Effect of Antenatal Pilates on Centre of Pressure Sway Velocity and its Correlation with the Intensity of Low Back Pain
DOI:
https://doi.org/10.47197/retos.v67.114038Keywords:
Antenatal Exercises, Centre of Pressure, Low Back Pain, Maternal Health, Pilates, Postural ControlAbstract
Introduction: Pilates have been shown to lower the risk of falls. Also, the intensity of low back pain (LBP) may affect the postural control.
Objective: To determine the impact of antenatal Pilates on postural control of the pregnant females and whether it is affected by the severity of LBP.
Methodology: A randomized controlled trial. The participants (18-35 years) were randomly allocated into two groups (31 in each group: Intervention group and Control group). The sway velocity of the centre of pressure was determined. The Visual Analogue Scale (VAS) was utilised to evaluate the severity of low back pain.
Results: A 2x2 mixed ANOVA showed significant results for average velocity of centre of pressure measured during eyes closed on hard surface (F= 8.743, ηp2 = 0.160, p = 0.005), eyes open on foam surface (F= 9.877, ηp2 = 0.177, p = 0.003) and eyes closed on foam surface (F= 19.937, ηp2 = 0.302, p = 0.001) The posttest VAS scores weakly to moderately correlated with the average velocity of postural sway during the third trimester.
Discussion: The static posture control of a pregnant lady is expected to deteriorate from second to third trimester. Pilates exercises enhances proprioceptive feedback and postural control by specifically targeting the core and pelvic floor muscles.
Conclusion: Pilates help pregnant women retain postural stability. This impact was greatest when the participants were tested on an unsteady surface without visual input. During third trimester, LBP severity and postural sway are weakly to moderately correlated.
References
Balogh, A. (2005). Pilates and pregnancy. RCM Midwives: The Official Journal of the Royal College of Midwives, 8(5), 220–222.
Beaupré, P., Da Silva, R. A., & Chevrette, T. (2022). The Impact of Pain on Functionality, Postural Con-trol and Fall Risk in Woman Aged 45 to 64 Years Old. Geriatrics, 7(1), 10. https://doi.org/10.3390/geriatrics7010010
Beserra Da Silva, R., Costa-Paiva, L., Siani Morais, S., Mezzalira, R., Oliveira Ferreira, N. D., & Mendes Pinto-Neto, A. (2010). Predictors of falls in women with and without osteoporosis. Journal of Orthopaedic & Sports Physical Therapy, 40(9), 582–588. https://doi: 10.2519/jospt.2010.3239
Borg-Stein, J., & Dugan, S. A. (2007). Musculoskeletal disorders of pregnancy, delivery and postpartum. Physical Medicine and Rehabilitation Clinics of North America, 18(3), 459–476. https://doi: 10.1016/j.pmr.2007.05.005
Borg-Stein, J., Dugan, S. A., & Gruber, J. (2005). Musculoskeletal aspects of pregnancy. American Journal of Physical Medicine & Rehabilitation, 84(3), 180–192. https://doi: 10.1097/01.PHM.0000156970.96219.48
Bulguroğlu, H. İ., Bulguroğlu, M., Özkul, Ç., & Güçlü Gündüz, A. (2023). Investigation of the Effect of Pila-tes Exercises on Postural Stability and Fear of Birth in Pregnancy. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 7(3), 530–540. https://doi.org/10.46237/amusbfd.1253720
Burke, T. N., França, F. J. R., Meneses, S. R. F. D., Cardoso, V. I., Pereira, R. M. R., Danilevicius, C. F., & Marques, A. P. (2010). Postural control among elderly women with and without osteoporosis: Is there a difference? Sao Paulo Medical Journal, 128(4), 219–224. https://doi.org/10.1590/S1516-31802010000400009
Butler, E. E., Colón, I., Druzin, M. L., & Rose, J. (2006). Postural equilibrium during pregnancy: Decreased stability with an increased reliance on visual cues. American Journal of Obstetrics and Gynecol-ogy, 195(4), 1104–1108. https://doi.org/10.1016/j.ajog.2006.06.015
Cakmak, B., Inanir, A., Nacar, M. C., & Filiz, B. (2014). The Effect of Maternity Support Belts on Postural Balance in Pregnancy. PM&R, 6(7), 624–628. https://doi.org/10.1016/j.pmrj.2013.12.012
Cakmak, B., Ribeiro, A. P., & Inanir, A. (2016). Postural balance and the risk of falling during pregnancy. The Journal of Maternal-Fetal & Neonatal Medicine, 29(10), 1623–1625. https://doi: 10.3109/14767058.2015.1057490
Carvalho, A. P. F., Dufresne, S. S., Oliveira, M. R. D., Beraldo, F. K. S., Souza, P. E. A. D., Silva, R. S. D., Dubois, M., Dallaire, M., Ngomo, S., & Jr, R. A. D. S. (2020). Pregnant and non-pregnant women and low back pain-related differences on postural control measures during different balance tasks. Manual Therapy, Posturology & Rehabilitation Journal, 1–7. https://doi.org/10.17784/mtprehabjournal.2019.17.755
Chung, S., Lee, J., & Yoon, J. (2013). Effects of stabilization exercise using a ball on mutifidus cross-sectional area in patients with chronic low back pain. Journal of Sports Science & Medicine, 12(3), 533.
https://pmc.ncbi.nlm.nih.gov/articles/PMC3772599/
Conder, R., Zamani, R., & Akrami, M. (2019). The Biomechanics of Pregnancy: A Systematic Review. Journal of Functional Morphology and Kinesiology, 4(4), 72. https://doi.org/10.3390/jfmk4040072
Corbeil, P., Simoneau, M., Rancourt, D., Tremblay, A., & Teasdale, N. (2001). Increased risk for falling associated with obesity: Mathematical modeling of postural control. IEEE Transactions on Neu-ral Systems and Rehabilitation Engineering, 9(2), 126–136. https://doi.org/10.1109/7333.928572
Cordeiro, C. C., Brasil, D. P., & Gonçalves, D. C. (2018). Os benefícios do Método Pilates no período gestacional: Uma revisão bibliográfica. Scire Salutis, 8(2), 98–103.
Danna-Dos-Santos, A., Magalhães, A. T., Silva, B. A., Duarte, B. S., Barros, G. L., Silva, M. D. F. C., Silva, C. S., Mohapatra, S., Degani, A. M., & Cardoso, V. S. (2018). Upright balance control strategies during pregnancy. Gait & Posture, 66, 7–12. https://doi.org/10.1016/j.gaitpost.2018.08.004
Davies, J., Fernando, R., McLeod, A., Verma, S., & Found, P. (2002). Postural Stability following Ambula-tory Regional Analgesia for Labor. Anesthesiology, 97(6), 1576–1581. https://doi.org/10.1097/00000542-200212000-00033
De Campos Júnior, J. F., De Oliveira, L. C., Dos Reis, A. L., De Almeida, L. I. M., Branco, L. V., & De Oliveira, R. G. (2024). Effects of Pilates exercises on postural balance and reduced risk of falls in older adults: A systematic review and meta-analysis. Complementary Therapies in Clinical Practice, 57, 101888. https://doi.org/10.1016/j.ctcp.2024.101888
Dillard, D. M. (2013). Perinatal Pilates. International Journal of Childbirth Education, 28(1), 20-25.
Donatoni Da Silva, L., Shiel, A., & McIntosh, C. (2022). Effects of Pilates on the risk of falls, gait, balance and functional mobility in healthy older adults: A randomised controlled trial. Journal of Body-work and Movement Therapies, 30, 30–41. https://doi.org/10.1016/j.jbmt.2022.02.020
Dunning, K., LeMasters, G., & Bhattacharya, A. (2010). A Major Public Health Issue: The High Incidence of Falls During Pregnancy. Maternal and Child Health Journal, 14(5), 720–725. https://doi.org/10.1007/s10995-009-0511-0
Dunning, K., LeMasters, G., Levin, L., Bhattacharya, A., Alterman, T., & Lordo, K. (2003). Falls in workers during pregnancy: Risk factors, job hazards, and high risk occupations. American Journal of In-dustrial Medicine, 44(6), 664–672. https://doi.org/10.1002/ajim.10318
El Kady, D., Gilbert, W. M., Anderson, J., Danielsen, B., Towner, D., & Smith, L. H. (2004). Trauma during pregnancy: An analysis of maternal and fetal outcomes in a large population. American Journal of Obstetrics and Gynecology, 190(6), 1661–1668. https://doi.org/10.1016/j.ajog.2004.02.051
El-shamy, F. F., Ribeiro, A. P., & Abo Gazia, A. A. (2019). Effectiveness of proprioceptive training on dy-namic postural balance during pregnancy: A randomized controlled trial. Physiotherapy Prac-tice and Research, 40(1), 77–85. https://doi.org/10.3233/PPR-180128
Goldsmith, L. T., & Weiss, G. (2009). Relaxin in Human Pregnancy. Annals of the New York Academy of Sciences, 1160(1), 130–135. https://doi.org/10.1111/j.1749-6632.2008.03800.x
Greig, A. M., Bennell, K. L., Briggs, A. M., Wark, J. D., & Hodges, P. W. (2007). Balance impairment is relat-ed to vertebral fracture rather than thoracic kyphosis in individuals with osteoporosis. Osteo-porosis International, 18(4), 543–551. https://doi.org/10.1007/s00198-006-0277-9
Gutke, A., Östgaard, H. C., & Öberg, B. (2008). Association between muscle function and low back pain in relation to pregnancy. Journal of Rehabilitation Medicine, 40(4), 304–311. https://doi.org/10.2340/16501977-0170
Hamaoui, A., Friant, Y., & Le Bozec, S. (2011). Does increased muscular tension along the torso impair postural equilibrium in a standing posture? Gait & Posture, 34(4), 457–461. https://doi.org/10.1016/j.gaitpost.2011.06.017
Hrvatin, I., & Rugelj, D. (2021). Risk factors for accidental falls during pregnancy – a systematic litera-ture review. The Journal of Maternal-Fetal & Neonatal Medicine, 1–10. https://doi.org/10.1080/14767058.2021.1935849
Hrvatin, I., Rugelj, D., & Šćepanović, D. (2024). Pregnancy-related pelvic girdle pain affects balance in the second and third trimesters of pregnancy. PLOS ONE, 19(3), e0287221. https://doi.org/10.1371/journal.pone.0287221
Hyun, A.-H., & Jeon, Y.-J. (2020). Effect of mat pilates on body fluid composition, pelvic stabilization, and muscle damage during pregnancy. Applied Sciences (Switzerland), 10(24), 1–14. https://doi.org/10.3390/app10249111
Inanir, A., Cakmak, B., Hisim, Y., & Demirturk, F. (2014). Evaluation of postural equilibrium and fall risk during pregnancy. Gait & Posture, 39(4), 1122–1125. https://doi.org/10.1016/j.gaitpost.2014.01.013
Jang, J., Hsiao, K. T., & Hsiao-Wecksler, E. T. (2008). Balance (perceived and actual) and preferred stance width during pregnancy. Clinical Biomechanics, 23(4), 468–476. https://doi.org/10.1016/j.clinbiomech.2007.11.011
Jeka, J., Kiemel, T., Creath, R., Horak, F., & Peterka, R. (2004). Controlling Human Upright Posture: Ve-locity Information Is More Accurate Than Position or Acceleration. Journal of Neurophysiology, 92(4), 2368–2379. https://doi.org/10.1152/jn.00983.2003
Kaya, D. O., Duzgun, I., Baltaci, G., Karacan, S., & Colakoglu, F. (2012). Effects of calisthenics and pilates exercises on coordination and proprioception in adult women: A randomized controlled trial. Journal of Sport Rehabilitation, 21(3), 235–243. https://doi.org/10.1123/jsr.21.3.235
Kinser, P. A., Pauli, J., Jallo, N., Shall, M., Karst, K., Hoekstra, M., & Starkweather, A. (2017). Physical Ac-tivity and Yoga-Based Approaches for Pregnancy-Related Low Back and Pelvic Pain. Journal of Obstetric, Gynecologic & Neonatal Nursing, 46(3), 334–346. https://doi.org/10.1016/j.jogn.2016.12.006
Kuo, C., Jamieson, D. J., McPheeters, M. L., Meikle, S. F., & Posner, S. F. (2007). Injury hospitalizations of pregnant women in the United States, 2002. American Journal of Obstetrics and Gynecology, 196(2), 161.e1-161.e6. https://doi.org/10.1016/j.ajog.2006.09.015
La Touche, R., Escalante, K., & Linares, M. T. (2008). Treating non-specific chronic low back pain through the Pilates Method. Journal of Bodywork and Movement Therapies, 12(4), 364–370. https://doi.org/10.1016/j.jbmt.2007.11.004
Lim, H. S., Kim, Y. L., & Lee, S. M. (2016). The effects of Pilates exercise training on static and dynamic balance in chronic stroke patients: A randomized controlled trial. Journal of Physical Therapy Science, 28(6), 1819–1824. https://doi.org/10.1589/jpts.28.1819
Lira, S. O. R., Sousa, V. P. S. D., Medeiros, C. N. A., & Viana, E. D. S. R. (2019). Impact of lumbopelvic pain on postural balance during sit-to-stand activity in pregnant women: A cross-sectional study. Fisioterapia Em Movimento, 32, e003221. https://doi.org/10.1590/1980-5918.032.ao21
Malhotra, D., Khan, A. R., Nigam, A., Khan, A., & Jaleel, G. (2025). Effectiveness of Pilates in pregnancy: A review. Sport Sciences for Health. https://doi.org/10.1007/s11332-025-01373-2
Martin C, A., Alvares R, F., Nascimento T, R., Paranaiba Ss, W., Silva Morais T, K. D., & Santos D, C. (2017). Pilates for Pregnant Women: A Healthy Alternative. Journal of Womens Health Care, 06(02). https://www.longdom.org/open-access-pdfs/pilates-for-pregnant-women-a-healthy-alternative-2167-0420-1000366.pdf
McCrory, J., Chambers, A., Daftary, A., & Redfern, M. S. (2010). Dynamic postural stability in pregnant fallers and non-fallers. BJOG: An International Journal of Obstetrics & Gynaecology, 117(8), 954–962. https://doi.org/10.1111/j.1471-0528.2010.02589.x
McCrory, J. L., Chambers, A. J., Daftary, A., & Redfern, M. S. (2010). Dynamic postural stability during advancing pregnancy. Journal of Biomechanics, 43(12), 2434–2439. https://doi.org/10.1016/j.jbiomech.2009.09.058
Mientjes, M., & Frank, J. (1999). Balance in chronic low back pain patients compared to healthy people under various conditions in upright standing. Clinical Biomechanics, 14(10), 710–716. https://doi.org/10.1016/S0268-0033(99)00025-X
Mirmolaei, S. T., Nakhostin Ansari, N., Mahmoudi, M., & Ranjbar, F. (2017). Efficacy of a Physical Train-ing Program on Pregnancy Related Lumbopelvic Pain. International Journal of Women’s Health and Reproduction Sciences, 6(2), 161–165. https://doi.org/10.15296/ijwhr.2018.27
Mirza, F., Devine, P., & Gaddipati, S. (2010). Trauma in Pregnancy: A Systematic Approach. American Journal of Perinatology, 27(07), 579–586. https://doi.org/10.1055/s-0030-1249358
Moreira, L. S., Elias, L. A., Gomide, A. B., Vieira, M. F., & DO Amaral, W. N. (2017). A longitudinal assess-ment of myoelectric activity, postural sway, and low-back pain during pregnancy. Acta of bio-engineering and biomechanics, 19(3), 77–83.
Nagai, M., Isida, M., Saitoh, J., Hirata, Y., Natori, H., & Wada, M. (2009). Characteristics of the control of standing posture during pregnancy. Neuroscience Letters, 462(2), 130–134. https://doi.org/10.1016/j.neulet.2009.06.091
Oktaviani, I. (2018). Pilates workouts can reduce pain in pregnant women. Complementary Therapies in Clinical Practice, 31, 349–351. https://doi.org/10.1016/j.ctcp.2017.11.007
Oliveira, L. F., Vieira, T. M. M., Macedo, A. R., Simpson, D. M., & Nadal, J. (2009). Postural sway changes during pregnancy: A descriptive study using stabilometry. European Journal of Obstetrics & Gynecology and Reproductive Biology, 147(1), 25–28. https://doi.org/10.1016/j.ejogrb.2009.06.027
Olsson, C., & Lena, N.-W. (2004). Health-related quality of life and physical ability among pregnant women with and without back pain in late pregnancy. Acta Obstetricia et Gynecologica Scandi-navica, 83(4), 351–357. https://doi.org/10.1111/j.0001-6349.2004.00384.x
Opala-Berdzik, A., Bacik, B., Markiewicz, A., Cieślińska-Świder, J., Świder, D., Sobota, G., & Błaszczyk, J. W. (2014). Comparison of Static Postural Stability in Exercising and Non-Exercising Women During the Perinatal Period. Medical Science Monitor, 20, 1865–1870. https://doi.org/10.12659/MSM.890846
Öztürk, G., Geler Külcü, D., Aydoğ, E., Kaspar, Ç., & Uğurel, B. (2016). Effects of lower back pain on pos-tural equilibrium and fall risk during the third trimester of pregnancy. The Journal of Maternal-Fetal & Neonatal Medicine, 29(8), 1358–1362. https://doi.org/10.3109/14767058.2015.1049148
Park, J., Nguyen, V. Q., Ho, R. L. M., & Coombes, S. A. (2023). The effect of chronic low back pain on pos-tural control during quiet standing: A meta-analysis. Scientific Reports, 13(1), 7928. https://doi.org/10.1038/s41598-023-34692-w
Pata, R. W., Lord, K., & Lamb, J. (2014). The effect of Pilates based exercise on mobility, postural stabil-ity, and balance in order to decrease fall risk in older adults. Journal of Bodywork and Move-ment Therapies, 18(3), 361–367. https://doi.org/10.1016/j.jbmt.2013.11.002
Perfeito, R. S., Allevato, L., & da Silva Silveira, D. (2019). Effects of the practice of Pilates in pregnancy: A literature review. Revista Saúde Física & Mental-ISSN 2317-1790, 7(2), 30–44.
https://revista.uniabeu.edu.br/index.php/SFM/article/view/3819
Pivarnik, J. M., Chambliss, H. O., Clapp, J. F., Dugan, S. A., Hatch, M. C., Lovelady, C. A., Mottola, M.F., & Williams, M. A. (2006). Impact of physical activity during pregnancy and postpartum on chron-ic disease risk: Roundtable consensus statement. Med. Sci. Sports Exer, 38, 989–1006.
Ratnani, G. R., Patil, S., Phansopkar, P., & Deshmukh, N. S. (2023). A Comparative Study of Knee Joint Proprioception Assessment in 12-Week Postpartum Women and Nulliparous Women. Cureus. https://doi.org/10.7759/cureus.48101
Roshko, J., Stefańska, M., & Skrzek, A. (2024). Impact of physical activity on postural stability in preg-nant and postpartum women. Human Movement, 25(1), 37–47. https://doi.org/10.5114/hm.2024.136053
Schober, P., Boer, C., & Schwarte, L. A. (2018). Correlation Coefficients: Appropriate Use and Interpreta-tion. Anesthesia & Analgesia, 126(5), 1763–1768. https://doi.org/10.1213/ANE.0000000000002864
Schönbrodt, F. D., & Perugini, M. (2013). At what sample size do correlations stabilize? Journal of Re-search in Personality, 47(5), 609–612. https://doi.org/10.1016/j.jrp.2013.05.009
Segal, N. A., & Chu, S. R. (2015). Musculoskeletal anatomic, gait, and balance changes in pregnancy and risk for falls. Musculoskeletal Health in Pregnancy and Postpartum: An Evidence-Based Guide for Clinicians, 1–18. https://link.springer.com/chapter/10.1007/978-3-319-14319-4_1
Tan, E. K., & Tan, E. L. (2013). Alterations in physiology and anatomy during pregnancy. Best Practice & Research Clinical Obstetrics & Gynaecology, 27(6), 791–802. https://doi.org/10.1016/j.bpobgyn.2013.08.001
Tipton, N., Alderink, G., & Rhodes, S. (2023). Approximate Entropy and Velocity of Center of Pressure to Determine Postural Stability: A Pilot Study. Applied Sciences, 13(16), 9259. https://doi.org/10.3390/app13169259
Wakkar, A., & Patil, S. P. (2022). Assessment of knee and ankle proprioception during the third tri-mester of pregnancy and postpartum period among primiparous women: An observational longitudinal study. Journal of Education and Health Promotion, 11(1), 241. https://doi.org/10.4103/jehp.jehp_311_22
Walowska, J., Bolach, B., & Bolach, E. (2018). The influence of Pilates exercises on body balance in the standing position of hearing impaired people. Disability and Rehabilitation, 40(25), 3061–3069. https://doi.org/10.1080/09638288.2017.1370731
Wu, X., & Yeoh, H. T. (2014). Intrinsic Factors Associated with Pregnancy Falls. Workplace Health & Safety, 62(10), 403–408. https://doi.org/10.3928/21650799-20140902-04
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