The role of waddling gait in balance control during pregnancy

IF 2.2 3区 医学 Q3 NEUROSCIENCES Gait & posture Pub Date : 2024-11-22 DOI:10.1016/j.gaitpost.2024.11.015
Zahra Abedzadehzavareh , Robert D. Catena
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Abstract

Background

Pregnant people experience many physical changes which might affect their walking pattern. Waddling gait is a common gait pattern pregnant individuals adopt. It is unknown whether waddling gait is a sign of poor balance or a protective mechanism against loss of balance, so the aim of this study was to understand why some pregnant individuals adopt this gait pattern.

Methods

We assessed twenty-three pregnant individuals longitudinally in 4-week intervals between 18 and 34 weeks of gestation. Participants completed a quiet standing balance trial and a walking trial. We measured spatiotemporal variables and body center of mass motion, from which we derived measures of balance and gait energetics. Forward-step multiple linear regression analyses were used to explore the correlation between step width (as a measure of waddling) and the other variables.

Results

We found a positive correlation between change in step width average and change in lateral motion of the center of mass during walking (R2=0.624, P<0.001) and change in step width standard deviation and change in minimum center of gravity distance to the lateral border (R2=0.339, p=0.004), suggesting wider steps help recapture balance during pregnancy. Surprisingly, no significant relationship was found between change in step width and changes in energy recovery (p=0.341) or mechanical work (p=0.482), indicating that taking wider steps is not inefficient. A negative correlation between change in step width and change in standing anteroposterior center of mass motion (R2=0.315, p=0.005) suggests better balance control among people that adopt a waddling gait pattern.

Significance

This study suggests that waddling gait is a protective mechanism during pregnancy. Clinicians and prosthetists can use this insight to promote step width during walking among pregnant individuals to increase their safety.
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蹒跚步态在孕期平衡控制中的作用
背景孕妇经历了许多身体变化,这些变化可能会影响她们的行走方式。蹒跚步态是孕妇常见的步态。目前还不清楚蹒跚步态是平衡能力差的表现还是防止失去平衡的保护机制,因此本研究的目的是了解为什么有些孕妇会采用这种步态。受试者完成了安静站立平衡试验和步行试验。我们测量了时空变量和身体质心运动,从中得出了平衡和步态能量的测量值。结果我们发现,步宽平均值的变化与行走时质心横向运动的变化(R2=0.624,P<0.001)以及步宽标准偏差的变化与最小重心到侧边距离的变化(R2=0.339,P=0.004)之间存在正相关,这表明更宽的步幅有助于在孕期恢复平衡。令人惊讶的是,在步幅变化与能量恢复(p=0.341)或机械功(p=0.482)的变化之间没有发现明显的关系,这表明迈出更宽的步伐并非效率低下。步幅变化与站立前胸质心运动变化之间的负相关(R2=0.315,p=0.005)表明,采用蹒跚步态的人平衡控制能力更好。临床医生和假肢制作者可以利用这一观点来促进孕妇在行走过程中的步幅,以提高她们的安全性。
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来源期刊
Gait & posture
Gait & posture 医学-神经科学
CiteScore
4.70
自引率
12.50%
发文量
616
审稿时长
6 months
期刊介绍: Gait & Posture is a vehicle for the publication of up-to-date basic and clinical research on all aspects of locomotion and balance. The topics covered include: Techniques for the measurement of gait and posture, and the standardization of results presentation; Studies of normal and pathological gait; Treatment of gait and postural abnormalities; Biomechanical and theoretical approaches to gait and posture; Mathematical models of joint and muscle mechanics; Neurological and musculoskeletal function in gait and posture; The evolution of upright posture and bipedal locomotion; Adaptations of carrying loads, walking on uneven surfaces, climbing stairs etc; spinal biomechanics only if they are directly related to gait and/or posture and are of general interest to our readers; The effect of aging and development on gait and posture; Psychological and cultural aspects of gait; Patient education.
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