TABLE OF CONTENTS 1.INTRODUCTION 2 2.PURPOSE 3 3.AIMS AND OBJECTIVE OF THE STUDY 4 4.BACKGROUND 5 A.Causes of postural changes during pregnancy 5 Centre of Mass (COM) 5 Connective Tissue Laxity 6 B.Types of Postural Changes: 8 Lumbar Lordosis and Sagittal Pelvic Tilt Increase (Whitcome, 2006) 8 Lumbar Lordosis Reduction (Moore et al…
INTRODUCTION Posture is defined as the arrangement of body parts with reference to each other. Thus a good posture refers to the optimum alignment of musculoskeletal system so as to enable body movement with maximum efficiency (Britnell et al., 2005). Pregnancy brings about multiple changes in the women’s body affecting almost every biological system. While some of these changes go with pregnancy, others continue to affect for longer duration. There is an increase in body mass and dimensions with non-uniform distribution of both of these parameters. Thus the centre of gravity of the body and therefore, its equilibrium is disturbed and in order to regain it the body must lean backwards. The skeletal and muscular system of the women’s body undergoes several biomechanical changes to accommodate the growing uterus, maintain body balance and facilitate smooth delivery. Moreover the hormonal changes during pregnancy too affect the musculoskeletal system. Later weeks of pregnancy are characterized by lordosis or a significantly increased curvature of the spine. Thus changes are observed in both the static and dynamic posture of the women during pregnancy. Along with these postural changes are observed discomforts such as low back pain which may or may not be associated with the postural changes. Moreover the postural changes have also been linked to increased vulnerability to fall incidences. Research has shown that the major postural adaptations associated with pregnancy include forward shift in centre of gravity, and subsequent anterior pelvic tilt, with some cases of lumbar lordosis and thoracic kyphosis. Approximately 75% of women exhibit a more posterior posture wherein the mass of the expanding uterus with the fetus is shifted posterior to the prior centre of gravity (Britnell et al., 2005). While pregnancy itself is associated with different levels of multiple discomforts both physical and mental, an understanding of the mechanism and nature of changes associated with pregnancy is imperative for developing measures to deal with these problems. This literature review aims to study the various aspects of postural changes associated with pregnancy. 2. PURPOSE Bipedalism is a distinguishing character of hominids and the human skeleton has developed several adaptations to enable it. One of the chief adaptations was an elongated lumbar region with both an increased length of individual vertebra and also increase in number of vertebra. Besides this, the lumbar vertebra are also arranged in a significantly concave curve, the feature being specifically termed as lumbar lordosis. As a consequence of lumbar lordosis the trunk’s centre of mass (COM) is shifted to a position above the hips thereby imparting stability to the upper part of body (Whitcome et al., 2007). The second major adaptation is sagittal pelvic tilt. Human posture and motion is thus defined by two biomechanical components responsible for imparting stability viz lumbar lordosis and sagittal pelvic tilt. However, pregnancy related marked changes in body shape and mass pose significant challenges to the bipedal stability (Whitcome et al. ...
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