Kinematic and spatiotemporal gait characteristics in pregnant women with pelvic girdle pain, asymptomatic pregnant and non-pregnant women

Abstract

Background: Walking difficulties are common among pregnant women with pelvic girdle pain. This cross-sectional study investigated the influence of pelvic girdle pain, pregnancy and speed on spatiotemporal and trunk, pelvic and hip kinematics during gait in the 2nd trimester of pregnancy. Methods: Three-dimensional gait analysis at self-selected speed was performed in 25 pregnant women with pelvic girdle pain, 24 asymptomatic pregnant and 24 nonpregnant women. Linear mixed models were used to investigate between-group differences in gait variables. Adjustment for gait speed was included in the analysis. Correlations between speed and fear of movement, disability and pain were examined using Spearman correlation coefficient (r s). Findings: Pregnant women with pelvic girdle pain walked 18% slower (estimated marginal means (95% confidence intervals) 1.18 (1.22, 1.24) meter/s) compared to asymptomatic pregnant women (1.44 (1.38, 1.50) meter/s) (P < 0.001). Moreover, with longer double limb support (5%, P = 0.04), shorter contralateral step length (3%, P = 0.03) and more restricted pelvic and hip kinematics (0.001 ≤ P ≤ 0.01) adjusted for speed. Only stance, double limb support and thoracic rotation (0.001 ≤ P ≤ 0.04) differed between asymptomatic pregnant and non-pregnant women. Speed was negatively correlated with fear of movement (r s = −0.63, P = 0.01) and disability (r s = −0.46, P = 0.03) in the pelvic girdle pain group. Interpretation: Gait is primarily influenced by pelvic girdle pain and less by pregnancy. Pregnant women with pelvic girdle pain walked slower and with a more rigid gait pattern compared to asymptomatic pregnant women, presumably related to altered load transfer. Our results may assist clinical evaluation of pelvic girdle pain, as well as direct future research.

Trunk, pelvic and hip kinematics during the Stork test in pregnant women with pelvic girdle pain, asymptomatic pregnant and non-pregnant women

“…with four response alternatives: "right", "left", "both legs" and "do not know". For three-dimensional (3D) movement analysis, reflective markers were placed on the participants (Christensen et al, 2019a). Pelvic width and trochanter major distance were determined by the distance between the two anterior spina iliaca superior (ASIS) on the pelvis and the trochanter major of each femur, respectively.…”

“…Joint angles were computed using Visual 3D software (C-motion Inc., Crabbs Branch Way Rockville MD). The thoracic and pelvic segments were modelled as described elsewhere (Christensen et al, 2019a) and analyzed with respect to the laboratory's coordinate system, oriented so that a positive y-direction was in the direction of standing. Pelvic angles were extracted using a rotation-obliquity-tilt sequence as recommended by Baker (Baker, 2001).…”

“…We recently found that women with PGP in the 2nd trimester of pregnancy walked slower with longer double limb support and shorter step length compared to asymptomatic pregnant women, i.e. shortening the time in single leg stance (SLS) (Christensen et al, 2019a). As minimizing SLS time likely reduces the demands on load transfer, these gait characteristics might be adaptive to altered load transfer through the lumbo-pelvic-hip region (Christensen et al, 2019a).…”

“…shortening the time in single leg stance (SLS) (Christensen et al, 2019a). As minimizing SLS time likely reduces the demands on load transfer, these gait characteristics might be adaptive to altered load transfer through the lumbo-pelvic-hip region (Christensen et al, 2019a). Pregnant women with PGP also walked with less pelvic frontal plane and hip sagittal and frontal plane movements, as well as greater lateral trunk translation (Christensen et al, 2019a).…”

“…Asymptomatic pregnant women also report disability (Robinson et al, 2010) and demonstrate gait alterations (Branco et al, 2016;Christensen et al, 2019a;Gilleard, 2013;McCrory et al, 2014). The progressive weight gain primarily localized in the anterior lower-trunk and pelvic region (Jensen et al, 1996) is a unique feature of pregnancy with a likely impact on biomechanics.…”