Stand-to-sit kinematic changes during pregnancy correspond with reduced sagittal plane hip motion

Abstract

BackgroundThe stand-to-sit motion has been linked to falls during pregnancy. It is also used in the clinical evaluation of functional performance. The physical and physiological changes during pregnancy may necessitate a change in stand-to-sit kinematic performance. Therefore, this study was conducted to evaluate the longitudinal changes to stand-to-sit kinematics during pregnancy. MethodsFifteen pregnant women were tested in 4-week intervals from 16 weeks to 36 weeks gestational age. They performed a 60-second trial of semi-continuous stand-to-sit motion. Sagittal plane motions at the ankle, knee, spine, and shoulders were measured. Additionally, three-dimensional hip motion was measured. Discrete variables (e.g. range of motion) and joint coordinations (through vector coding) were analyzed over time through a linear mixed model analysis. FindingsThe results indicate a shift away from sagittal hip motion throughout pregnancy. Hip range of motion and standing angle changed in favor of spine motion. Joint coordination shifted from hip dominant to spine- and shoulder-dominate coordination just before the start of sitting motion. Hip-knee joint coordination just before seat contact shifted from hip to a knee-dominant motion during pregnancy. InterpretationDiscrete variable changes in the entire stand-to-sit motion seem to be driven by initial standing posture related to an increase in gestational lordosis. Likewise, standing joint coordination shift to upper body motion can be attributed to gestational lordosis limiting functional ability around the hip. The shift in motion away from the hip may provide insight into why both fall rates and low back pain rates increase during stand-to-sit during pregnancy.