The effect of physiotherapy intervention on the load of the foot and low back pain in pregnancy

Czech version

Authors: R. Poděbradská ¹; M. Šarmírová ²; M. Janura ^2,3; M. Elfmark ³; M. Procházka ¹
Authors‘ workplace: Ústav porodní asistence, Fakulta zdravotnických věd UP, Olomouc, přednosta prof. MUDr. M. Procházka, Ph. D. ¹; Ústav rehabilitace LF OU, Ostrava, vedoucí doc. MUDr. M. Filip, Ph. D. ²; Katedra přírodních věd v kinantropologii, Fakulta tělesné kultury UP, Olomouc, vedoucí prof. RNDr. M. Janura, Dr. ³
Published in: Ceska Gynekol 2019; 84(6): 450-457
Category:

Overview

Objective: Pregnant women are at elevated risk for functional and structural changes in the movement system. Common problems are loss of foot arch height and low back pain which can have strong influence on the decrease in quality of life.

Aims: The aim of the study was to assess effect of physiotherapy intervention for preventing and treating changes in foot structure as well as low back pain during pregnancy.

Design: Parallel intervention study.

Setting: Department of Midwifery, Faculty of Health Sciences, Palacký University Olomouc.

Methods: Twelve healthy pregnant women were randomly divided into the experimental and control groups. The women in the experimental group performed daily exercises aimed at the foot arch. The McGill Pain Questionnaire and the Pregnancy Mobility Index were used to measure level of pain and its impact on quality of life. The Foot Posture Index, Navicular Drop test, Chippaux-Šmirák index, and a podoscope were used to evaluate load and anthropometry of the foot. The data were collected at the turn of the first and second trimester and in the third trimester of pregnancy.

Results: Statistically significant differences between the baseline and post-intervention were found only in the control group. Pain score obtained from the visual analogue scale as well as the Pregnancy Mobility Index score increased significantly (p = 0.04, p = 0.03 resp.). The Foot Posture Index results increased significantly on both the right (p = 0.04) and left (p = 0.04) lower limb. Chippaux-Šmirák index significantly increased on the right lower limb (p = 0.03).

Conclusions: The intervention prevented or reduced the changes in the foot structure and low back pain. This intervention can be recommended in primary or secondary prevention to increase quality of life in pregnant women.

Keywords:

pregnancy – Pain – low back pain – foot arch – posture – Foot Posture Index – Navicular Drop test – Chippaux-Šmirák index – Pregnancy Mobility Index

Sources

1. Cohen, J. Statistical power analysis for the behavioral sciences. 2. ed. New York: Academic Press, 1988, 567 s.

2. Davenport, MH., Marchand, AA., Mottola, MF., et al. Exercise for the prevention and treatment of low back, pelvic girdle and lumbopelvic pain during pregnancy: a systematic review and meta-analysis. Br J Sports Med, 2019, 53, 2, p. 90–98.

3. Fitzgerald, CM., Segal, NA. Musculoskeletal health in pregnancy and postpartum: an evidence-based guide for clinicians. Berlin: Springer, 2015, 296 p.

4. Franklin, ME., Conner-Kerr, T. An analysis of posture and back pain in the first and third trimesters of pregnancy. J Orthop Sports Phys Ther, 1998, 28, 3, p. 133–138.

5. Gijon-Nogueron, GA., Gavilan-Diaz, M., Valle-Funes, V., et al. Anthropometric foot changes during pregnancy a pilot study. J Am Podiatr Med Assoc, 2013, 103, 4, p. 314–321.

6. Glinkowski, VM., Tomasik, P., Walesiak, K., et al. Posture and low back pain during pregnancy: 3D study. Ginekol Pol, 2016, 87, 8, p. 575–580.

7. Charlesworth, SJ., Johansen, SM. Navicular Drop Test: user guide and manual. 2010 [cit. 2019-06-16]. Dostupné z: https://pdfs.semanticscholar.org/1e00/a658d65c3c2317cf938634a33f788cd96960.pdf.

8. Kalichová, M., Vysloužil, M. Komparace metod získávání a vyhodnocování plantogramů. Studia sportiva, 2018, 11, 2, s. 37–46.

9. Kinclová, L. Studijní materiál pro kurz: Diagnostika a terapie funkce nohy z pohledu vývojové kineziologie. Brno, 2018.

10. Knotek, P., Blahuš, P., Šolcová, I., Žalský, M. Standardizovaná česká verze krátké formy dotazníku bolesti McGillovy univerzity. Bolest, 2000, 3, 2, s. 113–117.

11. Kobilková, J. Základy gynekologie a porodnictví. Praha: Galén, 2005, 368 s.

12. Kolář, P. Rehabilitace v klinické praxi. Praha: Galén, 2009, 713 s.

13. Kolářová, K., Zvonař, M. Biomechanická analýza pohybového výkonu IV – Změny v distribuci plantárních tlaků spojených s těhotenstvím [online]. Brno: Masarykova univerzita, 2014 [cit. 2019-05-02]. Dostupné z: https://publi.cz/books/79/index.html

14. Kouhkan, S., Rahimi, A., Ghasemi, SS., Naimi, Akbarzadeh Baghban, A. Postural changes during first pregnancy. Br J Med Med Res, 2015, 7, 9, p. 744–753.

15. Kumar, SP., Chris, E. Pregnancy-related low back pain or gestational back pain: too complex to handle or too simple to ignore? Ind J Obstet Gynecol, 2013, 1, 2, p. 87–89.

16. Lagadec, N., Steinecker, M., Kapassi, A., et al. Factors influencing the quality of life of pregnant women: a systematic review. BMC Pregnancy Childbirth, 2018, 18, 1, p. 1–14.

17. Lewit, K., Lepšíková, M. Chodidlo – významná část stabilizačního systému. Rehabil Fyz Lék, 2008, 15, 3, s. 99–104.

18. Lewitová, CMH. Žena v těhotenství a v čase porodu. Umění fyzioterapie, 2018, 3, 5, s. 5–10.

19. Martinez-Marti, F., Ocón-Hernández, O., Martinez-Garcia, MS., et al. Plantar pressure changes and their relationships with low back pain during pregnancy using instrumented insoles. J Sensors, 2019, 2019, 1567584.

20. Petrovický, P. Anatomie s topografií a klinickými aplikacemi I. Martin: Osveta, 2001, 464 s.

21. Poděbradská, R. Komplexní kineziologický rozbor: Funkční poruchy pohybového systému. Praha: Grada Publishing, 2018, 176 s.

22. Ramachandra, P., Maiya, AG., Kumar, P., Kamath, A. Prevalence of musculoskeletal dysfunctions among Indian pregnant women. J Pregnancy, 2015, 2015, 437105.

23. Redmond, A, Crosbie, J., Ouvrier, RA. Development and validation of a novel rating system for scoring standing foot posture: The Foot Posture Index. Clin Biomech, 2006, 21, 1, p. 89–98.

24. Segal, NA., Boyer, ER., Teran-Yengle, P., et al. Pregnancy leads to lasting changes in foot structure. Am J Phys Med Rehabil, 2013, 92, 3, p. 232–240.

25. Silva, AM. Preventing and managing back pain during pregnancy. Norwood: Expect Fitness, 2004, 130 p.

26. Skalka, P. Možnosti léčebné rehabilitace v léčbě močové inkontinence. Urol praxi, 2002, 3, 3, s. 94–100.

27. Splichal, E., Taddeo, J. Pregnancy and your feet. In: Foot [online]. 3 oct 2018 [cit. 2019-05-21]. Dostupné z: https://www.foot.com/foot-conditions/pregnancy-and-your-feet/.

28. Tlapáková, E., Jelen, K., Minaříkova, M. The relationship between pelvis inclination, exercise and low back pain (LBP) during pregnancy. Acta Univ Palacki Olomuc, Gymn, 2011, 41, 3, p. 15–21.

29. Unver, B., Erdem, EU., Akbas, E. Effects of short-foot exercises on foot posture, pain, disability, and plantar pressure in pes planus. J Sport Rehabil, 2019, Ahead of print.

30. van de Pol, G., de Leeuw, JR., van Brummen, HJ., et al. The Pregnancy Mobility Index: a mobility scale during and after pregnancy. Acta Obstet Gynecol Scand, 2006, 85, 7, p. 786–791.

31. Vařeka, I., Vařeková, R. Kineziologie nohy. Olomouc: Univerzita Palackého v Olomouci, 2009, 189 s.

32. Vico Pardo, FJ., Lópet del Amo, A., Pardo Rios, M., et al. Changes in foot posture during pregnancy and their relation with musculoskeletal pain: A longitudinal cohort study. Women Birth, 2018, 31, 2, p. e84–e88.

33. Vojta, V., Peters, A. Vojtův princip: svalové souhry v reflexní lokomoci a motorické ontogenezi. Praha: Grada, 2010, 200 s.