Theoretical and experimental indicators of falls during pregnancy as assessed by postural perturbations

Details

• Personal Author:
  Ersal T ; McCrory JL ; Sienko KH
• Description:
  Throughout pregnancy, women experience physical, physiological, and hormonal alterations that are often accompanied by decreased postural control. According to one study, nearly 27% of pregnant women fell while pregnant. This study had two objectives: (1) to characterize the postural responses of pregnant fallers, nonfallers, and controls to surface perturbations, and (2) to develop a mathematical model to gain insights into the postural control strategies of each group. This retrospective analysis used experimental data obtained from 15 women with a fall history during pregnancy, 14 women without a fall history during pregnancy, and 40 nonpregnant controls. Small, medium, and large translational support surface perturbations in the anterior and posterior directions were performed during the pregnant participants' second and third trimesters. A two-segmented mathematical model of bipedal stance was developed and parameterized, and optimization tools were used to identify ankle and hip stiffness, viscosity, and the feedback time delay by searching for the best fits to experimental COP data. The peak differences between the center of pressure and center of gravity (COP-COG) values were significantly smaller for the pregnant fallers compared with the pregnant nonfallers and controls (p<0.01). Perturbation magnitude was a significant factor (p<0.01), but perturbation direction was not (p=0.24). Model fits were obtained with a mean goodness of fit value of R(2)=0.92. Theoretical results indicated that pregnant nonfallers had higher ankle stiffness compared with the pregnant fallers and the controls, which suggests that ankle stiffness itself may be the dominant reason for the different dynamic response characteristics (e.g., peak COP-COG) observed. We conclude that increasing ankle stiffness could be an important strategy to prevent falling by pregnant women. [Description provided by NIOSH]
• Subjects:
  Accidental Falls Accidents Biomechanical Phenomena Musculoskeletal System Occupational Health Pregnancy Safety Women
• Keywords:
  Author Keywords: Pregnancy Balance Biomechanics Body Distribution Body Mechanics Falls Mathematical-models Mathematical Modeling Perturbations Physiology Posture Walking Surfaces

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• ISSN:
  0966-6362
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Michigan ; OSHA Region 3 ; OSHA Region 5 ; Pennsylvania ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  218-223
• Volume:
  39
• Issue:
  1
• NIOSHTIC Number:
  nn:20044407
• Citation:
  Gait Posture 2014 Jan; 39(1):218-223
• Contact Point Address:
  Kathleen H. Sienko, Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA
• Email:
  sienko@umich.edu
• Federal Fiscal Year:
  2014
• Performing Organization:
  University of Pittsburgh
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Gait and Posture
• End Date:
  20081231
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:757e0bc964bddc2317cc385bd06649069b583ef2e2f4d063168193239ff0de21093de3d327b777a7678f863a4025b31dc05ac1689164c07eb94deff45417a968
• Download URL:
  https://stacks.cdc.gov/view/cdc/200114/cdc_200114_DS1.pdf
• File Type:
  [PDF - 503.19 KB ]