BackgroundLow back pain (LBP) during pregnancy might be strongly related to posture and movements of the body, and its management is a clinically important issue. The purpose of this study was to investigate the activities related to LBP during pregnancy.MethodsParticipants included 275 women before 12 weeks of pregnancy. The women were evaluated at 12, 24, 30, and 36 weeks of pregnancy. The intensity of LBP was assessed using the Numerical Rating Scale (NRS). Movements related to LBP were investigated by free descriptive answers. Descriptive statistics were used to compile the movements that pregnant women thought induced LBP at each evaluation. Subsequently, a linear regression analysis was performed to evaluate the degree of association of certain movements with LBP using the data of participants who had LBP. The intensity of LBP (NRS score) was specified as the dependent variable, the movements that were related to pain were specified as the independent variables at the analysis. A significance threshold was set at 0.05.ResultsThe final sample used in the analyses was 254, 249, 258, and 245 women at 12, 24, 30, and 36 weeks of pregnancy, respectively. There were 16 kinds of movements that induced LBP and all of them were daily activities rather than special movements that require extra task or effort. As pregnancy progressed, less number of participants attributed pain to a specific movement. At all evaluations, movements, especially sitting up, standing up from a chair, and tossing and turning were thought to be related to LBP. Furthermore, standing up from a chair and tossing and turning were significantly related to LBP throughout the pregnancy. In contrast, lying down and sitting up were significantly related to LBP but the relationship did not continue till late pregnancy.ConclusionsDaily routine activity is related to LBP during pregnancy. These results suggest that recommendations for pregnant women about basic physical movements, such as ways of standing up that reduce the load on the body might be useful in the management of LBP.

BackgroundThe function of the pelvic bones is to transfer load generated by body weight. Proper function of the pelvic bones can be disturbed by alignment changes that occur during pregnancy. Further, misalignment of the pelvic bones can lead to pain, urinary incontinence, and other complications. An understanding of the timing and nature of pelvic alignment changes during pregnancy may aid in preventing and treating these complications.ObjectiveTo investigate the changes in pelvic alignment during pregnancy and one month after childbirth.MethodsThis is a prospective, longitudinal cohort study. Pelvic measurements were obtained for 201 women at 12, 24, 30, and 36 weeks of pregnancy, and 1 month after childbirth. The anterior and posterior width of the pelvis (the distance between the bilateral anterior superior iliac spines and the bilateral posterior superior iliac spines), the anterior pelvic tilt, and pelvic asymmetry (the mean left and right pelvic tilt degrees and the bilateral difference of the anterior pelvic tilt) were measured. For the change in pelvic alignment, a Friedman test was conducted to determine any significant difference in the measurements over time.ResultsThe anterior and posterior width of the pelvis became significantly wider with pregnancy progress and the anterior width of the pelvis at 1 month after childbirth remained wider than that at 12 weeks of pregnancy (p < 0.001). The anterior pelvic tilt increased during pregnancy and decreased after childbirth (p < 0.05).ConclusionSome changes in pelvic alignment occur continuously during the perinatal period. Changes in the anterior width of the pelvis are not recovered at one month post-childbirth. Understanding these perinatal changes may help clinicians avert complications due to pelvic misalignment.

Background Pelvic alignment changes during pregnancy and post-childbirth. Pelvic belts exert external forces that compress and stabilize the joints, and therefore, could influence pelvic alignment. However, limited information is available regarding this potential effect. Therefore, the purpose of this study is to investigate the influence of pelvic belt use on pelvic alignment during and after pregnancy. Methods Data of 201 pregnant women in late pregnancy and 1 month after childbirth were used. Pelvic alignment measurements, including anterior and posterior pelvic width, pelvic asymmetry, and pelvic belt use during and after pregnancy were investigated. Participants were divided into four groups according to pelvic belt use: before and after childbirth (BAC), before childbirth only (BC), after childbirth only (AC), and non-use (NU). Then, an initial one-way ANOVA was conducted to compare the amount of change in pelvic alignment from late pregnancy to post-childbirth between the groups. After the initial analysis, a multivariate regression analysis was performed to determine the statistically significant differences between the groups to consider other factors that influenced pelvic alignment such as age, BMI, number of previous childbirths, vaginal delivery and pelvic asymmetry in late pregnancy. Next, a cutoff point for subgroup stratification based on the weekly duration of pelvic belt use and inter-group changes in pelvic alignment were compared. Results As the result of the initial one-way ANOVA, the decrease in pelvic asymmetry from during pregnancy to postpartum for BAC was greater than that for AC. Moreover, multiple regression analysis showed that the effect of pelvic belt that was revealed in the initial analysis was statistical significance even after adjustment for other factors. Moreover, pelvic asymmetry in the BAC group decreased, compared to being increased or unchanged in the NU and AC groups when the group cutoff time was 7 h per week. Conclusions Continuous and extended use of pelvic belts during and after pregnancy might be related to modifications of pelvic asymmetry in the perinatal period. Therefore, the instruction of correct and comfortable usage and the recommendation of continuous use of pelvic belt especially during pregnancy are required for prevention of some discomforts related to pelvic malalignment. Electronic supplementary material The online version of this article (10.1186/s12884-019-2457-6) contains supplementary material, which is available to authorized users.

Background: More than half of the pregnant women are affected by lumbopelvic pain (LPP) in their daily lives. Physical activity (PA) contributes to LPP relief. There are several reports on exercise habits, including the recommended activity intensity (moderate) and time spent (at least three times a week); however, only a few detailed reports on household/child-rearing and occupational activity are available. Therefore, this study explored the relationships between housework/child-rearing, occupational hours, and LPP. Methods: This study included 95 pregnant females who attended an obstetrics and gynecology hospital. The participants were divided into two groups based on the results of an interview on the presence of LPP and classified by intensity or category using the Pregnancy Physical Activity Questionnaire (PPAQ-J). The Wilcoxon signed-rank test was used to compare PA between the two groups. When a significant difference was observed, we performed logistic regression analysis using body mass index (BMI) as an adjustment variable. Results: There were 16 females with LPP and 17 women without LPP in the third trimester. There were significant associations between the PPAQ scores of housework/child-rearing activities and LPP in the third trimester. No significant differences in any category of PPAQ scores were observed between the groups with and without LPP in the first and second trimester of pregnancy. Conclusions: Our study showed the association between PA and LPP in the third pregnancy. Pregnant females with LPP tended to spend more time on housework and child-rearing necessary for their lives. The duration of housework and child rearing should be reduced because of prolonged standing and the burden on the lumbar area.

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Purpose of investigation:To investigate the influence of the change in pelvic alignment during pregnancy on sacroiliac joint pain (SIJP). Materials and Methods: Participants included 168 women without SIJP at recruitment and were evaluated at 12 and 36 weeks of pregnancy. SIJP intensity was assessed using the Numerical Rating Scale (NRS). Pelvic alignment measurements included the anterior and posterior width of the pelvis, anterior pelvic tilt, and pelvic asymmetry. Participants were divided into the SIJP and non-SIJP groups based on the presence of SIJP at 36 weeks of pregnancy. The influence of the change in pelvic alignment during pregnancy between the groups was investigated. Results: The amount of change in pelvic anteversion during pregnancy was smaller and the change in pelvic asymmetry was significantly greater in the SIJP group compared to that in the non-SIJP group. In addition, an increase in pelvic asymmetry was the most strongly associated risk factor for SIJP. Conclusions: A forward-bending pelvis in early pregnancy and an increase in pelvic asymmetry during pregnancy are risk factors for pregnancy-related SIJP.

BACKGROUND: Lumbopelvic pain (LPP) is a very common cause of discomfort during pregnancy, but its etiology remains unclear. The association between abdominal muscle thickness and LPP in pregnant women has not been studied extensively, despite the significant abdominal changes that occur during pregnancy. This study aimed to examine the relationship between abdominal muscle thickness and LPP during pregnancy. METHODS: In this study, 49 pregnant women in their second trimester participated. The intensity of LPP was assessed using a numerical rating scale. Ultrasound imaging was used to measure the thickness of abdominal muscles, including the rectus abdominis, external oblique, internal oblique, and transversus abdominis muscles. Participants were classified into two groups, the LPP group and non-LPP group, and the abdominal muscle thickness was compared between the two groups. The statistical significance level was set at p<0.05.RESULTS: There were 24 and 25 participants in the LPP and non-LPP groups, respectively. Internal oblique (IO) thickness was significantly thinner in the LPP group than in the non-LPP group (5.4±0.2 mm vs. 6.1±0.2 mm; p=0.042). Multivariate logistic regression analysis showed that IO thickness was significantly associated with LPP (odds ratio, 0.516; 95% confidence interval, 0.284-0.935; p=0.019). CONCLUSIONS: This study suggested that LPP in second trimester pregnancy might be related to IO thickness. Further longitudinal studies are needed to understand the role of this muscle as an LPP risk factor for pregnant women.

Specific physiological changes during pregnancy exert excessive strain on muscles such as the erector spinae (ES) and contribute to low back pain (LBP). The link between LBP and sit-to-stand (STS) motion has previously been investigated through motion analysis using an inertial measurement unit (IMU); however, the factors leading to LBP have not been revealed. Moreover, clinicians require an effective assessment method for reducing the physical burden on pregnant women. Therefore, the investigation of the relationships between motion, muscle load calculated from musculoskeletal model for pregnancy, and the severity of LBP during STS in pregnant women was conducted. Furthermore, this study proposes a method for assessing motion and muscle load during STS using an IMU. The relationship among (i) motion evaluation indices and ES muscle torque, and (ii) the ES torque and the intensity of LBP during STS was investigated. As the results, significant positive correlations were observed between (i) the angular velocity of the torso in the sagittal plane and ES torque, and (ii) two types of evaluation indices of ES torque and intensity of LBP. The proposed method by an IMU attached to the torso could effectively assess ES load related to LBP during STS in pregnant women.