Prevalence of Scapulothoracic Dysfunction in Primipara after One Year of Delivery

Abstract

Background: During pregnancy, there are various physiological, biomechanical, postural, and emotional changes taking place. The changes in posture which occurs during pregnancy are even maintained in postpartum period if they remain uncorrected. Due to the enlargement of breasts, size of the uterus, and mother’s weight, there is increase in lumbar and cervical lordosis and there is compensatory thoracic kyphosis, the shoulder and upper back become rounded. There is scapular protraction and internal rotation of the upper extremity; these adaptations of posture may also persist in the postpartum period due to infant care demands. Pectoralis muscles tightness and weakness of the scapular stabilizers may be pre-existing to or may occur due to pregnancy postural changes. Hence, there is a need of evaluating the upper quadrant musculoskeletal involvement during the postpartum period and its correlation with changes that occur during pregnancy. Objective: The objective of this study was to study the prevalence of scapulothoracic dysfunction in primipara after 1 year of delivery. Methods: A total 150 primipara women who had completed 1 year of delivery were randomly selected from the Krishna Institute of Medical Sciences, Karad in this analytical observational study. Scapulothoracic dysfunction was assessed using postural examination chart in the anterior, lateral and posterior views by plumb line, manual muscle testing for muscle strength, and special tests for scapular dysfunction. Results: The result showed that 71% found to be positive for scapulothoracic dysfunction through YES/NO test, respectively. Majority of the subjects (45%) had type II scapular dyskinesis, while 18% subjects had type I, 11% had type III, and 22% had type IV. On postural examination, 27% had forward head posture, 55% had protracted shoulder, and 60% had kyphotic posture. The strength test showed that 57% subjects had weak trapezius, 60% had serratus anterior weak and significant amount of weakness with gradings in the range of −3–+3 for 57% subjects in trapezius, 60% in serratus anterior, and 65% had weak rhomboid’s major with gradings in the range of −3–+3, respectively. Conclusion: The study concludes that, statistically, there was high prevalence of scapulothoracic dysfunction in primipara women after 1 year of delivery. This was due of the slouched posture that the women’s adapted due to increase in breast size, increased size of the uterus, breast feeding positioning, and also infant care which demanded hunched back posture. It was also found that women had lack of knowledge about posture.