Objective: To design Canadian guidelines advising obstetric care providers of the maternal, fetal, and neonatal implications of aerobic and strength-conditioning exercises in pregnancy. Outcomes: K...

http://www.luzimarteixeira.com.br/wp-content/uploads/2010/08/joint-sogc-csep-clinical-practice-guideline-exercise-in-pregnancy-and-the-postpartum-period.pdf

Joint SOGC/CSEP clinical practice guideline: exercise in pregnancy and the postpartum period.

The efficacy of specific exercise interventions that advocate training the co-contraction of the deep abdominal muscles with lumbar multifidus for treating chronic back pain conditions has not been tested. A randomized controlled trial involving 42 subjects with a specific chronic back pain condition investigated whether this form of intervention results in changes to the ratio of activation of the internal oblique relative to the rectus abdominis. Data were collected before and after the intervention, using surface electromyography, while subjects performed different abdominal maneuvers. Subjects were randomly allocated to either a specific exercise group or control group. Following intervention, the specific exercise group showed a significant (p < 0.05) increase in the ratio of activation of the internal oblique relative to the rectus abdominis. The control group showed no significant change. The study findings provide evidence that the conscious and automatic patterns of abdominal muscle activation ca...

https://www.jospt.org/doi/pdfplus/10.2519/jospt.1998.27.2.114

Altered Abdominal Muscle Recruitment in Patients With Chronic Back Pain Following a Specific Exercise Intervention

Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review

Background: There are many anatomical changes during pregnancy that could potentially lead to substantial alterations in gait. Gait deviations may contribute to a variety of musculoskeletal overuse conditions associated with pregnancy, such as low-back, hip, and calf pain. Because we are aware of little research on this topic, the purpose of this study was to objectively analyze gait during pregnancy.

Methods: Three-dimensional gait analysis was performed on fifteen women during the second half of the last trimester of pregnancy and again one year post partum. Selected kinematic and kinetic parameters for the pregnancy and one-year postpartum conditions were compared with use of paired t tests (95 percent significance level).

Results: Overall, gait kinematics were remarkably unchanged during pregnancy. No evidence of a so-called waddling gait during pregnancy was found. Maximum anterior pelvic tilt during gait increased a mean of 4 degrees during pregnancy, although individual subject-to-subject variation (range, an increase of 13 degrees to a decrease of 10 degrees) was observed. Significant increases in hip and ankle kinetic gait parameters, however, were observed during pregnancy (p < 0.05).

Conclusions: Significant increases in kinetic gait parameters during pregnancy (p < 0.05) explain how gait motion remained relatively unchanged despite increases in body mass and width as well as changes in mass distribution about the trunk. This finding indicates that during pregnancy there may be an increased demand placed on hip abductor, hip extensor, and ankle plantar flexor muscles during walking.

Clinical Relevance: Many of the common musculoskeletal problems associated with pregnancy may be due, in part, to musculoskeletal overuse injuries incurred as a consequence of secondary gait deviations that compensate for changes in body mass and distribution. Physicians caring for pregnant women with musculoskeletal problems should emphasize the value of exercise and conditioning during pregnancy for both preventative and rehabilitative management.

A Biomechanical Analysis of Gait During Pregnancy

Background and Purpose. The purpose of this study was to investigate the abdominal muscle structural adaptations and functional capabilities during pregnancy and the postbirth period. Subjects. Six primigravid subjects, aged 28 to 33 years, participated in nine test sessions from 14 weeks of gestation to 8 weeks postbirth. Methods. At each test session, three-dimensional photography of abdominal skin markers was used to determine the gross morphology of a representative abdominal muscle, the rectus abdominis muscle. The functional capability of the abdominal muscle group was assessed on the ability of the muscle group to stabilize the pelvis against resistance. Results. Increases were found in rectus abdominis muscle separation width, length, and angles of insertion as pregnancy progressed. Reversal in rectus abdominis muscle separation was found by 4 weeks postbirth. The ability to stabilize the pelvis against resistance was shown to be decreased as pregnancy progressed and remained compromised postbirth. Decrements in abdominal muscle function paralleled in time the structural adaptations, as pregnancy progressed. Continued functional deficits were found in parallel with incomplete resolution of structural adaptations postbirth. Conclusion and Discussion. Abdominal muscle function is affected by structural adaptations that occur during pregnancy. Because our results showed that the ability to stabilize the pelvis against resistance is decreased during pregnancy and at least 8 weeks postbirth, abdominal muscle exercises should be chosen with care.

/pdf/structure-and-function-of-the-abdominal-muscles-in-3atzg7sq1z.pdf

J.Mark M. Brown

Papers

Structure and Function of the Abdominal Muscles in Primigravid Subjects During Pregnancy and the Immediate Postbirth Period

An electromyographic validation of an abdominal muscle test.