Does Women's Health Matter? No abstract available

Restriction in Pelvis and Trunk Motion in Postpartum Runners Compared With Pre-pregnancy Background: Biomechanical changes in gait during pregnancy have been well studied in walking but not in running. Objective: To specifically examine adaptations in running biomechanics pre- to post-pregnancy, especially in the pelvis and trunk. Study Design: Pilot study. Methods: Five regular runners who were pregnant for the first time participated in this study. Participants ran at a self-selected speed on an instrumented treadmill while trunk, pelvis, and lower extremity kinematics were recorded. Baseline biomechanics were recorded prior to conception or within the first 14 weeks of gestation. Follow-up testing occurred at 6 weeks postpartum. Digital surveys were administered at baseline and 6 weeks postpartum, as well as at 14, 22, and 30 weeks of gestation. Surveys queried information regarding training characteristics, experience of pain, and perceived injury risk compared with pre-pregnancy. Results: Pelvis and trunk rotation excursions, sagittal hip range of motion, and cadence decreased from baseline to post-pregnancy, whereas stance time, step width, and sagittal knee range of motion increased. Average running volume and pace decreased postpartum, although variation occurred among participants. Abdominal pain was reported by 2 participants during pregnancy, with 2 participants reporting increased perceived injury risk. Conclusion: Taken together, these findings suggest postpartum runners restrict pelvis and trunk motion and increase gait stability, potentially as a protective response. Despite sample size, this pilot study presents initial evidence of biomechanical changes to running gait that occur pre- to post-pregnancy, which may have implications in developing support for pregnant and postpartum women interested in continuing or returning to running.

Predictive Risk Factors for First-Onset Lumbopelvic Pain in Postpartum Women: A Systematic Review Background: Lumbopelvic pain is common during pregnancy and postpartum. This pain has been linked to a variety of comorbidities, such as depression. Although pain is common in the postpartum period, the etiology of first-onset pain is unclear and the risk factors associated with this pain in the postpartum period are unknown. Objectives: The objective of the review was to determine risk factors for first-onset lumbopelvic pain during the postpartum period. Study Design: Systematic review. Methods: Included articles were prospective cohort studies that identified modifiable and nonmodifiable risk factors for first-onset lumbopelvic postpartum pain. Articles were selected following a comprehensive search of 4 databases. The Quality in Prognostic Studies tool was used to evaluate the quality of studies. Risk factors from the articles were categorized as extrinsic, intrinsic, or mixed and ranked by the strength of their association statistic. Results: Four articles met the inclusion criteria. The pooled incidence of first-onset lumbopelvic pain was 32%. Of the 11 risk factors investigated for low back pain, cesarean delivery (CD) with epidural anesthesia, duration of first stage of labor, age of the mother, race, and urinary tract infections were significantly predictive of first-onset low back pain. Nine risk factors were investigated for pelvic pain; none were significant. Conclusion: First-onset low back pain is present among postpartum women. The 5 risk factors identified in single studies were nonmodifiable. High-quality prognostic studies need to more consistently investigate risk factors for first-onset back pain in the postpartum pain.

Reorganization of Postural Stability After Tram Flap Breast Reconstruction Surgery: A Longitudinal Case Report Background Context: Transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction is a common method of reconstruction performed after mastectomy. However, the short and long-term effect on posture, balance, and coordination is unknown. Purpose: The purpose of this study was to investigate the effects of TRAM flap breast reconstruction on anticipatory postural control and balance in a breast cancer survivor. Study Design: A repeated-measures cohort design. Patient Sample: A 47-year-old woman who underwent ipsilateral mastectomy and TRAM flap breast reconstruction. Outcome Measure: Anticipatory muscle activity including muscle onset timing, magnitude of muscle activation, and center-of-pressure displacement during a modified Trendelenburg task. Muscle onsets occurring before initiation of weight shift were considered “early activation” and likely to represent a feedforward postural control mechanism whereas muscle onsets occurring after weight shift were considered “late activation” representing reliance on feedback mechanism for postural control. Methods: Electromyographic muscle activity and displacement of center of pressure were examined in a single-subject design with pre- and post-TRAM flap surgery measures taken 6 days preoperation, 6 weeks, and 13 weeks postoperation. Results: The timing of muscle onset differed significantly day-to-day for all muscles. Preoperatively, the unaffected side presented earlier activation compared with the affected side. At 6 weeks, there were no early activations. At 13 weeks, early activation was identified in 6 of 8 muscles. Reaction time and balance instability were significantly greater at 6 weeks and highest on the affected. Conclusions: The permanent disruption of the rectus abdominis had an immediate and significant impact on muscle activity and balance, which was restored by 13 weeks postoperation without specifically targeted stability rehabilitation.

Effects of Yoga on Quality of Life and Pain in Women With Chronic Pelvic Pain: Systematic Review and Meta-Analysis Background: Chronic pelvic pain (CPP) is a multifactorial condition affecting 20% of women in the United States. Treatment includes pharmacological interventions, physical therapy, and lifestyle modifications. Previous studies show yoga effectively managing low back pain and pregnancy-related low back and pelvic pain, yet evidence related to CPP is limited. Objective: To synthesize the existing literature on the effect of yoga on pain and quality of life (QOL) in women with CPP. Study Design: PubMed, PEDro, and CINAHL were searched for intervention studies that used yoga to treat women with CPP and reported pain and QOL outcomes. Methods: Effect sizes (ES) and 95% confidence intervals (CI) were calculated from study means and standard deviations for pain and QOL. Individual study ESs were pooled using the fixed-effects or random-effects models for within-group and between-group analyses. Results: Three studies met the inclusion criteria. Statistically significant improvements were seen following the yoga intervention for within-group analysis of QOL (ES =−1.4, CI: −1.8 to 1.1) and pain (ES: −2.2, CI: −2.7 to −1.6). Between-group analysis found statistically significant differences in QOL (ES =−1.5, CI: −2.0 to −1.0) and pain (ES = −1.4, CI: −1.7 to −1.0), favoring the yoga group. Studies varied in dosage and were of low to moderate quality. Conclusion: The results support the use of yoga to improve pain and QOL in women with CPP. Future studies should aim to determine the minimal dosage needed for a successful yoga intervention and use a randomized controlled design with assessor blinding to increase the quality of evidence.

Book Reviews No abstract available