Comparison of Physical Activity, Pelvic Girdle Pain and Kinesiophobia Levels of Pregnant Women According to Different Trimesters and Body Mass Index

Yıl 2024, Cilt: 11 Sayı: 2, 543 - 558, 02.08.2024

Seren Aşkar Yolcu , Gizem Boztaş Elverişli , Esra Atılgan

https://doi.org/10.21020/husbfd.1322174

Öz

Objectives: To compare the physical activity, pelvic girdle pain and kinesiophobia levels of pregnant women according to different trimesters and body mass index.
Materials and Methods: 143 pregnant women between the ages of 18-49 were included in the study. Pregnant women were divided into 3 groups according to their trimesters. Pregnancy week 0-13. Those between weeks 1st Trimester (n=36), 14-27. Those who were at the gestational week were included in the 2nd Trimester (n = 54) and those who were at the 28th week and above were included in the 3rd Trimester (n = 53) group. In addition, pregnant women were classified as normal weight, overweight and obese according to their body mass index. Data were collected with a demographic information form, Pregnancy Physical Activity Questionnaire (PPFAQ), Pelvic Girdle Questionnaire (PGQ), Tampa Kinesiophobia Scale (TKS), and Kinesiophobia Causes Scale (KCS). Data analysis was done using SPSS 26.0 program with a 5% margin of error.
Results: In the comparison between trimesters in pregnant women, while there was no difference between physical activity and kinesiophobia levels (p>0.05), pelvic girdle pain severity was high in the 3rd trimester (p<0.001). In the comparison between trimesters according to body mass index, the severity of pelvic girdle pain was high in normal weight and obese pregnant women in the 3rd trimester (p<0.05). Additionally, kinesiophobia was found to be high in obese pregnant women in the 3rd trimester (p=0.043).
Conclusion: According to our study, while the severity of pelvic girdle pain increased in pregnant women as the trimesters increased, kinesiophobia and physical activity levels did not change. According to the body mass index of the pregnant women, the physical activity level did not change as the trimesters increased. Kinesiophobia was high in the 2nd trimester in obese pregnant women, and pelvic girdle pain severity was high in the 3rd trimester in normal weight and obese pregnant women.

Anahtar Kelimeler

Physical activity, pregnancy, kinesiophobia, pelvic girdle pain, trimester.

Gebelerin Farklı Trimesterlere ve Vücut Kütle İndeksine Göre Fiziksel Aktivite, Pelvik Kuşak Ağrısı ve Kinezyofobi Düzeylerinin Karşılaştırılması

Öz

Amaç: Gebelerin farklı trimesterlere ve vücut kütle indeksine göre fiziksel aktivite, pelvik kuşak ağrısı ve kinezyofobi düzeylerini karşılaştırmaktır.
Gereç ve Yöntem: Çalışmaya, 18-49 yaş arasında 143 gebe dahil edildi. Gebeler, trimesterlerine göre 3 gruba ayrıldı. Gebelik haftası 0-13. hafta arasında olanlar 1. trimester (n=36), 14-27. gebelik haftasında olanlar 2. trimester (n=54) ve 28. hafta ve üzeri olanlar 3. trimester (n=53) grubuna dahil edildi. Ayrıca gebeler vücut kütle indekslerine göre normal kilolu, aşırı kilolu ve obez olarak sınıflandırıldı. Veriler demografik bilgi formu, Gebelik Fiziksel Aktivite Anketi (GFAA), Pelvik Kuşak Anketi (PKA), Tampa Kinezyofobi Ölçeği (TKÖ) ve Kinezyofobi Nedenleri Ölçeği (KNÖ) ile toplandı. Verilerin analizi %5 hata payı ile SPSS 26.0 programı kullanılarak yapıldı.
Bulgular: Gebelerde trimesterler arası karşılaştırmada, fiziksel aktivite ve kinezyofobi düzeyleri arasında fark yokken (p>0,05), 3. trimesterde pelvik kuşak ağrı şiddeti yüksekti (p<0,001). Vücut kütle indeksine göre trimesterler arası karşılaştırmada, 3.trimesterde normal kilolu ve obez gebelerde pelvik kuşak ağrı şiddeti yüksekti (p<0,05). Ayrıca obez gebelerde 3. trimesterde kinezyofobi de yüksek bulundu (p=0,043).
Sonuç: Çalışmamıza göre, trimesterler ilerledikçe gebelerde pelvik kuşak ağrı şiddeti artarken, kinezyofobi ve fiziksel aktivite seviyesinin değişmediği görüldü.Gebelerin vücut kütle indeksine göre de trimesterler ilerledikçe fiziksel aktivite seviyesi değişmedi. Obez gebelerde kinezyofobi 2. trimesterde, normal kilolu ve obez gebelerde de pelvik kuşak ağrı şiddeti 3. trimesterde yüksekti.

Anahtar Kelimeler

Fiziksel aktivite, gebelik, kinezyofobi, pelvik kuşak ağrısı, trimester

Kaynakça

• Ahlqvist, K., Bjelland, E. K., Pingel, R., Schlager, A., Nilsson-Wikmar, L., & Kristiansson, P. (2020). The association of self-reported generalized joint hypermobility with pelvic girdle pain during pregnancy: A retrospective cohort study. BMC musculoskeletal disorders, 21(1), 474. https://doi.org/10.1186/s12891- 020-03486-w.
• Elbaz Braun, A., Solt, I., & Constantini, N. (2023). Physical activity during pregnancy and after birth. Harefuah, 162(3), 146–151. https://pubmed.ncbi.nlm.nih.gov/36966370/
• Ceprnja, D., Chipchase, L., Fahey, P., Liamputtong, P., & Gupta, A. (2021). Prevalence and factors associated with pelvic girdle pain during pregnancy in australian women: A cross-sectional study. Spine, 46(14), 944–949. https://doi.org/10.1097/BRS.0000000000003954
• Chan, C. W. H., Au Yeung, E., & Law, B. M. H. (2019). Effectiveness of physical activity ınterventions on pregnancy-related outcomes among pregnant women: A systematic review. International journal of environmental research and public health, 16(10), 1840. https://doi.org/10.3390/ijerph16101840
• Chasan-Taber, L., Schmidt, M. D., Roberts, D. E., Hosmer, D., Markenson, G., & Freedson, P. S. (2004). Development and validation of a pregnancy physical activity questionnaire. Med Sci Sports Exerc, 36(10), 1750–1760. https://doi.org/10.1249/01.mss.0000142303.49306.0d.
• Çayır, M., Durutürk, N. A. ve Tekindal, M. A. (2020). Kinezyofobi Nedenleri Ölçeği’nin Türkçe uyarlamasının geçerlik ve güvenirliği. [Reliability and validity of the Turkish version of Kinesiophopia Causes Scale]. Journal of Exercise Therapy and Rehabilitation, 7(1), 64-73. https://dergipark.org.tr/en/download/article-file/1028949
• Çırak, Y., Yılmaz, G. D., Demir, Y. P., Dalkılınç, M., & Yaman, S. (2015). Pregnancy physical activity questionnaire (PPAQ): reliability and validity of Turkish version. Journal of physical therapy science, 27(12), 3703–3709. https://doi.org/10.1589/jpts.27.3703
• Daşıkan, Z., Güner, Ö. ve Bozkurt, T. (2019). İkinci ve üçüncü trimester gebelerin fiziksel aktivite düzeyi ve fiziksel aktivite engelleri. [Physical Activity Level and Barriers of Second and Third Trimester Pregnant Women]. Adıyaman Üniversitesi Sağlık Bilimleri Dergisi, 5(3), 1731-1745. https://doi.org/10.30569/adiyamansaglik.643369
• Ebina, A., Sawa, R., Kondo, Y., Murata, S., Takada, M., Fujii, H., Okuyama, Y., Tanikawa, Y., Souke, K., & Ono, R. (2020). Influence of kinesiophobia with pregnancy-related lumbopelvic pain at late pregnancy on postpartum depressive symptoms. Physical therapy research, 23(1), 92–98. https://doi.org/10.1298/ptr.E9999
• Forczek, W., Curyło, M., & Forczek, B. (2017). Physical activity assessment during gestation and ıts outcomes: A Review. Obstetrical & gynecological survey, 72(7), 425–444. https://doi.org/10.1097/OGX.0000000000000458.
• Karaçam, Z. ve Özçelik, G. (2014). Gebelikte sık karşılaşılan yakınmalar, fiziksel, ruhsal ve cinsel sağlık sorunları, risk faktörleri ve yaşam kalitesi ile ilişkileri. [Common symptoms, health problems, risk factors, and relationships with their quality of life during the pregnancy]. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 30(3), 1-18.
• Kepenek Varol, B., Aydoğdu, A., Temur, E.N., Fırat, G., Selvi, M., Yazıcı Gülay, M., & Aksoy H. (2023). The relationship between pregnancy-related low back pain, kinesiophobia, and physical activity in the third trimester. Clin Exp Health Sci, 13, 25-31. https://doi.org/10.33808/clinexphealthsci.984617
• Kesikburun, S., Güzelküçük, Ü., Fidan, U., Demir, Y., Ergün, A., & Tan, A. K. (2018). Musculoskeletal pain and symptoms in pregnancy: a descriptive study. Therapeutic advances in musculoskeletal disease, 10(12), 229–234. https://doi.org/10.1177/1759720X1881244
• Kızılay, F. ve Ünver, H. (2022). Gebelerde fiziksel aktivite, kinezyofobi ve stres; kilo alımı ve bel ağrısının etkileri. [Physical Activity, Kinesiophobia and Stress in Pregnancy; Effects of Weight Gain and Low Back Pain]. İnönü Üniversitesi Beden Eğitimi ve Spor Bilimleri Dergisi, 9 (3) , 25-35. https://dergipark.org.tr/en/download/article-file/2692615
• Kostanoğlu, A., Manzak, A.S. ve Şahin, A. (2019). Gebelerde fiziksel aktivite seviyesi ve uyku kalitesinin yaşam kalitesine etkisi. [The Effect of Physical Activity Level and Sleep Quality on Quality of Life in Pregnant Women]. J Turk Sleep Med, 3, 80-87. http://doi.org/10.4274/jtsm.galenos.2019.64936
• Kovacs, F.M, Garcia E, Royuela A., González, L., & Abraira, V. (2012). Prevalence and factors associated with low back pain and pelvic girdle pain during pregnancy. Spine. 37(17), 1516-1533. https://doi.org/10.1097/BRS.0b013e31824dcb74
• Kozan, R., Bayhan, H., Soykan, Y., Anadol, A. Z., Sare, M., & Aytac, A. B. (2020). Acute Appendicitis in Pregnancy: How to Manage?. Sisli Etfal Hastanesi tip bulteni, 54(4), 457–462. https://doi.org/10.14744/SEMB.2020.85453
• Krzepota, J., Sadowska, D., & Biernat, E. (2018). Relationships between physical activity and quality of life in pregnant women in the second and third trimester. International Journal Of Environmental Research And Public Health, 15(12), 2745. https://doi.org/10.3390/ijerph15122745.
• Santos, P. C., Abreu, S., Moreira, C., Santos, R., Ferreira, M., Alves, O., Moreira, P., & Mota, J. (2016). Physical Activity Patterns During Pregnancy in a Sample of Portuguese Women: A Longitudinal Prospective Study. Iranian Red Crescent medical journal, 18(3), e22455. https://doi.org/10.5812/ircmj.22455.
• Stendal Robinson, H., Lindgren, A., & Bjelland, E. K. (2022). Generalized joint hypermobility and risk of pelvic girdle pain in pregnancy: does body mass index matter?. Physiotherapy theory and practice, 38(12), 2222–2229. https://doi.org/10.1080/09593985.2021.1913774
• Sward, L., Manning, N., Murchison, A. B., Ghahremani, T., McCaulley, J. A., & Magann, E. F. (2023). Pelvic Girdle Pain in Pregnancy: A Review. Obstetrical & gynecological survey, 78(6), 349–357. https://doi.org/10.1097/OGX.0000000000001140
• Uzelpasaci, E., Akbayrak, T., Özgül, S., Orhan, C., Baran, E., Nakip, G., Beksac, S., & Topuz, S. (2019). The Reliability and Validity of the Turkish Kaiser Physical Activity Survey for Pregnant Women. Journal of physical activity and health, 16(11), 962–967. https://doi.org/10.1123/jpah.2018-0573
• Uzelpasaci, E., Özdemir, M., & Gürşen, C. (2023). Reliability and validity of the Turkish version of the pregnancy exercise self-efficacy scale. Sexual & Reproductive Healthcare, 37, 100899
• Vleeming, A., Albert, H. B., Ostgaard, H. C., Sturesson, B., & Stuge, B. (2008). European guidelines or the diagnosis and treatment of pelvic girdle pain. 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, 17(6), 794–819. https://doi.org/10.1007/s00586-008-0602-4
• Yelvar, G. D. Y., Cirak, Y., Demir, Y. P., & Türkyılmaz, E. S. (2019). Cultural adaptation, reliability and validity of the pelvic girdle questionnaire in pregnant women. Ankara Medical Journal, 19(3), 513-523. https://doi.org/10.17098/amj.624417
• Yılmaz, Ö. T., Yakut, Y., Uygur, F. ve Uluğ, N. (2011). Tampa kinezyofobi ölçeği’nin türkçe versiyonu ve test-tekrar test güvenirliği. [Turkish version of the Tampa Scale for Kinesiophobia and its test-retest reliability]. Türk Fizyoterapi ve Rehabilitasyon Dergisi, 22(1), 44-9. https://dergipark.org.tr/en/download/article-file/138103
• World Health Organization. (2010). https://www.who.int/europe/news-room/fact-sheets/item/a-healthy-lifestyle---who-recommendations