Posture and Gait Biomechanical Aspects during Pregnancy and the Importance of Therapeutic Exercise: Literature Review

The purpose of this study was to analyze studies that have investigated posture and gait during pregnancy and the importance of exercise. For this purpose, a systematic literature search was conducted on the following electronic databases: Scielo, Scopus, Embase, Pubmed, and Medline. Gait biomechanics, posture, lower limb alignment, postural balance, and physical exercise studies from 1943 to 2014 were accepted as potentially relevant for inclusion in this review. In general, posture studies showed that pregnant women demonstrated pain and discomfort in the pelvis and lumbar spine during pregnancy and after childbirth. Static posture changes, such as increased lumbar and thoracic curvatures during pregnancy and up to two months after childbirth, pelvic anteversion, and stretching of the abdominal musculature resulted in reduced functional stability of the hip. The lower limb alignment studies showed hyperextension or valgus knee and decreased longitudinal arch with increased support bases and distances between the feet. Postural balance studies showed that postural stability decreased during pregnancy and after childbirth, leading to an increased risk of falls. Gait studies showed a pattern of feet rollover with greater stance phase duration, a decrease of plantar flexion and propulsion force associated with increased hip flexion, as well as extensor and abductor moments. Other changes were characterized by greater anterior-posterior and medial-lateral sway with increased plantar load over the forefoot and rearfoot areas. Gait training and resistance exercises at moderate intensity showed to be low-cost aerobic exercises with positive therapeutic effects to reduce the risk of pre-eclampsia and gestational diabetes mellitus. However, no studies were found regarding the therapeutic effects of exercise to improve the biomechanical aspects of posture, specially lumbar curvature, knee angle and plantar arch, and of gait, such as propulsion, hip angle and overload feet in pregnant women.