Document Type : Original Article
Authors
Department of Community Health Physiotherapy, Ravi Nair Physiotherapy College, Sawangi (Meghe), Wardha, Maharashtra, India
Abstract
BACKGROUND: Pregnant women experience falls, particularly in the third trimester. In this
population, physiological changes, as well as ligament laxity, might influence joint proprioception and
do not return to normal during the postpartum period. The prevalence of falls during pregnancy and
postpartum periods imposes a need to study proprioception in pregnant women and the postpartum
period.
MATERIALS AND METHOD: An observational longitudinal study was conducted in June 2018 in
outpatient clinic Chinchwad Pune. A total of 36 primiparous women were included in the study by using
purposive sampling. The mean and standard deviation of the age was 25.92 (2.59). Proprioception
was assessed for the knee joint and the ankle joint during the third trimester of pregnancy and 6th and
12th week postpartum. Outcomes included were the Joint Reposition Test for both knee and ankle
joints using UTHSCSA Image Tool Software 3.0. Repeated‑measure ANOVA was performed for the
normally distributed data, and nonparametric test Friedman’s test was performed for data that were
not distributed normally. The data was statistically analyzed using the SPSS software version 26.
The level of significance was set at 0.05, confidence intervals of 95% were used.
RESULT: The result revealed significant (P < 0.05) improvement in both knee and ankle proprioception
during the third trimester of pregnancy and postpartum period 6th and 12th week.
CONCLUSION: Knee proprioception and ankle proprioception were found to improve significantly
during the postpartum period 6th and 12th weeks compared to the third trimester of pregnancy but do
not return to the prepregnancy state.
Keywords
- Riemann BL, Lephart SM. The sensorimotor system, part I:
The physiologic basis of functional joint stability. J Athl Train
2002;37:71‑9.
2. Proske U. Kinesthesia: The role of muscle receptors. Muscle Nerve
2006;34:545‑58.
3. Ribeiro F, Oliveira J. Factors influencing proprioception: what
do they reveal? In: Klika V, editor. Biomechanics in applications.
Intec ; Rijeka: 2011.
4. Goble DJ, Coxon JP, Wenderoth N, Van Impe A, Swinnen SP.
Proprioceptive sensibility in the elderly: Degeneration, functional
consequences and plastic‑adaptive processes. Neurosci Biobehav
Rev 2009;33:271‑8.
5. Myers JB, Lephart SM. The role of the sensorimotor system in the
athletic shoulder. J Athl Train 2000;35:351‑63.
6. Riemann BL, Lephart SM. The sensorimotor system, Part II:
The role of proprioception in motor control and functional joint
stability. J Athl Train 2002;37:80‑4.
7. Batson G. Update on proprioception: Considerations for dance
education. J Dance Med Sci 2009;13:35‑41.
8. Marghmaleki FG, Dehnavi ZM, Beigi M. Investigating the
relationship between cognitive emotion regulation and the health
of pregnant women. J Educ Health Promot 2019;8:175.
9. Opala‑Berdzik A, Błaszczyk JW, Bacik B, Cieślińska‑Świder J,
Świder D, Sobota G. Static postural stability in women during
and after pregnancy: A prospective longitudinal study. PLoS One
2015;10:e0124207.
10. Butler EE, Colón I, Druzin ML, Rose J. Postural equilibrium
during pregnancy: Decreased stability with an increased reliance
on visual cues. Am J Obstet Gynecol 2006;195:1104‑8.
11. Kawakami O, Sudoh H, Koike Y, Mori S, Sobue G, Watanabe S.
Control of upright standing posture during low‑frequency linear
oscillation. Neurosci Res 1998;30:333‑42.
12. Kang H, Lipsitz L. Stiffness control of balance during quiet
standing and dual task in older adults: The MOBILIZE Boston
study. J Neurophysiol 2010:3510‑7.
13. Roerdink M, Hlavackova P, Vuillerme N. Effects of
plantar‑flexor muscle fatigue on the magnitude and regularity
of center‑of‑pressure fluctuations. Exp Brain Res 2011;212:471‑6.
14. Okeke TC, Ugwu EO, Ikeako LC, Adiri CO, Ekwuazi KE,
Okoro OS. Falls among pregnant women in Enugu, Southeast
Nigeria. Niger J Clin Pract 2014;17:292‑5.
15. Shultz SJ, Kirk SE, Johnson ML, Sander TC, Perrin DH.
Relationship between sex hormones and anterior knee laxity
across the menstrual cycle. Med Sci Sports Exerc 2004;36:1165‑74.
16. Wu X, Yeoh HT. Intrinsic factors associated with pregnancy falls.
Workplace Health Saf 2014;62:403‑8.
17. Solomon J, Ramachandra P. Comparison of Ankle Proprioception
Between Pregnant and Non Pregnant Women. Online J Health
Allied Sci. 2011 Aug 30;10.
18. Pausić J, Pedisić Z, Dizdar D. Reliability of a photographic method
for assessing standing posture of elementary school students.
J Manipulative Physiol Ther 2010;33:425‑31. - 19. Schmidt PM, Flores Fda T, Rossi AG, Silveira AF. Hearing and
vestibular complaints during pregnancy. Braz J Otorhinolaryngol
2010;76:29‑33.
20. Ribeiro AP, João SM, Sacco IC. Static and dynamic biomechanical
adaptations of the lower limbs and gait pattern changes during
pregnancy. Womens Health (Lond) 2013;9:99‑108.
21. Cakmak B, Ribeiro AP, Inanir A. Postural balance and the risk
of falling during pregnancy. J Matern Fetal Neonatal Med
2016;29:1623‑5.
22. Rejali M, Soghra AS, Hassanzadeh A, Yazdani R, Ahmadi SN. The
relationship between weight gain during pregnancy and urinary
tract infections in pregnant women of Shahrekord, by using the
“Nested case‑control study”. J Educ Health Promot 2015;4:84.
23. Danna‑Dos‑Santos A, Magalhães AT, Silva BA, Duarte BS,
Barros GL, Silva MFC. Upright balance control strategies during
pregnancy. Gait Posture 2018;66:7‑12.
24. Bányai T, Haga A, Gera L, Molnár B, Tóth K, Nagy E. Knee
joint stiffness and proprioception during pregnancy. J Orthop
2009;1:29‑32.
25. Abichandani D, Gupta V. Comparison of knee proprioception
during the three trimesters of pregnancy. Int J Sci Res 2016;4:223‑7.
26. Ramachandra P, Maiya AG, Kumar P, Kamath A. Ankle
proprioception pattern in women across various trimesters of
pregnancy and postpartum. Online J Health Allied Sci 2015;14:7.
)