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      Gait in Pregnancy-related Pelvic girdle Pain: amplitudes, timing, and coordination of horizontal trunk rotations

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          Abstract

          Walking is impaired in Pregnancy-related Pelvic girdle Pain (PPP). Walking velocity is reduced, and in postpartum PPP relative phase between horizontal pelvis and thorax rotations was found to be lower at higher velocities, and rotational amplitudes tended to be larger. While attempting to confirm these findings for PPP during pregnancy, we wanted to identify underlying mechanisms. We compared gait kinematics of 12 healthy pregnant women and 12 pregnant women with PPP, focusing on the amplitudes of transverse segmental rotations, the timing and relative phase of these rotations, and the amplitude of spinal rotations. In PPP during pregnancy walking velocity was lower than in controls, and negatively correlated with fear of movement. While patients’ rotational amplitudes were larger, with large inter-individual differences, spinal rotations did not differ between groups. In the patients, peak thorax rotation occurred earlier in the stride cycle at higher velocities, and relative phase was lower. The earlier results on postpartum PPP were confirmed for PPP during pregnancy. Spinal rotations remained unaffected, while at higher velocities the peak of thorax rotations occurred earlier in the stride cycle. The latter change may serve to avoid excessive spine rotations caused by the larger segmental rotations.

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          Most cited references38

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          Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance.

          Two studies are presented that investigated 'fear of movement/(re)injury' in chronic musculoskeletal pain and its relation to behavioral performance. The 1st study examines the relation among fear of movement/(re)injury (as measured with the Dutch version of the Tampa Scale for Kinesiophobia (TSK-DV)) (Kori et al. 1990), biographical variables (age, pain duration, gender, use of supportive equipment, compensation status), pain-related variables (pain intensity, pain cognitions, pain coping) and affective distress (fear and depression) in a group of 103 chronic low back pain (CLBP) patients. In the 2nd study, motoric, psychophysiologic and self-report measures of fear are taken from 33 CLBP patients who are exposed to a single and relatively simple movement. Generally, findings demonstrated that the fear of movement/(re)injury is related to gender and compensation status, and more closely to measures of catastrophizing and depression, but in a much lesser degree to pain coping and pain intensity. Furthermore, subjects who report a high degree of fear of movement/(re)injury show more fear and escape/avoidance when exposed to a simple movement. The discussion focuses on the clinical relevance of the construct of fear of movement/(re)injury and research questions that remain to be answered.
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            Statistical Analysis of Circular Data

            N. FISHER (1993)
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              Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants.

              to establish reference values for both comfortable and maximum gait speed and to describe the reliability of the gait speed measures and the correlation of selected variables with them. descriptive and cross-sectional. subjects were 230 healthy volunteers. Gait was timed over a 7.62 m expanse of floor. Actual and height normalized speed were determined. Lower extremity muscle strength was measured with a hand-held dynamometer. mean comfortable gait speed ranged from 127.2 cm/s for women in their seventies to 146.2 cm/s for men in their forties. Mean maximum gait speed ranged from 174.9 cm/s for women in their seventies to 253.3 cm/s for men in their twenties. Both gait speed measures were reliable (coefficients > or = 0.903) and correlated significantly with age (r > or = -0.210), height (r > or = 0.220) and the strengths of four measured lower extremity muscle actions (r = 0.190-0.500). The muscle action strengths most strongly correlated with gait speed were nondominant hip abduction (comfortable speed) and knee extension (maximum speed). these normative values should give clinicians a reference against which patient performance can be compared in a variety of settings. Gait speed can be expected to be reduced in individuals of greater age and of lesser height and lower extremity muscle strength.
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                Author and article information

                Contributors
                +31-20-5988590 , +31-20-5988529 , o_g_meijer@fbw.vu.nl
                Journal
                Eur Spine J
                European Spine Journal
                Springer-Verlag (Berlin/Heidelberg )
                0940-6719
                1432-0932
                26 July 2008
                26 July 2008
                September 2008
                : 17
                : 9
                : 1160-1169
                Affiliations
                [1 ]Second Affiliated Hospital of Fujian Medical University, Quanzhou, People’s Republic of China
                [2 ]Orthopaedic Biomechanics Laboratory, Fujian Medical University, Fuzhou, Fujian People’s Republic of China
                [3 ]Research Institute MOVE, Faculty of Human Movement Sciences, Vrije Universiteit, Van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands
                [4 ]Zhongshan Hospital, University of Xiamen, Xiamen, Fujian People’s Republic of China
                [5 ]Department of Orthopaedic Surgery, Research Institute MOVE, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands
                Article
                703
                10.1007/s00586-008-0703-0
                2527418
                18661160
                9e0c28b6-3e4b-4929-be67-72e419b1021e
                © The Author(s) 2008
                History
                : 27 November 2007
                : 29 April 2008
                : 9 June 2008
                Categories
                Original Article
                Custom metadata
                © Springer-Verlag 2008

                Orthopedics
                trunk coordination,relative phase,gait kinematics,pregnancy-related pelvic girdle pain,transverse rotation

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