0) before pregnancy and (P1) at the end of the first trimester of pregnancy (12th week of gestation). At first the anthropometric measures were taken. Then, walking trials at a self-selected speed along a walkway were registered with Vicon 250 (Oxford Metrics Ltd.; Oxford, UK) and FreeMED force platform (Sensor Medica, Italy).ResultsAn analysis of anthropometric parameters in 12th pregnancy week demonstrated significant changes in mean values of waist circumference and waist to hip ratio as well as waist to height ratio indexes compared to the results before pregnancy. No significant differences were found in the basic kinematic gait parameters between experimental conditions. Significant increase of mean inter—ankle distance during double support phase occurred during the first trimester of pregnancy. Also, the ratio of the ankle separation width to the pelvic width was noticeably higher in gestation. Then, angular changes of the pelvis in coronal and transverse planes throughout gait cycle during pregnancy demonstrated significant differences compared to those measured before pregnancy. At the same time in the first trimester of pregnancy no adaptive changes in the pattern of feet loading take place.SignificanceSince our study is of longitudinal character, in the course of pregnancy we expect compensatory mechanisms more clearly demonstrated. Therefore, we hope to identify a strategy of the gravid body progression in space.

Pelvic capacity in pregnant women, identified using magnetic resonance imaging

“…17 However, that group did not address the impact of physical adaptation to the weight of the growing fetus or laxity of the surrounding ligaments with hormonal changes. 3,6,8,17 Our pelvic inlet measurements were largest in the supine position at gestational week 32 (Table 4), consistent with a previous study by Reitter et al showing a decrease in the obstetric conjugate in women in the kneeling squat position. 13 The supine position may be optimal during early labor, when the largest possible pelvic inlet dimension is desirable for successful engagement of the fetal head.…”

“…9,13,18 The beneficial influence of upright positions such as the kneeling squat may be due to gravity and larger pelvic dimensions, and possibly to laxity of the ligaments that allows increased pelvic joint movement. 3,6,8,11,12 Gravity also supports the descent of the fetal head, with pressure directly and evenly on the cervix, leading to more regular and frequent contractions. 12 including shorter length of the second stage and reduced risks of both assisted birth and episiotomy.…”

“…7,8 This laxity of the ligaments provides increased movement of the joints, which contributes to physical adaptation to the growing fetus and optimizes pelvic capacity during childbirth. 3,6,8 Pelvic capacity is described in three planes: the pelvic brim or inlet, the pelvic cavity and the pelvic outlet. 2,3 The fetus engages the pelvic inlet in late pregnancy or at the onset of labor and rotates through the pelvic cavity during labor.…”

“…Hormonal changes relax the ligaments and connective tissue in early pregnancy, 2–6 a process that increases toward the end of pregnancy 7,8 . This laxity of the ligaments provides increased movement of the joints, which contributes to physical adaptation to the growing fetus and optimizes pelvic capacity during childbirth 3,6,8 . Pelvic capacity is described in three planes: the pelvic brim or inlet, the pelvic cavity and the pelvic outlet 2,3 .…”

Assessing physical fitness during pregnancy: validity and reliability of fitness tests, and relationship with maternal and neonatal health-related outcomes. A systematic review

“…Another 15 articles used 3-D camera motion capture systems using 13 different protocols. Twelve of the 15 articles were walking protocols [160,161,[170][171][172][162][163][164][165][166][167][168][169] and 2 used a stand to sit motion protocol [173,174].…”