Influence of unstable shoes on women with lumbopelvic postpartum pain
randomized clinical trial
Palavras-chave:
Postpartum period, Low back pain, Shoes, PregnancyResumo
BACKGROUND: Back pain is a normal symptom during pregnancy and is expected to become worse beyond the first three months after childbirth. OBJECTIVES: To determine the effectiveness of wearing unstable shoes instead of conventional shoes, regarding pain intensity, low back mobility and stability, among women with lumbopelvic pain (LPP) during the postpartum period. DESIGN AND SETTING: Prospective, single-blinded, randomized clinical trial conducted at a podiatry and physiotherapy clinical center. METHODS: A nine-week program of wearing either unstable shoes (A) or conventional shoes (B) was implemented. The following outcomes were measured in three assessments: pain intensity, using a visual analogue scale (VAS); low-back mobility, using a modified Schober test; and stability, using a pressure platform. RESULTS: The lateral stability speed, anterior stability speed and anterior center of pressure (COP) showed significant (P < 0.05) decreases in the unstable shoes group after nine weeks, in relation to the conventional group. Intra-group measurements showed significant differences (P < 0.05) in VAS between the second and third assessments and between the first and third assessments in both groups. Intra-group evaluations also showed statistically significant differences (P < 0.05) in the lateral stability speed and anterior stability speed. CONCLUSIONS: Unstable shoes were effective in decreasing the pain intensity at five and nine weeks in women with postpartum LPP. In addition, their use produced decreases in lateral stability speed, anteriorstability speed and anterior COP at nine weeks.
Downloads
Referências
Ostgaard HC, Zetherström G, Roos-Hansson E. Back pain in relation to pregnancy: a 6-year follow-up. Spine (Phila Pa 1976). 1997;22(24):2945-50. PMID: 9431631; https://doi.org/10.1097/00007632-199712150-00018.
Norén L, Ostgaard S, Johansson G, Ostgaard HC. Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up. Eur Spine J. 2002;11(3):267-71. PMID: 12107796; https://doi.org/10.1007/s00586-001-0357-7.
Albert H, Godskesen M, Westergaard J. Prognosis in four syndromes of pregnancy-related pelvic pain. Acta Obstet Gynecol Scand. 2001;80(6):505-10. PMID: 11380285.
Lopez-Lopez D, Vilar-Fernandez JM, Calvo-Lobo C, et al. Evaluation of Depression in Subacute Low Back Pain: A Case Control Study. Pain Physician. 2017;20(4):E499-E505. PMID: 28535558.
Gutke A, Lundberg M, Östgaard HC, Öberg B. Impact of postpartum lumbopelvic pain on disability, pain intensity, health-related quality of life, activity level, kinesiophobia, and depressive symptoms. Eur Spine J. 2011;20(3):440-8. PMID: 20593205; https://doi.org/10.1007/s00586-010-1487-6.
Fritz JM, Delitto A, Erhard RE. Comparison of classification-based physical therapy with therapy based on clinical practice guidelines for patients with acute low back pain: a randomized clinical trial. Spine (Phila Pa 1976). 2003;28(13):1363-71; discussion 1372. PMID: 12838091; https://doi.org/10.1097/01.BRS.0000067115.61673.FF.
Bastiaenen CH, de Bie RA, Wolters PM, et al. Effectiveness of a tailor-made intervention for pregnancy-related pelvic girdle and/or low back pain after delivery: short-term results of a randomized clinical trial [ISRCTN08477490]. BMC Musculoskelet Disord. 2006;7:19. PMID: 16504165; https://doi.org/10.1186/1471-2474-7-19.
Hodges PW, Richardson CA. Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb. J Spinal Disord. 1998;11(1):46-56. PMID: 9493770.
Teyhen DS, Rieger JL, Westrick RB, et al. Changes in deep abdominal muscle thickness during common trunk-strengthening exercises using ultrasound imaging. J Orthop Sports Phys Ther. 2008;38(10):596-605. PMID: 18827329; https://doi.org/10.2519/jospt.2008.2897.
Sihawong R, Janwantanakul P, Jiamjarasrangsi W. A prospective, cluster-randomized controlled trial of exercise program to prevent low back pain in office workers. Eur Spine J. 2014;23(4):786-93. PMID: 24492949; https://doi.org/10.1007/s00586-014-3212-3.
Brumitt J, Matheson JW, Meira EP. Core stabilization exercise prescription, part 2: a systematic review of motor control and general (global) exercise rehabilitation approaches for patients with low back pain. Sports Health. 2013;5(6):510-3. PMID: 24427425; https://doi.org/10.1177/1941738113502634.
Stuge B, Laerum E, Kirkesola G, Vøllestad N. The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: a randomized controlled trial. Spine (Phila Pa 1976). 2004;29(4):351-9. PMID: 15094530; https://doi.org/10.1097/01.brs.0000090827.16926.1d.
Romkes J, Rudmann C, Brunner R. Changes in gait and EMG when walking with the Masai Barefoot Technique. Clin Biomech (Bristol, Avon). 2006;21(1):75-81. PMID: 16169641; https://doi.org/10.1016/j.clinbiomech.2005.08.003.
Nigg B, Hintzen S, Ferber R. Effect of an unstable shoe construction on lower extremity gait characteristics. Clin Biomech (Bristol, Avon). 2006;21(1):82-8. PMID: 16209901; https://doi.org/10.1016/j.clinbiomech.2005.08.013.
Nigg BM, Davis E, Lindsay D, Emery C. The effectiveness of an unstable sandal on low back pain and golf performance. Clin J Sport Med. 2009;19(6):464-70. PMID: 19898073; https://doi.org/10.1097/JSM.0b013e3181c0a96f.
Lisón JF, Pérez-Soriano P, Llana-Belloch S, Sánchez-Zuriaga D, Salvador-Coloma P. Effects of unstable shoes on trunk muscle activity and lumbar spine kinematics. Eur J Phys Rehabil Med. 2016;52(4):440-6. PMID: 25854301.
Armand S, Tavcar Z, Turcot K, et al. Effects of unstable shoes on chronic low back pain in health professionals: a randomized controlled trial. Joint Bone Spine. 2014;81(6):527-32. PMID: 24985691; https://doi.org/10.1016/j.jbspin.2014.05.006.
Shim MJ, Lee YS, Oh HE, Kim JS. Effects of a back-pain-reducing program during pregnancy for Korean women: a non-equivalent control-group pretest-posttest study. Int J Nurs Stud. 2007;44(1):19-28. PMID: 16386740; https://doi.org/10.1016/j.ijnurstu.2005.11.016.
Stewart L, Gibson JN, Thomson CE. In-shoe pressure distribution in “unstable” (MBT) shoes and flat-bottomed training shoes: a comparative study. Gait Posture. 2007;25(4):648-51. PMID: 16901702; https://doi.org/10.1016/j.gaitpost.2006.06.012.
Goddard G, Karibe H, McNeill C. Reproducibility of visual analog scale (VAS) pain scores to mechanical pressure. Cranio. 2004 Jul;22(3):250-6. PMID: 15293781; https://doi.org/10.1179/crn.2004.030.
Tousignant M, Poulin L, Marchand S, Viau A, Place C. The Modified-Modified Schober Test for range of motion assessment of lumbar flexion in patients with low back pain: a study of criterion validity, intra- and inter-rater reliability and minimum metrically detectable change. Disabil Rehabil. 2005 May 20;27(10):553-9. PMID: 16019864; https://doi.org/10.1080/09638280400018411.
Lafond D, Corriveau H, Hébert R, Prince F. Intrasession reliability of center of pressure measures of postural steadiness in healthy elderly people. Arch Phys Med Rehabil. 2004;85(6):896-901. PMID: 15179642; https://doi.org/10.1016/j.apmr.2003.08.089.
Vieira ER, Brunt D. Does wearing unstable shoes reduce low back pain and disability in nurses? A randomized controlled pilot study. Clin Rehabil. 2016 Feb;30(2):167-73. PMID: 25780261; https://doi.org/10.1177/0269215515576812.
Hodges PW, Moseley GL. Pain and motor control of the lumbopelvic region: effect and possible mechanisms. J Electromyogr Kinesiol. 2003;13(4):361-70. PMID: 12832166; https://doi.org/10.1016/s1050-6411(03)00042-7.
Nigg BM, Emery C, Hiemstra LA. Unstable shoe construction and reduction of pain in osteoarthritis patients. Med Sci Sports Exerc. 2006;38(10):1701-8. PMID: 17019290; https://doi.org/10.1249/01.mss.0000228364.93703.53.
Sánchez-Sáez JM, Palomo-López P, Becerro-de-Bengoa-Vallejo R, et al. Stability of Three Different Sanitary Shoes on Healthcare Workers: A Cross-Sectional Study. Int J Environ Res Public Health. 2019;16(12):2126. PMID: 31208123; https://doi.org/10.3390/ijerph16122126.
Ruhe A, Fejer R, Walker B. Center of pressure excursion as a measure of balance performance in patients with non-specific low back pain compared to healthy controls: a systematic review of the literature. Eur Spine J. 2011;20(3):358-68. PMID: 20721676; https://doi.org/10.1007/s00586-010-1543-2.
Taniguchi M, Fukumoto Y, Kobayashi M, et al. Quantity and Quality of the Lower Extremity Muscles in Women with Knee Osteoarthritis. Ultrasound Med Biol. 2015t;41(10):2567-74. PMID: 26099784; https://doi.org/10.1016/j.ultrasmedbio.2015.05.014.
Alonso-Montero C, Torres-Rubio A, Padrós-Flores N, Navarro-Flores E, Segura-Heras JV. Footprint Curvature in Spanish Women: Implications for Footwear Fit. Int J Environ Res Public Health. 2020;17(6):1876. PMID: 32183182; https://doi.org/10.3390/ijerph17061876.
Downloads
Publicado
Como Citar
Edição
Seção
Licença

Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.