Trunk, pelvic and hip kinematics during the Stork test in pregnant women with pelvic girdle pain, asymptomatic pregnant and non-pregnant women

Lene Christensen,Nina K Vøllestad,Marit B Veierød,Vidar E Jakobsen,Britt Stuge,Eva S Bakke,Jan Cabri,Hilde Stendal Robinson

doi:10.1016/j.clinbiomech.2020.105168

Lene Christensen, Nina K Vøllestad + Show 6 more

Open Access

https://doi.org/10.1016/j.clinbiomech.2020.105168

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Abstract

BackgroundPelvic girdle pain is prevalent during pregnancy, and women affected report weight-bearing activities to be their main disability. The Stork test is a commonly used single-leg-stance test. As clinicians report specific movement patterns in those with pelvic girdle pain, we aimed to investigate the influence of both pregnancy and pelvic girdle pain on performance of the Stork test. MethodsIn this cross-sectional study, 25 pregnant women with pelvic girdle pain, 23 asymptomatic pregnant and 24 asymptomatic non-pregnant women underwent three-dimensional kinematic analysis of the Stork test. Linear mixed models were used to investigate between-group differences in trunk, pelvic and hip kinematics during neutral stance, weight shift, leg lift and single leg stance. FindingsFew and small significant between-group differences were found. Pregnant women with pelvic girdle pain had significantly less hip adduction during single leg stance compared to asymptomatic pregnant women (estimated marginal means (95% confidence intervals) -1.1° (−2.4°, 0.3°) and 1.0° (−0.4°, 2.4°), respectively; P = 0.03). Asymptomatic pregnant women had significantly less hip internal rotation compared to non-pregnant women 4.1° (1.6°, 6.7°) and 7.9° (5.4°, 10.4°), respectively (P = 0.04) and greater peak hip flexion angle of the lifted leg in single leg stance 80.4° (77.0°, 83.9°) and 74.1° (70.8°, 77.5°), respectively (P = 0.01). Variation in key kinematic variables was large across participants in all three groups. InterpretationOur findings indicate that trunk, pelvic and hip movements during the Stork test are not specific to pregnancy and/or pelvic girdle pain in the 2nd trimester. Instead, movement strategies appear unique to each individual.

Highlights

During pregnancy, women experience physiological, anatomical and functional changes (Jensen et al, 1996; Robinson et al, 2010; Vøllestad et al, 2012)
We recently found that women with pelvic girdle pain (PGP) in the 2nd trimester of pregnancy walked slower with longer double limb support and shorter step length compared to asymptomatic pregnant women, i.e. shortening the time in single leg stance (SLS) (Christensen et al, 2019a)
Since speed has an influence on biomechanics during gait (Levine et al, 2012; Neumann, 2010; Roislien et al, 2009; Wu et al, 2004; Wu et al, 2008), it seems reasonable that the speed of leg lift may affect trunk, pelvic and hip kinematics during the Stork test

Summary

Introduction

Women experience physiological, anatomical and functional changes (Jensen et al, 1996; Robinson et al, 2010; Vøllestad et al, 2012). Pelvic girdle pain is prevalent during pregnancy, and women affected report weight-bearing activities to be their main disability. As clinicians report specific movement patterns in those with pelvic girdle pain, we aimed to investigate the influence of both pregnancy and pelvic girdle pain on performance of the Stork test. Linear mixed models were used to investigate between-group differences in trunk, pelvic and hip kinematics during neutral stance, weight shift, leg lift and single leg stance. Pregnant women with pelvic girdle pain had significantly less hip adduction during single leg stance compared to asymptomatic pregnant women (estimated marginal means (95% confidence intervals) -1.1° (−2.4°, 0.3°) and 1.0° (−0.4°, 2.4°), respectively; P = 0.03). Interpretation: Our findings indicate that trunk, pelvic and hip movements during the Stork test are not specific to pregnancy and/or pelvic girdle pain in the 2nd trimester.

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