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Exercise testing in pregnancy
Published in R. C. Richard Davison, Paul M. Smith, James Hopker, Michael J. Price, Florentina Hettinga, Garry Tew, Lindsay Bottoms, Sport and Exercise Physiology Testing Guidelines: Volume II – Exercise and Clinical Testing, 2022
Victoria L. Meah, Amal Hassan, Lin Foo, Christoph Lees, Marlize de Vivo
Pregnancy results in hormonally mediated increases in joint laxity and changes to axial, thoracic, pelvic and lower-limb biomechanics, which shift the centre of gravity forwards, thus focussing load on the anterior chain. This can contribute to the experience of musculoskeletal pain in day-to-day life, as well as during and following physical activity. Up to three quarters of pregnant individuals suffer from low back and/or pelvic girdle pain (Weis et al., 2018). Exercise modality should be adjusted to reduce the risk of worsening an individual’s musculoskeletal pain simply because of participating. If any pregnant individual does suffer from musculoskeletal pain, practitioners should offer non-weight bearing options (e.g., recumbent cycle) where possible.
Dystrophia Myotonica
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
This an autosomal dominant condition which, although it does not alter life expectancy, causes morbidity. The patients present with bilateral, symmetrical weakness of facial and sternoclavicular muscles. Patients may have bilateral ptosis. The pelvic girdle and lower limb muscles may also become involved in later years. There may be loss of (or diminished) reflexes in the affected muscles with no sensory deficit.
The Musculoskeletal System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
The thoracic vertebrae articulate with the ribs to form the thorax or chest cavity. The upper seven ribs also join in the front of the body with the breast bone or sternum. The eighth, ninth, and tenth ribs are known as vertebrochondral ribs because they join the cartilage of the seventh rib (chondro- denotes cartilage). The lowest two ribs are referred to as floating ribs because they are not connected in front. The pelvic girdle includes the sacrum and coccyx and joins with the vertebral column above and the thigh bones or femurs below.
Generalized joint hypermobility and risk of pelvic girdle pain in pregnancy: does body mass index matter?
Published in Physiotherapy Theory and Practice, 2022
Hilde Stendal Robinson, Anne Lindgren, Elisabeth Krefting Bjelland
It is assumed that the development of pelvic girdle pain is linked to changes occurring in the pelvic joints (Vleeming et al., 2008). Some studies have reported an association with certain hormones during pregnancy, but such association has also been disputed (Aldabe, Ribeiro, Milosavljevic, and Dawn Bussey, 2012). Previously, we found an association between high serum concentrations of relaxin in pregnancy and positive scores on the functional active straight leg raise (ASLR) test, suggesting a hormonal influence (Vollestad, Torjesen, and Robinson, 2012). Early menarche, an indicator of high hormone levels during reproductive age (Apter, Reinila, and Vihko, 1989), has also been associated with the development of pelvic girdle pain in large population studies (Bjelland, Eberhard-Gran, Nielsen, and Eskild, 2011; Kirkeby et al., 2013).
Telerehabilitation for pelvic girdle dysfunction in pregnancy during COVID-19 pandemic crisis: A case report
Published in Physiotherapy Theory and Practice, 2022
Pelvic girdle pain (PGP) is defined as pain in the symphysis and/or between the posterior iliac crest and the gluteal fold, which may spread to the posterolateral thigh (Vleeming et al., 2008). Pregnancy-induced hormonal changes with ligament laxity and stress on the ligaments with alteration in biomechanics may cause dysfunctional movements at the pelvic girdle (Aldabe, Milosavljevic, and Bussey, 2012; Aldabe, Ribeiro, Milosavljevic, and Bussey, 2012; O’Sullivan and Beales, 2007; Palsson and Graven-Nielsen, 2012). Dysfunctional load transfer due to changes in the pelvic mechanism with impaired motor control may result in pelvic girdle dysfunction (PGD) (Aldabe, Milosavljevic, and Bussey, 2012). Pelvic girdle pain is also associated with a change in lumbopelvic stabilization with excessive or deficient motor activation of the surrounding musculature (O’Sullivan and Beales, 2007). A systematic review has reported that movement in pelvic girdle joints is 32–68% larger in patients with PGP and low back pain than in healthy controls (Mens, Pool-Goudzwaard, and Stam, 2009).
Adaptation to a changed body. Experiences of living with long-term pelvic girdle pain after childbirth
Published in Disability and Rehabilitation, 2018
Annelie Gutke, Jennifer Bullington, Madeleine Lund, Mari Lundberg
Pregnancy-related pelvic girdle pain is complex and multifactorial [4] and its etiology remains unknown. To date, most explanations of pregnancy-related pelvic girdle pain have been constructed from a biomedical perspective. One common hypothesis is that during pregnancy, the hormonal-related increase of ligament laxity reduces the stability of the lower lumbar region and the pelvis [12]. Insufficient stabilization could account for pain that occurs within 30 min of performing daily activities requiring pelvic girdle stability, such as standing, sitting, and walking [13]. Pregnancy-related pelvic girdle pain persisting beyond the duration of pregnancy-related hormonal and biomechanical changes may be partly explained by altered muscular function [14,15]. Several interventions addressing stability and pain have effectively decreased symptoms both during and after pregnancy [16].