孕妇和产后妇女步态运动学参数：系统回顾和荟萃分析

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture Pub Date : 2025-04-27 DOI:10.1016/j.gaitpost.2025.04.030

Heloisa da Costa Souza , Rayane Quintão Castro , Maria Eduarda de Oliveira Gonçalves , Gabriela Vieira Caneco , Angélica Lorena dos Santos Oliveira , Letícia Tagliati Nogueira , Nathalia de Souza Abreu Freire , Fabiana Roberta Nunes Carnaúba , Diogo Simões Fonseca

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引用次数: 0

摘要

在怀孕期间，适应性步态机制被假设为适应胎儿生长的生理变化而发展。研究问题：孕妇和产后妇女步态运动学和时空参数的平均值和变化是什么？方法检索截止到2025年2月3日的Scopus、PubMed、Web of Science、Embase数据库。观察性研究和随机对照试验评估了孕妇和产后妇女的步态运动学或时空参数。使用JBI关键评估工具评估偏倚风险。标准化平均差异和置信区间比较妊娠、产后和对照组。I²指数评估研究异质性；如果I²超过40 %，则采用随机效应模型。结果共纳入32项研究。对骨盆矢状面和横向ROM、步态速度、节奏、步幅、双支撑时间、步长和步宽进行meta分析。在矢状面和横向盆腔ROM在妊娠中期和晚期无显著差异。孕妇比产后和非孕妇走得慢，但在三个月之间的步态速度、节奏、步幅、步长、双支撑时间或步宽没有显著差异。非合并研究的结果表明，骨盆倾斜、膝关节屈曲和外侧足前进角增加，髋关节伸展和踝关节跖屈减少。孕妇走路时减少步长、摆动阶段和单支撑时间，同时增加双支撑时间。这些变化在妊娠晚期最为突出，有些出现在妊娠晚期，产后倾向减轻，但与未怀孕妇女相比仍存在时空差异。运动学差异的持久性仍不确定。意义本研究增强了对孕期和产后生物力学步态适应的认识，为更有效、以患者为中心的护理奠定了基础。

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Pregnant and postpartum women gait kinematics parameters: A systematic review and meta-analysis

Background

During pregnancy, adaptive gait mechanisms are hypothesized to develop to accommodate physiological changes from fetal growth.

Research question

What are the average values and variations of gait kinematic and spatiotemporal parameters in pregnant and postpartum women?

Methods

A bibliographic search was conducted in Scopus, PubMed, Web of Science, and Embase up to February 3rd, 2025. Observational studies and randomized controlled trials assessing gait kinematic or spatiotemporal parameters in pregnant and postpartum women were included. Risk of bias was assessed using JBI Critical Appraisal Tools. Standardized mean difference and confidence intervals compared pregnancy, postpartum, and control groups. The I² index assessed study heterogeneity; a random-effects model was used if I² exceeded 40 %.

Results

Thirty-two studies were included. Meta-analyses were performed for sagittal and transverse pelvic ROM, gait speed, cadence, stride length, double support time, step length, and step width. No significant differences were found in sagittal and transverse pelvic ROM between the second and third trimesters. Pregnant women walked more slowly than postpartum and non-pregnant women, but no significant differences in gait speed, cadence, stride length, step length, double support time, or step width were found between trimesters. Findings from non-pooled studies indicated increased pelvic tilt, knee flexion, and lateral foot progression angle, with decreased hip extension and ankle plantarflexion. Pregnant women walked with reduced step length, swing phase, and single support time, alongside increased double support duration. These changes were most prominent in the 3rd trimester, some appearing in the 2nd trimester, and tended to lessen postpartum, though spatiotemporal disparities remained compared to non-pregnant women. The persistence of kinematic differences remains uncertain.

Significance

This study enhances understanding of biomechanical gait adaptations during pregnancy and postpartum, providing a foundation for more effective, patient-centered care.

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来源期刊

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.