DOĞUM HİKAYESİ OMURGANIN SAGİTAL EĞRİLİKLERİNİ ETKİLER Mİ?

Abstract

Amaç: Gebelik ve doğum süreci kadın vücudunda fizyolojik, hormonal, anatomik ve biyomekaniksel değişime yol açmaktadır. Lumbar omurga başta olmak üzere, tüm omurgada meydana gelen bu adaptasyonların omurga sagital eğrileri üzerine etkilerini inceleyen çalışma sayısı sınırlıdır. Çalışmadaki amaç, doğum hikayesi olan ve olmayan kadınlarda omurganın ayakta duruştaki statik sagital eğriliklerini karşılaştırmaktı. Yöntem: Çalışmaya 18-57 yaş aralığında 201 sağlıklı kadın (doğum hikayesi olan 87 ve olmayan 114 katılımcı) dahil edildi. Torakal kifoz ve lumbal lordoz (C7-S2 vertebra aralığı) Spinal Mouse cihazı ile değerlendirildi. Oswestry Disabilite İndeksi ve İskandinav Kas İskelet Sistemi Sorgusu dahil edilme ya da dışlama kriteri olarak kullanıldı. Bulgular: Katılımcıların (n=201 ve yaş ortalaması: 35,73±11.29 yıl) ortalama torakal kifoz derecesi 48.50±9.66 ve lumbar lordoz derecesi 32,66±12,33 idi. Katılımcılar hiç doğum yapmamış (n=114 doğum hikayesi olmayan) ve en az 1 kez doğum yapmış (n=87 doğum hikayesi olan) kadınlardan oluşmaktaydı. Gruplar arasında torakal kifoz ve lumbal lordoz açısından anlamlı bir fark bulunmadı (p>0,05). Doğum sayılarına göre de torakal kifoz ve lumbal lordoz gruplar arasında benzerdi (p>0,05). Sonuç: Çalışma sonuçları, doğum hikayesi olan ve olmayan kadınların omurga sagital eğriliklerinin benzer olduğunu gösterdi. Ayrıca doğum hikayesi olan kadınlarda torasik kifoz ve lomber lordoz açılarının doğum sayısından etkilenmediği gözlendi.

Keywords

• Doğum
• gebelik
• lumbal lordoz
• torakal kifoz

DOES THE BIRTH HISTORY AFFECT THE SAGITTAL SPINAL CURVATURES?

Abstract

Purpose: Pregnancy and labour lead to physiological, hormonal, anatomical, and biomechanical changes in a woman's body. Limited studies examine the effects of all these adaptations on the sagittal curvatures of the spine, particularly in the lumbar region. This study aimed to compare the static sagittal curvatures of the spine in women with and without a birth history. Methods: The study included 201 healthy women aged 18-57 (114 participants with a birth history and 87 participants without a birth history). Thoracic kyphosis and lumbar lordosis (C7-S2 vertebra range) were assessed using the Spinal Mouse device. The Oswestry Disability Index and the Scandinavian Musculoskeletal System Questionnaire were used as inclusion or exclusion criteria. Results: The participants’ mean thoracic kyphosis angle (n=201, average age: 35.73±11.29 years) was 48.50±9.66 degrees, and the lumbar lordosis angle was 32.66±12.33 degrees. Participants consisted of women who had never given birth (n=114, without a birth history) and women who had given at least one birth (n=87 with a birth history). No significant difference was found between the groups regarding thoracic kyphosis and lumbar lordosis (p>0.05). The thoracic kyphosis and lumbar lordosis were similar between the groups according to the number of births (p>0.05). Conclusion: The study results indicate that the sagittal curvatures of the spine are similar in women with and without a birth history. Additionally, it was observed that the angles of thoracic kyphosis and lumbar lordosis in women with a birth history were unaffected by the number of births.

Keywords

• Birth
• pregnancy
• lumbar lordosis
• thoracic kyphosis

References

1. Angão, M. O. B., Poeira, A. F., Branco, M., & Santos-Rocha, R. (2024). Changes in Foot Biomechanics during Pregnancy and Postpartum: Scoping Review. International journal of environmental research and public health, 21(5), 638. https://doi.org/10.3390/ijerph21050638
2. Atan SÜ, Duran ET, Kavlak O, Donmez S, Sevil U. Spontaneous vaginal delivery or caesarean section? What do Turkish women think? Int J Nurs Pract. 2013 Feb;19(1):1-7. doi: 10.1111/ijn.12029. PMID: 23432882.
3. Bryndal, A., Glowinski, S., & Majchrzycki, M. (2022). Influence Of Pregnancy On The Occurrence Of Lumbar Spine Pain İn Polish Women: A Retrospective Study. Journal Of Personalized Medicine, 12(3), 357.
4. Bullock Je, Jull Ga, Bullock Mı, (1987) The Relationship Of Low Back Pain To Postural Changes During Pregnancy, Australian Journal Of Physiotherapy, 33.10-17
5. Conder R, Zamani R, Akrami M. The Biomechanics of Pregnancy: A Systematic Review. J Funct Morphol Kinesiol. 2019 Dec 2;4(4):72. doi: 10.3390/jfmk4040072. PMID: 33467386; PMCID: PMC7739277.
6. Conder, R.; Zamani, R.; Akrami, M., 2019. The Biomechanics Of Pregnancy: A Systematic Review. Journal Of Functional Morphology And Kinesiology; 4(4):10.3390
7. Demir E.& Atalay Guzel N. & Cobanoglu G. & Kafa N. (2020). The Reliability Of Measurements With The Spinal Mouse Device İn Frontal And Sagittal Planes İn Asymptomatic Female Adolescents. 10.4328/Jcam.6201.
8. Demirbüken İ., Özyürek S., Angın S. (2016) An Approach To Common Foot Problems During Pregnancy Journal Of Physiotherapy Rehabilitation Special Topics; 2(3):37-41

9. Döner Şi, &Gerçek H. (2023) Gebelikle İlişkili Lumbopelvik Ağrı Ve Güncel Fizyoterapi Yöntemleri: Geleneksel Derleme. Igusabder. 20: 692
10. Fadaee, E. & Seidi, F. & Rajabi, R. (2017). The Validity And Reliability Of Spinal Mouse Device İn Measuring Angle Values Of Thoracic Kyphosis And Lumbar Lordosis. 19. 137-147.
11. Gilleard W.& Brown M. (1996). Structure And Function Of The Abdominal Muscles İn Primigravid Subjects During Pregnancy And The Immediate Postbirth Period, Physical Therapy, Volume 76-7-750–762,
12. Gilleard WL, Crosbie J, Smith R. Static trunk posture insitting and standing during pregnancy and early postpartum.Arch Phys Med Rehabil. 2002;83:1739–44
13. Glinkowski, W. M., Tomasik, P., Walesiak, K., Głuszak, M., Krawczak, K., Michoński, J., Czyżewska, A., Żukowska, A., Sitnik, R., & Wielgoś, M. (2016). Posture And Low Back Pain During Pregnancy - 3d Study. Ginekologia Polska, 87(8), 575–580.
14. Goldsmith Lt, Weiss G.., (2009). Relaxin İn Human Pregnancy. Annals Of The New York Academy Of Sciences, April 1160:130–135.
15. Kahraman T, Genç A., Göz E. (2016). The Nordic Musculoskeletal Questionnaire: Cross-Cultural Adaptation İnto Turkish Assessing İts Psychometric Properties. Disabil Rehabil. 2016 Oct;38(21)
16. Koo Tk, Li My (2016). A Guideline Of Selecting And Reporting Intraclass Correlation Coefficients For Reliability Research. J Chiropr Med. 2016 Jun;15(2):155-63.
17. Liang H, Fan Y, Zhang N, Chongsuvivatwong V, Wang Q, Gong J, Sriplung H. Women's cesarean section preferences and influencing factors in relation to China's two-child policy: a cross-sectional study. Patient Prefer Adherence. 2018 Oct 11;12:2093-2101. doi: 10.2147/PPA.S171533. PMID: 30349203; PMCID: PMC6188957.
18. Linjuan W., Yan W., Yinghu P., Qitao T., Yaodong G., Li L., Ming Z. (2023). Review Of Biomechanical Deviations Among Nonpregnant, Pregnant, And Postpartum Cohorts. Medicine İn Novel Technology And Devices, Volume 18. P. 100226.
19. Livanelioglu, A., Kaya, F., Nabiyev, V., Demirkiran, G., & Fırat, T. (2016). The Validity And Reliability Of "Spinal Mouse" Assessment Of Spinal Curvatures İn The Frontal Plane İn Pediatric Adolescent İdiopathic Thoraco-Lumbar Curves. European Spine Journal : Official Publication Of The European Spine Society, The European Spinal Deformity Society, And The European Section Of The Cervical Spine Research Society, 25(2), 476–482.
20. Marnach, M. L., Ramin K., Ramsey P., Song S. (2003). Characterization Of The Relationship Between Joint Laxity And Maternal Hormones İn Pregnancy. Obstetrics And Gynecology, 101(2), 331–335.
21. Michoński J, Walesiak K, Pakuła A, Glinkowski W, Sitnik R. (2016). Monitoring Of Spine Curvatures And Posture During Pregnancy Using Surface Topography – Case Study And Suggestion Of Method. Scoliosis 11 (Suppl 2), 31
22. Moore K, Dumas GA, Reid JG. Postural changes associated with pregnancy and their relationship with low-back pain. Clin Biomech (Bristol, Avon). 1990 Aug;5(3):169-74. doi: 10.1016/0268-0033(90)90020-7. PMID: 23916220.
23. Okanishi N, Kito N, Akiyama M, Yamamoto M. (2012). Spinal Curvature And Characteristics Of Postural Change İn Pregnant Women. Acta Obstetricia Et Gynecologica Scandinavica, 91(7), 856–861.
24. Petrenko Ap, Castelo-Branco C, Marshalov Dv, Kuligin Av, Mysovskaya Ys, Shifman Em, Abdulaev Amr. (2021) Physiology Of İntra-Abdominal Volume During Pregnancy. J Obstet Gynaecol. 2021 Oct;41(7):1016-1022.
25. Rasmussen K.M., Yaktine A.L., Institute Of Medicine And National Research Council Of The National Academies. Weight Gain During Pregnancy: Reexamining The Guidelines. Washington, Dc: The National Academies Press; 2009..
26. Ripani, M., Di Cesare, A., Giombini, A., Agnello, L., Fagnani, F., & Pigozzi, F. (2008). Spinal Curvature: Comparison Of Frontal Measurements With The Spinal Mouse And Radiographic Assessment. The Journal Of Sports Medicine And Physical Fitness, 48(4), 488–494.
27. Santos-Rocha, R., (2019). Biomechanical Adaptations Of Gait İn Pregnancy: Implications For Physical Activity And Exercise. Exercise And Sporting Activity During Pregnancy. Springer, Cham
28. Sarğın, G., Karadağ, H., & Dirik, D. (2024). Comparıson Of Spinal Curvatures Of Women Had Gıven Multiple Times And Never Given Birth. Journal Of International Health Sciences And Management, 10(19), 39-44.
29. Schröder G., Kundt G., Otte M., Wendig D. (2016) Impact Of Pregnancy On Back Pain And Body Posture İn Women. J Phys Ther Sci. 2016 Apr;28(4):1199-207.
30. Smajdor, Anna & Räsänen, Joona. (2024). Is Pregnancy A Disease? A Normative Approach. Journal Of Medical Ethics. 10.1136/Jme-2023-109651
31. Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. (2016). Physiological Changes İn Pregnancy. Cardiovasc J Afr. 27(2):89-94.
32. Spankus Jd (1965), Cause And Treatment Of Low Back Pain During Pregnancy, The Wisconsin Medical Journal, 64(9), 303-304
33. Starzec-Proserpio M. & Truszczynska-Baszak, A. (2017). Pregnancy-Related Lumbopelvic Pain: Classification And Diagnostics According To European Guidelines And A Review Of Literature. Rehabilitacja Medyczna. 21.
34. Vermani E, Mittal R, Weeks A., (2009). Pelvic Girdle Pain And Low Back Pain İn Pregnancy: A Review Pain Practice, 10:1:60
35. Wolf Jm, Scher Dl, Etchill Ew, Scott F, Williams Ae, Delaronde S, King Kb. (2014). Relationship Of Relaxin Hormone And Thumb Carpometacarpal Joint Arthritis. Clinical Orthopaedics And Related Research, 472(4), 1130–1137.
36. Yakut E, Düger T, Oksüz C, Yörükan S, Ureten K, Turan D, Frat T, Kiraz S, Krd N, Kayhan H, Yakut Y, Güler C. (2004). Validation Of The Turkish Version Of The Oswestry Disability Index For Patients With Low Back Pain. Spine (Phila Pa 1976). 2004 Mar 1;29(5):581-5.
37. Yoo H, Shin D, Song C. Changes in the spinal curvature, degree of pain, balance ability, and gait ability according to pregnancy period in pregnant and nonpregnant women. J Phys Ther Sci. 2015 Jan;27(1):279-84. doi: 10.1589/jpts.27.279. Epub 2015 Jan 9. PMID: 25642091; PMCID: PMC4305582.