Pregnancy leads to lasting changes in foot structure

Abstract

Objective: Women are disproportionately affected by musculoskeletal disorders. Parous women seem to be at a particularly elevated risk for structural and functional changes in the lower limbs. The combination of increased weight on the joints with potentially greater laxity during pregnancy could lead to permanent structural changes in the feet. Although arches may become lax during pregnancy, it is unknown whether the changes persist. The objective of this study was to determine whether arch height loss persists postpartum.

Design: Forty-nine women completed this longitudinal study. Static and dynamic arch measurements were collected in the first trimester and at 19 wks postpartum. Linear mixed models were used to determine whether outcome measures significantly changed overall or by parity.

Results: Arch height and rigidity indices significantly decreased, with concomitant increases in foot length and arch drop. The first pregnancy accounted for the reduction in arch rigidity and the increases in foot length and arch drop. No changes were detected in the center of pressure excursion index.

Conclusions: Pregnancy seems to be associated with a permanent loss of arch height, and the first pregnancy may be the most significant. These changes in the feet could contribute to the increased risk for musculoskeletal disorders in women. Further research should assess the efficacy of rehabilitative interventions for prevention of pregnancy-related arch drop.

Figures

Figure 1

Summary of participant involvement

Figure 2

Arch Height Index Measurement System (AHIMS) for arch height measurement during weight bearing and non-weight bearing conditions

Figure 3

Measurements of arch function (a) pressure platform (top left), (b) foot pressures during walking (bottom left), and (c) center of pressure excursion (black line on right)

Figure 4

Distribution of changes in (a) foot length, (b) arch drop, (c) sitting Arch Height Index (AHI), (d) standing AHI, and (e) Arch Rigidity Index (ARI) (Darker shaded bars indicate the direction of structural loss)

Figure 4

Distribution of changes in (a) foot length, (b) arch drop, (c) sitting Arch Height Index (AHI), (d) standing AHI, and (e) Arch Rigidity Index (ARI) (Darker shaded bars indicate the direction of structural loss)

Figure 4

Distribution of changes in (a) foot length, (b) arch drop, (c) sitting Arch Height Index (AHI), (d) standing AHI, and (e) Arch Rigidity Index (ARI) (Darker shaded bars indicate the direction of structural loss)

Figure 4

Distribution of changes in (a) foot length, (b) arch drop, (c) sitting Arch Height Index (AHI), (d) standing AHI, and (e) Arch Rigidity Index (ARI) (Darker shaded bars indicate the direction of structural loss)

Figure 4

Distribution of changes in (a) foot length, (b) arch drop, (c) sitting Arch Height Index (AHI), (d) standing AHI, and (e) Arch Rigidity Index (ARI) (Darker shaded bars indicate the direction of structural loss)