Narrow Results

Background: Musculoskeletal disorders have been a major cause of disability in pregnant women. The aim of this study is to determine the effect of exercise in an aquatic environment on the musculoskeletal pain among pregnant women. Material and methods: This randomized clinical trial was conducted on 54 pregnant women aged 20–35 years. The subjects were divided into the intervention group and control groups. Women who were in 20 to 26 weeks of gestation were included in the study. The intervention was Water Exercise in Pregnancy program conducted from week 20 to week 34. The control group received standard prenatal care. Musculoskeletal complications were assessed using the Nordic questionnaires at the baseline and, 4th and 8th week of pregnancy. The intensity of pain was assessed using a visual analog scale in the two groups. Data were analyzed using descriptive and inferential statistics via the SPSS v.16. The lsmeans package was used to examine comparisons. Results: Results of the study showed that level of discomfort and musculoskeletal complications in the intervention group was significantly reduced during the 4th and 8th week of the study compared to the control group ($p<0.001$). After the intervention, intensity of musculoskeletal pain in the intervention group showed a significant decrease compared to the control group ($p<0.001$). Conclusion: Exercise in water during pregnancy can be effective to reduce musculoskeletal complications. Aquatic exercises should be developed in the exercise program for pregnant women with musculoskeletal pain.

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Walking is daily physical activity and a common way of exercise during pregnancy, but morphological changes can modify the gait pattern. Biomechanical models can help in evaluating joint mechanical loads and kinetics and kinematics during gait, and provide patterns. This study aimed to describe the gait pattern during the second trimester of pregnancy and give an orientation for biomechanical modeling for pregnant women. The ankle and hip joints seem to be more overloaded, mainly in the sagittal and frontal planes, respectively. Results show that pregnant women have a similar walking pattern to the normal gait. This model construction was revealed to be appropriate for describing gait during the second trimester of pregnancy.

Most of the anatomical changes related to the body of pregnant women occur between the second and third trimesters of pregnancy. The purposes of the study were to quantify the lower limb kinetics of gait and draw a comparison between women in the second and third trimesters of pregnancy, and a nonpregnant group. Subjects and methods: A three-dimensional (3D) kinetic analysis of gait was performed in 24 pregnant and 12 nonpregnant women. Results: Between trimesters of pregnancy, a decrease in the third peak of vertical ground reaction force (GRF) in the third trimester was observed. Most of the changes found between pregnant and nonpregnant women were in the sagittal plane for hip, knee and ankle moments, which report a decrease in mechanical load of the lower limb. In frontal plane a significant decrease in ankle joint moment was found, and in the transverse plane a significant increase in hip moment was found. Joints power decreases for hip and ankle power in sagittal and frontal plane, and increases for hip power in transverse plane. The function of propulsion and mobilization appears to be related to the different changes that occur between the right leg and left. Conclusion: These results suggest that adaptations regarding muscle participation occur first (second trimester), followed by adaptations in muscle power (third trimester). Understanding the biomechanical adaptations during pregnancy may provide more information about mechanical loads, which subsequently will be helpful for prescribing exercise and rehabilitation programs, as well as for the prevention of musculoskeletal injuries.

Morphological changes are associated to pregnancy, such as weight gain and increased volume of the trunk. The soft tissue artifact can also increase with these characteristics and affect the real joint kinematics. The main objective of this study was to understand the effect of using three different constraining sets in the lower limb joints, in the amount of soft tissue artifact (STA) of pregnant women, in order to obtain the most appropriated joint set to be used in gait and in this population. The ankle, knee and hip joints were modeled respectively with the following characteristics: (1) Universal–revolute–spherical (URS), (2) spherical–revolute–spherical (SRS) and (3) spherical–spherical–spherical (SSS). The six degrees of freedom (6DOF) model was used as the basis for comparison and considered the one with the highest error associated to the STA. In pregnant women, the URS model seems to affect more the kinematic variables when compared with the 6DOF model. Assuming that the kinematic error associated with pregnant women is increased due to the STA, the URS model may be affecting more the angular kinematics of the knee joint. SSS model seems to be more appropriated to analyze gait in second trimester pregnant women.