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Gait in Pregnant Women: Spinal and Lower Extremity Changes From Pre- to Postpartum

Hagan, Laura PT, DPT, MS, OCS1; Wong, Christopher Kevin PT, PhD, OCS2

Journal of Women’s Health Physical Therapy: May/August 2010 - Volume 34 - Issue 2 - p 46–56
doi: 10.1097/JWH.0b013e3181e8fd4d
Research Reports

Objective To study pregnancy-related changes in women's gait.

Study Design A prospective longitudinal descriptive case series with repeated measures.

Background Past studies of pregnancy-related gait changes have not followed women from before pregnancy through the natural progression of pregnancy and into postpartum to assess gait parameters and kinematic changes of the lower extremities, pelvis, and spine.

Subjects Two nulliparous women, aged 21 and 39 years.

Methods and Measures Subjects were assessed before pregnancy (P0); near the end of the first (P1), second (P2), and third trimesters (P3); and 12 to 16 weeks postpartum (PP). Two-dimensional gait analysis of digital video was performed for each subject walking barefoot at a self-selected pace. Gait parameters and joint angles of the spine and lower extremity were visually analyzed for all stages of pregnancy to identify potential changes.

Results Gait speed was at least 10 cm/s slower than P0-P1, and PP gait speed was at least 10 cm/s faster than P3. Compared to P0 and P1, ankle dorsiflexion decreased at P3 in all phases of gait by at least 5° at P3, and decreased ankle dorsiflexion continued at PP. Increased hip flexion and anterior pelvic tilt at P3 reversed in PP. No consistent changes were observed in knee, thoracic spine index, or cervical spine index during the course of study.

Conclusions Gait speed, hip angle, and pelvic tilt in gait changed during pregnancy and then returned to values similar to those before pregnancy by 12 to 16 weeks postpartum. Ankle dorsiflexion decreased in all phases of gait during pregnancy and the reduction in ankle dorsiflexion persisted postpartum. Pregnancy-related spinal and lower extremity changes in women's gait should be monitored to prevent or reduce potential dysfunction.

1Touro College, New York.

2Columbia University, New York.

Copyright © 2010 Section on Women's Health, American Physical Therapy Association