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Changes in the Plantar Pressure Distribution During Gait Throughout Gestation

Ana Paula Ribeiro Physical Therapy, Speech, and Occupational Therapy Department, School of Medicine, University of São Paulo, São Paulo, Brazil.

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Francis Trombini-Souza Physical Therapy, Speech, and Occupational Therapy Department, School of Medicine, University of São Paulo, São Paulo, Brazil.

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Isabel de Camargo Neves Sacco Physical Therapy, Speech, and Occupational Therapy Department, School of Medicine, University of São Paulo, São Paulo, Brazil.

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Rodrigo Ruano Obstetrics and Gynecology Department, University of São Paulo, São Paulo, Brazil.

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Marcelo Zugaib Obstetrics and Gynecology Department, University of São Paulo, São Paulo, Brazil.

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Sílvia Maria Amado João Physical Therapy, Speech, and Occupational Therapy Department, School of Medicine, University of São Paulo, São Paulo, Brazil.

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Background:

The intention of this investigation was to longitudinally describe and compare the plantar pressure distribution in orthostatic posture and gait throughout pregnancy.

Methods:

A prospective longitudinal observational study was conducted with six pregnant women (mean ± SD age, 32 ± 3 years) with a mean ± SD weight gain of 10.0 ± 1.4 kg. Peak pressure, contact time, contact area, and maximum force in five plantar areas were evaluated using capacitive insoles during gait and orthostatic posture. For 1 year, the plantar pressures of pregnant women were evaluated the last month of each trimester. Comparisons among plantar areas and trimesters were made by analysis of variance.

Results:

For orthostatic posture, no differences in contact time, contact area, peak pressure, and maximum force throughout the trimesters were found. During gait, peak pressure and maximum force of the medial rearfoot were reduced from the first to third and second to third trimesters. Maximum force increased at the medial forefoot from the first to second trimester. Contact area increased at the lateral rearfoot from the second to third trimester and at the midfoot from the first to third trimester. Contact time increased at the midfoot and medial and lateral forefoot from the first to third trimester.

Conclusions:

Pregnant women do not alter plantar pressure during orthostatic posture, but, during gait, the plantar loads were redistributed from the rearfoot (decrease) to the midfoot and forefoot (increase) throughout pregnancy. These adjustments help maintain the dynamic stability of the pregnant woman during locomotion. (J Am Podiatr Med Assoc 101(5): 415–423, 2011)

Corresponding author: Ana Paula Ribeiro, Physical Therapy, Speech, and Occupational Therapy Department, School of Medicine, University of São Paulo, R. Cipotânia, 51, Cidade Universitária – São Paulo – SP, Brasil, 056360–160. (E-mail: apribeiro@usp.br or anapaulafisioterapia@yahoo.com.br)
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