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Pregnancy Leads to Lasting Changes in Foot Structure

Segal, Neil A. MD, MS, CSCS; Boyer, Elizabeth R. MS; Teran-Yengle, Patricia PT, MA; Glass, Natalie A. MA; Hillstrom, Howard J. PhD; Yack, H. John PT, PhD

American Journal of Physical Medicine & Rehabilitation: March 2013 - Volume 92 - Issue 3 - p 232–240
doi: 10.1097/PHM.0b013e31827443a9
Original Research Articles

Objective Women are disproportionately affected by musculoskeletal disorders. Parous women seem to be at a particularly elevated risk for structural and functional changes in the lower limbs. The combination of increased weight on the joints with potentially greater laxity during pregnancy could lead to permanent structural changes in the feet. Although arches may become lax during pregnancy, it is unknown whether the changes persist. The objective of this study was to determine whether arch height loss persists postpartum.

Design Forty-nine women completed this longitudinal study. Static and dynamic arch measurements were collected in the first trimester and at 19 wks postpartum. Linear mixed models were used to determine whether outcome measures significantly changed overall or by parity.

Results Arch height and rigidity indices significantly decreased, with concomitant increases in foot length and arch drop. The first pregnancy accounted for the reduction in arch rigidity and the increases in foot length and arch drop. No changes were detected in the center of pressure excursion index.

Conclusions Pregnancy seems to be associated with a permanent loss of arch height, and the first pregnancy may be the most significant. These changes in the feet could contribute to the increased risk for musculoskeletal disorders in women. Further research should assess the efficacy of rehabilitative interventions for prevention of pregnancy-related arch drop.

From the Department of Orthopaedics & Rehabilitation (NAS, ERB, NAG), the Department of Radiology (NAS), the Department of Epidemiology (NAS), and the Graduate Program in Physical Therapy & Rehabilitation Sciences (PT-Y, HJY), The University of Iowa; and the Rehabilitation Department, Hospital for Special Surgery, New York, New York (HJH).

All correspondence and requests for reprints should be addressed to: Neil A. Segal, MD, MS, CSCS, Department of Orthopaedics & Rehabilitation, University of Iowa, 200 Hawkins Drive, 0728 JPP, Iowa City, IA 52242-1088.

Supported by funds from a American Geriatrics Society 2006 Dennis W. Jahnigen Career Development Scholars Award and a National Institutes on Aging Paul B. Beeson Career Development Award in Aging Research (1K23AG030945).

Presented, in part, at Women’s Health 2012: The 20th Annual Congress (Washington, DC).

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2013 Lippincott Williams & Wilkins, Inc.