Savla Rajal, Mullerpatan Rajani, Agarwal Bela, Kuttan Victoria, Kumar Sushil
MGM School of Physiotherapy, MGM Institute of Health Science, Navi Mumbai, Maharashtra, INDIA.
Department of Obstetrics and Gynaecology, MGM Medical College, MGM Institute of Health Sciences, Mumbai, Maharashtra, INDIA.
Int J Exerc Sci. 2024 Apr 1;17(1):504-516. doi: 10.70252/VGAK1504. eCollection 2024.
Daily living physical activities of rural pregnant women, across most continents in the world, involve adoption of high-flexion postures like deep-squat. Deep-squat elicits substantial activation of major trunk and lower extremity muscles. Adequate strength of trunk muscles is known to facilitate forward-downward propulsion of baby during labour. Therefore, current study aimed to explore influence of overall physical activity including squat exposure on trunk and lower-extremity muscle strength and labour outcomes in rural and urban primigravida women. Twenty-eight primi-gravida women were stratified into 2 groups: rural habitual-squatters (n=14) and urban non-squatters (n=14). Daily squat exposure was measured using MGM-Ground-Level-Activity-Questionnaire; lower-lumbar spine motion with modified-Schober-test; lower-extremity muscle strength using 30-sec-chair-raise-test, trunk muscle endurance with pressure biofeedback, calf muscle endurance was measured using calf raise test. Duration of second stage of labour and type of delivery was recorded. Habitual Squatters (average squat exposure=68.9±25.3 min) demonstrated lower waist: hip ratio (p=0.02); greater overall physical activity level (p=0.001), lumbo-pelvic mobility (p=0.02), lower-extremity muscle strength (p=0.001); and shorter duration of 2nd stage of labour (p=0.001) compared to non-squatters. Excellent positive correlation was observed between daily-squat exposure and back muscle endurance (Spearman's rho=0.98, p=0.001). Normal vaginal delivery was conducted in 83% squatters and in 71% non-squatters. Present findings indicate strong influence of habitual physical activity including squat exposure on improved trunk-lower-extremity strength, lumbo-pelvic mobility and shorter duration of second stage of labor.
在世界上大多数大陆,农村孕妇的日常生活体力活动包括采取如深蹲这样的高屈曲姿势。深蹲会引起躯干和下肢主要肌肉的大量激活。已知躯干肌肉有足够的力量有助于分娩时胎儿向前向下推进。因此,当前研究旨在探讨包括深蹲暴露在内的总体体力活动对农村和城市初产妇躯干和下肢肌肉力量以及分娩结局的影响。28名初产妇被分为两组:农村习惯性深蹲者(n = 14)和城市非深蹲者(n = 14)。使用MGM地面活动问卷测量每日深蹲暴露情况;用改良Schober试验测量腰椎下段运动;用30秒椅子起立试验测量下肢肌肉力量,用压力生物反馈测量躯干肌肉耐力,用小腿抬高试验测量小腿肌肉耐力。记录第二产程的持续时间和分娩类型。与非深蹲者相比,习惯性深蹲者(平均深蹲暴露时间 = 68.9±25.3分钟)的腰臀比更低(p = 0.02);总体体力活动水平更高(p = 0.001),腰骶骨盆活动度更大(p = 0.02),下肢肌肉力量更强(p = 0.001);第二产程持续时间更短(p = 0.001)。每日深蹲暴露与背部肌肉耐力之间观察到极好的正相关(Spearman秩相关系数 = 0.98,p = 0.001)。83%的深蹲者和71%的非深蹲者进行了正常阴道分娩。目前的研究结果表明,包括深蹲暴露在内的习惯性体力活动对改善躯干 - 下肢力量、腰骶骨盆活动度以及缩短第二产程有很大影响。