Vpliv bolečine v medeničnem obroču povezane z nosečnostjo na statično ravnotežje v drugem in tretjem trimesečju nosečnosti : magistrsko delo

Hrvatin, Ivana (author), Rugelj, Darja (mentor), Šćepanović, Darija (comentor), Vauhnik, Renata (reviewer)

Uvod: Zaradi hormonskih sprememb v nosečnosti opazimo spremembe v mišičnoskeletnem sistemu, ki vplivajo na spremembe drže in slabše ravnotežje. Gibanje telesnega težišča se, ob mirni stoji, poveča v drugem in tretjem trimesečju nosečnosti, predvsem v antero-posteriorni smeri. Različne pridružene bolezni in okvare mišično-skeletnega sistema dodatno vplivajo na slabše ravnotežje. Z nosečnostjo povezana bolečina v medeničnem obroču (NBMO) je zelo pogosta v nosečnosti, najpogosteje se pojavi med 17. in 19. tednom nosečnosti. Vzrok za nastanek bolečine je neznan in je najverjetneje posledica spremembe položaja težišča, zmanjšanja stabilnosti medenice in hormonskih sprememb. Namen: Namen magistrske naloge je bil ugotoviti ali imajo nosečnice z NBMO slabše statično ravnotežje v primerjavi z nosečnicami brez bolečin. Metode dela: V raziskavo so bile vključene nosečnice med 18. in 45. letom starosti, med 12. in 38. tednom nosečnosti. Razdeljene so bile v 4 skupine glede na trimesečje in prisotnost NBMO. Ocenjevali smo statično ravnotežje na pritiskovni plošči na trdi in mehki podlagi z odprtimi in zaprtimi očmi. Rezultati: Bolečina v medeničnem obroču vpliva na slabše statično ravnotežje, predvsem v tretjem trimesečju nosečnosti. Med nosečnicami z NBMO in brez bolečin, v drugem trimesečju nosečnosti, razlik nismo opazili. Hitrost gibanja središča pritiska, pot gibanja središča pritiska v medio-lateralni smeri ter ploščina gibanja središča pritiska je bila pri nosečnicah z NBMO, v tretjem trimesečju nosečnosti, statistično značilno večja, v primerjavi z nosečnicami brez bolečin, v tretjem trimesečju nosečnosti. Nosečnice, v tretjem trimesečju nosečnosti, so imele višjo hitrost gibanja središča pritiska ter večjo ploščino gibanja središča pritiska, v primerjavi z nosečnicami v drugem trimesečju, ne glede na prisotnost NBMO. Razprava in zaključek: Nosečnice z NBMO imajo slabše statično ravnotežje v primerjavi z nosečnicami brez bolečin, predvsem v tretjem trimesečju nosečnosti. Vzrok za slabše ravnotežje je najverjetneje posledica slabše sposobnosti stabilizacije trupa in medenice, slabše propriocepcije in težav z avtomatskimi gibalnimi vzorci. Predlagamo, da bi bile nosečnice deležne svetovanja o težavah z ravnotežjem v nosečnosti in preventivi pred padci, posebno nosečnice z NBMO.

• Language: Slovenian
• Keywords: magistrska dela, fizioterapija, nosečnost, bolečina v medeničnem obroču, statično ravnotežje, ravnotežje
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [I. Hrvatin]
• Year: 2021
• Number of pages: 50 str.
• PID: 20.500.12556/RUL-126486
• UDC: 615.8
• COBISS.SI-ID: 61071619
• Publication date in RUL: 23.04.2021

Secondary language

• Language: English
• Title: Efficacy of pregnancy related pelvic girdle pain on static balance in the second and third trimester of pregnancy : master thesis

Abstract

Introduction: During pregnancy many changes occur in the musculo-skeletal system that affect posture and postural stability. In quiet stance in the second and third trimester of pregnancy, the center of pressure movement increases, especially in the antero-posterior direction. Many pregnancy related disorders additionally affect postural stability. Pregnancy related pelvic girdle pain (PPGP) is a common disorder in pregnancy that usually occurs between the 17th and 19th gestational week. The cause PPGP remains unknown, although it is probably related to the change in center of gravity, hormonal changes and pelvic instability. Purpose: The purpose of this master thesis was to determine if PPGP affects static postural stability in pregnant women. Methods: Pregnant women between the ages of 18 and 45 and between the 12th and 38th week of gestation were included in the study. They were divided into four groups depending on the trimester and the presence of PPGP. Static balance was assessed using a force plate on firm and foam surface with eyes open and close. Results: Pregnant women with PPGP had poorer postural stability, especially in the third trimester of pregnancy. No difference was observed between pregnant women with PPGP and without pain during the second trimester. Pregnant women with PPGP in the third trimester had greater velocity of center of pressure movement, greater center of pressure excursion in the medio-lateral direction and larger postural sway area compared to pregnant women without pain in the third trimester. Pregnant women in the third trimester of pregnancy had greater velocity of center of pressure movement and larger postural sway area when compared to pregnant women in the second trimester of pregnancy, regardless of PPGP. Discussion and conclusion: Pregnant women with PPGP have poorer static stability when compared to pregnant women without pain, especially in the third trimester of pregnancy. The cause could be found in the poorer ability to stabilize trunk and pelvis, poorer proprioception and issues with automatic movement patterns. Pregnant women should receive information about changes in balance during pregnancy and fall prevention, especially pregnant women with PPGP.

• Keywords: amaster's theses, physiotherapy, pregnancy, pregnancy related pelvic girdle pain, postural stability, balance