Simulation of Pregnancy-Related Abdominal Mass Results in Nonimmediate Changes in Postural Control: An Exploratory Study

A. Danna-dos-Santos, V. S. Cardoso, A. T. Magalhães, P. Driusso, A. Degani
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Abstract

Background: Changes to segmental inertial properties, abdominal growth, and increased circulating relaxin are some of the numerous contributing factors to higher risks of falling during pregnancy. These factors emerge in different phases of pregnancy, have a cumulative effect, and vary across women. For these reasons, determining each factor's role in the development of higher fall risk is challenging and yet crucial in uncovering their clinical importance. Objectives: To investigate the independent effect of additional abdominal weight on balance control in nonpregnant women. Study Design: A longitudinal study. Methods: Ten healthy women were submitted to computerized posturography while an additional abdominal weight (7% of body mass) was applied for 24 hours. Postural behavior was recorded from 4 experimental conditions: before placement of the additional weight (Baseline), immediately after placement of the abdominal weight (T1), 24 hours after continuous application of the abdominal weight (T2), and immediately after abdominal weight removal (T3). Variables of interest were extracted from the participant's body sway dynamics and included the center of pressure (COP) migration area, range, root mean square (RMS), mean velocity, median frequency (F50), and signal sample entropy (SEnt). Results: At T3, significant increases were found for the COP migration area, mediolateral range, and mediolateral RMS (P values range: .005-.013). Also at T3, significant decreases were found for mediolateral F50 and SEnt (P values range: .001-.038). Conclusion: Modifications in balance behavior were observed when the abdominal weight was removed after 24 hours of application. Significant changes occurred in the mediolateral body sway amplitude and regularity suggesting the presence of mediolateral instability.
模拟妊娠相关腹部肿块导致姿势控制的非即时变化:一项探索性研究
背景:节段性惯性特性的改变、腹部生长和循环松弛素的增加是妊娠期间摔倒风险增加的一些因素。这些因素出现在怀孕的不同阶段,具有累积效应,并且因女性而异。由于这些原因,确定每个因素在更高跌倒风险发展中的作用是具有挑战性的,但在揭示其临床重要性方面至关重要。目的:探讨腹部额外重量对非妊娠妇女平衡控制的独立影响。研究设计:纵向研究。方法:10名健康女性进行计算机体位照相,同时增加腹部重量(体重的7%)24小时。在4种实验条件下记录体位行为:放置额外重量前(基线)、放置腹部重量后立即(T1)、连续施加腹部重量后24小时(T2)和立即去除腹部重量后(T3)。从参与者的身体摇摆动力学中提取感兴趣的变量,包括压力中心(COP)迁移面积、范围、均方根(RMS)、平均速度、中位数频率(F50)和信号样本熵(SEnt)。结果:在T3时,COP迁移面积、中外侧范围和中外侧RMS显著增加(P值范围:0.005 - 0.013)。同样在T3时,发现中外侧F50和SEnt显著降低(P值范围:0.001 - 0.038)。结论:应用24小时后腹部重量去除,观察到平衡行为的改变。中外侧身体摆动幅度和规律性发生显著变化,提示存在中外侧不稳定。
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