Plantar Pressure Changes and Their Relationships with Low Back Pain during Pregnancy Using Instrumented Insoles

Abstract

Low back pain affects around 50% of pregnant women and presents significant morbidity and persistence for years in 20% of postpartum women who report that pain. Numerous studies have documented gait alterations during pregnancy and postpartum. Therefore, an analysis of the relationship between certain gait parameters and low back pain was attempted using low-cost validated instrumented insoles. This work presents a longitudinal cohort study carried out during routine gynecological follow-up visits in the first, second, and third trimesters of pregnancy at an Obstetrics and Gynecology Service. Sample size was 62. Plantar pressure data were collected with specially designed instrumented insoles containing four force sensors to measure peak pressure, center of pressure, and stance phase time in each foot and in each pregnancy trimester. The analysis was carried out on a two-dimensional level, simultaneously considering the data from both feet using Hotelling's T2 test. This longitudinal study detected relationships between certain gait parameter changes and low back pain during pregnancy. It revealed a cyclic tendency of low back pain prevalence with a maximum in the second trimester and a decrease in the third trimester, which was correlated with alterations of the pregnant gait: excessive foot pronation and rearfoot pressure increase.