Orthopedic Considerations During Pregnancy

Ritchie, Joseph R.

doi:10.1097/00003081-200306000-00024

Cited by 138 publications

(104 citation statements)

References 31 publications

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“…Muitas destas alterações contribuem para a ocorrência de disfunções musculoesqueléticas, sendo a dor lombopélvica a de maior preocupação 1 . Estudos mostram que aproximadamente metade de todas as gestantes apresenta esta dor 2,3 .…”

Section: Introductionunclassified

“…Acredita-se que os principais motivos para a ocorrência da dor lombopélvica na gestação sejam as adaptações da coluna vertebral, que se devem, principalmente, à ação do hormônio relaxina e ao aumento considerável do peso do abdômen [3][4][5][6] . O hormônio relaxina é considerado o principal responsável pela frouxidão ligamentar durante a gravidez 1 , o que permite que a sínfise púbica e a articulação sacro-ilíaca tornem-se mais flexíveis para a passagem do feto, levando à redução da estabilidade pélvica 1,7 . Muitos autores 1,8,9 acreditam que o peso adquirido na gestação acrescido da frouxidão ligamentar provocaria uma rotação anterior da pelve 10 .…”

Section: Introductionunclassified

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Avaliação da lordose lombar e sua relação com a dor lombopélvica em gestantes

Firmento¹,

Moccellin²,

Albino³

et al. 2012

Fisioter. Pesqui.

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| The purpose of this study was to evaluate the magnitude of lumbar lordosis, its influence on lumbopelvic pain and quality of life in pregnant women. To this end, a study was done with 20 non-pregnant women (C) and 13 pregnant women during the trimesters of pregnancy (G1, G2 and G3). All women underwent initial assessment for registration of personal data, lifestyle, personal history, medications, gynecological and obstetric history. Later, the volunteers in the control group were evaluated once and pregnant women were evaluated at three different times, the first, second and third trimesters of pregnancy. The evaluation of the degree of lumbar lordosis was performed by a photogrammetric technique. The assessment of points/places of pain, the kind of pain and its intensity were made by McGill Pain Questionnaire, and the quality of life assessment was made by WHOQOL-bref. In this study, it was not possible to observe a pattern of change in lumbar curvature during pregnancy. There was also no relationship between lumbar curvature and lumbopelvic pain related to pregnancy.Keywords | pregnancy; spinal curvatures; low back pain.RESUMO | O objetivo deste trabalho foi avaliar a magnitude da lordose lombar, sua influência na dor lombopélvica e a qualidade de vida em gestantes. Para tal, foi realizado um estudo com 20 mulheres não gestantes (C) e 13 gestantes ao longo dos trimestres gestacionais (G1, G2 e G3). Todas as mulheres foram submetidas à avaliação inicial para registro dos dados pessoais, hábitos de vida, antecedentes pessoais, uso de medicamentos, história ginecológica e obstétri-ca. Posteriormente, as voluntárias do grupo controle foram avaliadas uma vez e as gestantes foram avaliadas em três momentos distintos, no 10, 20 e 30 trimestres gestacionais. A avaliação do grau de lordose lombar foi realizada por meio de técnica fotogramétrica; a avaliação de locais de dor, o tipo de dor e sua intensidade foram feitas por meio do Questionário McGill de dor; e a avaliação da qualidade de vida foi feita pelo Questionário WHOQOL-bref. Neste trabalho, não foi possível observar padrão de alteração da curvatura lombar no decorrer da gestação. Também não foi observada relação entre a curvatura lombar e a dor lombopélvica relacionada à gestação.Descritores | gravidez; curvaturas da coluna vertebral; dor lombar.Avaliação da lordose lombar e sua relação com a dor lombopélvica em gestantes Evaluation of lumbar lordosis and its relation to the lumbopelvic pain in pregnants

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Section: Introductionunclassified

Avaliação da lordose lombar e sua relação com a dor lombopélvica em gestantes

Firmento¹,

Moccellin²,

Albino³

et al. 2012

Fisioter. Pesqui.

View full text Add to dashboard Cite

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“…This correlation is in alignment with Ritchie, who described the mechanical strain on the low back and sacroiliac joints during pregnancy due to the anterior shift in the center of gravity. 10 Chiropractors commonly treat low back and sacroiliac joint dysfunction leading to low back pain. Wang et al reported that 37% of prenatal care providers recommended chiropractic care for patients with low back pain.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,5 This condition may be due in part to the increased biomechanical stresses placed on the lumbopelvic region throughout pregnancy, as well as the widening of the pelvis in preparation for birth. 10 Unfortunately, many pregnant women go without care for their pain. Skaggs et al 9 demonstrated that 85% of women surveyed perceived that they had not been offered treatment of their musculoskeletal disorders.…”

Section: Introductionmentioning

confidence: 99%

Chiropractic treatment of a pregnant patient with lumbar radiculopathy

Kruse¹,

Gudavalli²,

Cambron

2007

Journal of Chiropractic Medicine

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Objective: The purpose of this report is to describe chiropractic treatment of lower back and unilateral leg pain in a pregnant patient. Clinical Features: A 26-year-old woman in her second trimester of pregnancy had severe pain in her lower back that radiated to her hips bilaterally and to her right leg. She reported tingling down her right lower leg to the dorsum of her foot. Although no diagnostic imaging was performed, her differential diagnoses included lumbalgia with associated radiculopathy. Intervention and Outcome: Treatment consisted of manual traction in the side-lying position using a specialized chiropractic table and treatment technique (Cox flexion-distraction decompression) modified for pregnancy. Relief was noted after the first treatment, and complete resolution of her subjective and objective findings occurred after 8 visits. Conclusion: When modified, this chiropractic technique appears to be an effective method for treating lower back pain with radiation to the leg in a pregnant patient who cannot lie prone.

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“…During pregnancy, the gravid uterus load acting on the spine and pelvis increases considerably. As pregnancy progresses the pubic symphysis softens, the pelvic ligaments become lax and the uterus tends to shift forward changing the line of gravity and orientation of the pelvis [11]. These mechanical and hormonal effects are thought to lead to constant overload of the pelvic ligaments and consequential instability.…”

Section: Introductionmentioning

confidence: 99%

Is pregnancy related pelvic girdle pain associated with altered kinematic, kinetic and motor control of the pelvis? A systematic review

2012

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Purpose To determine the level of evidence for altered mechanical and motor control of the pelvis being associated with pregnancy-related pelvic girdle pain (PPGP). Methods This systematic review was undertaken by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six different databases were used for the electronic search. Observational cohorts, cross sectional or case-control studies focused on the association between altered kinematic/kinetic and motor control of the pelvis and PPGP during pregnancy were included. Study selection was conducted by two reviewers who firstly screened for titles, then for abstracts and finally for full articles. The Newcastle-Ottawa scale and the guidelines proposed by the Cochrane back review group were used to assess risk of bias and quality of evidence, respectively. Results 354 references were identified, and after excluding unwanted articles, 10 studies met the final inclusion criteria. Studies not related to motor control or pelvic mobility were the main reason for exclusion. Seven studies were case-control and three were prospective cohort studies. Seven studies were ranked as high while three were ranked as low quality. Among the high quality studies, six found association between PPGP and altered motor control and mobility of the pelvis.Conclusions The level of evidence for an association between PPGP and altered motor control and kinematic or kinetic parameters of the pelvis was found to be moderate.

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Orthopedic Considerations During Pregnancy

Cited by 138 publications

References 31 publications

Avaliação da lordose lombar e sua relação com a dor lombopélvica em gestantes

Avaliação da lordose lombar e sua relação com a dor lombopélvica em gestantes

Chiropractic treatment of a pregnant patient with lumbar radiculopathy

Is pregnancy related pelvic girdle pain associated with altered kinematic, kinetic and motor control of the pelvis? A systematic review

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