Division of Exercise Physiology, Department of Human Performance and Applied Exercise Science, West Virginia University School of Medicine, Morgantown, West Virginia, United States of America.
Division of Physical Therapy, Department of Human Performance and Applied Exercise Science, West Virginia University School of Medicine, Morgantown, West Virginia, United States of America.
PLoS One. 2024 Feb 23;19(2):e0292115. doi: 10.1371/journal.pone.0292115. eCollection 2024.
Fifty percent of pregnant females experience pain with 20% reporting long-term pain post-partum. Pregnant females undergo changes in foot anthropometry, lower extremity alignment, and joint laxity. It is unknown if asymmetric alterations may be related to development of pain. The purpose of this study was twofold: 1) to compare asymmetric alignment in pregnant females with and without pain during pregnancy and in nulliparous controls and 2) to assess the relationship between asymmetric alignment and pain severity in all participants.
Ten pregnant females in their third trimester and nine nulliparous controls participated. Bilateral asymmetry of foot length, width, arch index, arch height index, arch rigidity index, arch drop, rearfoot angle, and pelvic obliquity were determined. Joint laxity and musculoskeletal pain were also assessed. ANOVAs were utilized to compare asymmetries between pregnant females reporting pain (n = 5), those not reporting pain (n = 5), and controls. Spearman's Rho correlations were used to relate asymmetry to pain magnitude (α = 0.05).
No statistical differences (p>0.05) were found between pregnant females with or without pain and controls for any of the metrics. Negative correlations were found between arch index asymmetry and low back pain (p = 0.005), foot length asymmetry and lower leg pain (p = 0.008), and pelvic obliquity and lower leg pain (p = 0.020). Positive correlations were found between foot width asymmetry and knee pain (p = 0.028), as well as arch drop asymmetry and upper leg (p = 0.024), knee (p = 0.005), and lower leg pain (p = 0.019).
This study was successful in identifying potential targets for prevention and treatment of pain in pregnancy. Furthermore, because pain during pregnancy may be predictive of pain post-partum, it is important to conduct future research to determine both if interventions such as footwear or exercise can prevent or treat these asymmetries and prevent post-partum pain.
50%的孕妇会出现疼痛，其中 20%报告产后长期疼痛。孕妇的足部形态学、下肢对线和关节松弛度会发生变化。目前尚不清楚不对称的改变是否与疼痛的发生有关。本研究的目的有两个：1）比较孕期有疼痛和无疼痛的孕妇与未生育对照组之间的不对称对线情况；2）评估所有参与者的不对称对线与疼痛严重程度之间的关系。
研究纳入 10 名处于妊娠晚期的孕妇和 9 名未生育的对照组。测量双侧足部长度、宽度、足弓指数、足弓高度指数、足弓刚性指数、足弓下降、后足角和骨盆倾斜度的不对称性。还评估了关节松弛度和肌肉骨骼疼痛。采用方差分析比较报告疼痛（n = 5）、无疼痛（n = 5）的孕妇与对照组之间的不对称性。采用 Spearman's Rho 相关分析评估不对称性与疼痛程度的关系（α = 0.05）。
在任何指标上，报告疼痛的孕妇与无疼痛的孕妇和对照组之间均无统计学差异（p>0.05）。足弓指数不对称性与腰痛呈负相关（p = 0.005），足部长度不对称性与小腿疼痛呈负相关（p = 0.008），骨盆倾斜度与小腿疼痛呈负相关（p = 0.020）。足部宽度不对称性与膝关节疼痛呈正相关（p = 0.028），足弓下降不对称性与大腿（p = 0.024）、膝关节（p = 0.005）和小腿疼痛（p = 0.019）呈正相关。
本研究成功确定了妊娠疼痛预防和治疗的潜在靶点。此外，由于妊娠期间的疼痛可能预示着产后疼痛，因此进行未来的研究确定是否可以通过鞋类或运动等干预措施预防或治疗这些不对称性并预防产后疼痛非常重要。
