1,721,027 research outputs found
Body perception disturbances in women with pregnancy-related lumbopelvic pain and their role in the persistence of pain postpartum
No full textBACKGROUND: Lumbopelvic pain (LPP) is common during pregnancy and can have long-lasting negative consequences in terms of disability and reduced quality of life. Therefore, it is crucial to identify women at risk of having pregnancy-related LPP after childbirth. This study aimed to investigate the association between body perception, pain intensity, and disability in women with pregnancy-related LPP during late pregnancy and postpartum, and to study whether a disturbed body perception during late pregnancy predicted having postpartum LPP. METHODS: A prospective cohort study in 130 primiparous women (median age = 30 years) was performed. Pain intensity, disability, and lumbopelvic body perception during the last month of pregnancy and 6 weeks postpartum were assessed with the Numerical Pain Rating Scale (NPRS), Oswestry Disability Index, and Fremantle Back Awareness Questionnaire, respectively. Having pregnancy-related LPP was defined as an NPRS score ≥ 1/10. At both timepoints, women were categorized into three groups; pain-free, LPP with low disability, and LPP with high disability (based on Oswestry Disability Index scores). At each timepoint, body perception was compared between groups, and correlations between body perception, pain intensity, and disability were evaluated in women with LPP by using non-parametric tests. Logistic regression analysis was used to determine whether body perception during the last month of pregnancy predicted the presence of LPP 6 weeks postpartum. RESULTS: Women with LPP at the end of pregnancy, and 6 weeks postpartum reported a more disturbed body perception compared to pain-free women (p ≤ 0.005). Greater body perception disturbance correlated with higher pain intensity (σ = 0.266, p = 0.008) and disability (σ = 0.472, p < 0.001) during late pregnancy, and with pain intensity 6 weeks postpartum (σ = 0.403, p = 0.015). A disturbed body perception during late pregnancy nearly significantly predicted having postpartum LPP (Odds Ratio = 1.231, p = 0.052). CONCLUSIONS: Body perception disturbance was greater in women experiencing LPP during late pregnancy and postpartum compared to pain-free women, and correlated with pain intensity and disability. Though non-significant (p = 0.052), the results of the regression analysis suggest that greater body perception disturbance during late pregnancy might predict having LPP postpartum. However, future studies should follow up on this.sponsorship: This study was supported by the Competentiecentrum Kinesitherapie UZ/KU Leuven and the AXA Research Fund (Postdoctoral Fellowship of Nina Goossens). The funders played no role in the design, data collection, data analysis, interpretation of results, or writing of this study. (Competentiecentrum Kinesitherapie UZ/KU Leuven, AXA Research Fund (Postdoctoral Fellowship of Nina Goossens))status: Publishe
Disturbed proprioceptive weighting during postural control in pregnant women compared to non-pregnant controls
No full textBACKGROUND AND AIM: Falling during pregnancy can seriously harm mother and child, and should thus be avoided. However, 1/4 women report falling during pregnancy. Pregnant women show a decreased postural balance (i.e., greater sway variability and velocity), particularly during the second part of pregnancy. Unfortunately, the underlying mechanisms are poorly understood. Postural balance depends greatly on proprioceptive inputs from e.g., ankle and lumbar muscles. Depending on the postural condition, the brain will adjust the weight assigned to these inputs. For example during standing on unstable support surfaces, healthy individuals up-weight lumbar proprioception and down-weight ankle proprioception. So far, it remains unclear whether the weighting of ankle and lumbar proprioception during postural control differs in pregnant compared to non-pregnant women. METHODS: We recruited 12 pregnant, multiparous women in the third trimester, and 20 non-pregnant women. Exclusion criteria were a history of surgery/major trauma to spine, pelvis or lower limbs; specific balance or neurological disorders; and acute ankle problems. All women stood on a force plate (AMTI), with the heels 20 cm apart and vision occluded. After 20 s, muscle vibration (60 Hz, 15 s) was applied to the ankle or lumbar muscles. A stable and unstable support surface was used. Center-of-pressure (COP) displacements during vibration, and the Relative Proprioceptive Weighting (RPW) ratio, a measure of ankle vs. lumbar proprioceptive dominance, were calculated. Group differences in age, and pre-pregnancy BMI were determined with Mann-Whitney U tests, differences in COP displacement during vibration, and RPW ratio with mixed-design ANOVAs with "Surface" as the within-subjects factor, and "Pregnant" as the between-subjects factor. RESULTS: Pregnant women were significantly older (31 (30-34) vs. 28 (27-30) years, p= 0.004), and reported lumbopelvic pain more often (7/12 vs. 1/20, p= 0.002) than the non-pregnant controls. Pre-pregnancy BMI did not differ between groups (23.3 (21.4-27.2) vs. 22.4 (21.1-23.8), p= 0.219). For COP displacement during lumbar muscle vibration, a significant interaction effect of "Pregnant x Surface" was found (F= 8.157, p= 0.009). Post-hoc tests showed a significantly larger COP displacement during lumbar muscle vibration on the unstable compared to the stable support surface in the non-pregnant women (p< 0.001), but not in the pregnant group (p= 0.065). CONCLUSIONS: While non-pregnant women adequately up-weighted lumbar proprioception when switching from the stable to the unstable support surface, pregnant women did not show this increase in reliance on lumbar proprioception when needed. Future research must determine whether this decreased ability for proprioceptive re-weighting in pregnant women is already present in early pregnancy or even before conception, and whether it correlates to the presence of lumbopelvic pain and an increased risk of falling. ACKNOWLEDGEMENTS AND FUNDING: The authors wish to thank all participants. Nina Goossens is a beneficiary of an AXA Research Fund Postdoctoral Grant
Disturbed Body Perception in Primiparous Women with Prenatal Pregnancy-related Lumbopelvic Pain and its Potential Role in Pain Persistence
No full textDisturbed proprioceptive weighting during postural control in pregnant women compared to non-pregnant controls
No full textBACKGROUND AND AIM: Falling during pregnancy can seriously harm mother and child, and should thus be avoided. However, 1/4 women report falling during pregnancy. Pregnant women show a decreased postural balance (i.e., greater sway variability and velocity), particularly during the second part of pregnancy. Unfortunately, the underlying mechanisms are poorly understood. Postural balance depends greatly on proprioceptive inputs from e.g., ankle and lumbar muscles. Depending on the postural condition, the brain will adjust the weight assigned to these inputs. For example during standing on unstable support surfaces, healthy individuals up-weight lumbar proprioception and down-weight ankle proprioception. So far, it remains unclear whether the weighting of ankle and lumbar proprioception during postural control differs in pregnant compared to non-pregnant women. METHODS: We recruited 12 pregnant, multiparous women in the third trimester, and 20 non-pregnant women. Exclusion criteria were a history of surgery/major trauma to spine, pelvis or lower limbs; specific balance or neurological disorders; and acute ankle problems. All women stood on a force plate (AMTI), with the heels 20 cm apart and vision occluded. After 20 s, muscle vibration (60 Hz, 15 s) was applied to the ankle or lumbar muscles. A stable and unstable support surface was used. Center-of-pressure (COP) displacements during vibration, and the Relative Proprioceptive Weighting (RPW) ratio, a measure of ankle vs. lumbar proprioceptive dominance, were calculated. Group differences in age, and pre-pregnancy BMI were determined with Mann-Whitney U tests, differences in COP displacement during vibration, and RPW ratio with mixed-design ANOVAs with "Surface" as the within-subjects factor, and "Pregnant" as the between-subjects factor. RESULTS: Pregnant women were significantly older (31 (30-34) vs. 28 (27-30) years, p= 0.004), and reported lumbopelvic pain more often (7/12 vs. 1/20, p= 0.002) than the non-pregnant controls. Pre-pregnancy BMI did not differ between groups (23.3 (21.4-27.2) vs. 22.4 (21.1-23.8), p= 0.219). For COP displacement during lumbar muscle vibration, a significant interaction effect of "Pregnant x Surface" was found (F= 8.157, p= 0.009). Post-hoc tests showed a significantly larger COP displacement during lumbar muscle vibration on the unstable compared to the stable support surface in the non-pregnant women (p< 0.001), but not in the pregnant group (p= 0.065). CONCLUSIONS: While non-pregnant women adequately up-weighted lumbar proprioception when switching from the stable to the unstable support surface, pregnant women did not show this increase in reliance on lumbar proprioception when needed. Future research must determine whether this decreased ability for proprioceptive re-weighting in pregnant women is already present in early pregnancy or even before conception, and whether it correlates to the presence of lumbopelvic pain and an increased risk of falling. ACKNOWLEDGEMENTS AND FUNDING: The authors wish to thank all participants. Nina Goossens is a beneficiary of an AXA Research Fund Postdoctoral Grant
Pregnancy-Related Lumbopelvic Pain and its Relationship with Postural Control in Multigravid Pregnant Women
No full textBackground and Aims: Pregnancy-related lumbopelvic pain (PLPP) affects 50-90% of pregnant women, substantially impairing their quality of life. The underlying mechanisms of PLPP remain largely unknown. Altered postural control has gained interest as a potential risk factor for PLPP. This study aims to determine the relationship between postural control and PLPP in the third trimester of pregnancy, while also exploring the differences in postural control between pregnant and non-pregnant women, and across different stages of pregnancy. Methods: A total of 68 women were included: 17 multigravid women in the first trimester of pregnancy (age 32.1±2.3yr, BMI 23.7±3.5), 25 multigravid women in the third trimester of pregnancy (age 32±2.6yr, BMI 28.4±4.2), and 26 non-pregnant women (age 29.7±3.7yr, BMI 22.2±1.8). Postural control was assessed in upright standing on a force plate under various postural conditions (with/without vision, feet together/20 cm apart, and/or stable/unstable support surface). Center of pressure (COP) variables were measured: mean COP sway anterior-posterior (AP), mean COP velocity AP, and COP 95% confidence ellipse area (CEA). In the third trimester, PLPP intensity was evaluated with the Numerical Pain Rating Scale (NPRS) to categorize into a no-PLPP subgroup (NPRS=0, N=9) and a PLPP subgroup (NPRS>0, N=16). Linear mixed models or Kruskal-Wallis tests, at nominal significance level 0.05, were used to compare COP variables between the no-PLPP and PLPP subgroups, between pregnant women (first or third trimester) and non-pregnant women, and between trimesters (uncorrected for BMI). Results: No significant differences in COP variables were found between the subgroups with and without PLPP (p>0.05). Pregnant women in the third trimester had significantly greater mean COP sway AP and COP 95% CEA compared to non-pregnant women when standing with feet together (p0.05). There were no significant differences in any COP variable between pregnant women in the first trimester and non-pregnant women, nor between trimesters (p>0.05). Conclusion: Pregnant women in the third trimester demonstrate larger postural sway compared to non-pregnant women, likely due to the biomechanical adaptations associated with advanced pregnancy. However, no direct relationship between these alterations in postural control and PLPP is identified
Pregnancy-Related Lumbopelvic Pain and its Relationship with Postural Control in Multigravid Pregnant Women
No full textBackground and Aims: Pregnancy-related lumbopelvic pain (PLPP) affects 50-90% of pregnant women, substantially impairing their quality of life. The underlying mechanisms of PLPP remain largely unknown. Altered postural control has gained interest as a potential risk factor for PLPP. This study aims to determine the relationship between postural control and PLPP in the third trimester of pregnancy, while also exploring the differences in postural control between pregnant and non-pregnant women, and across different stages of pregnancy. Methods: A total of 68 women were included: 17 multigravid women in the first trimester of pregnancy (age 32.1±2.3yr, BMI 23.7±3.5), 25 multigravid women in the third trimester of pregnancy (age 32±2.6yr, BMI 28.4±4.2), and 26 non-pregnant women (age 29.7±3.7yr, BMI 22.2±1.8). Postural control was assessed in upright standing on a force plate under various postural conditions (with/without vision, feet together/20 cm apart, and/or stable/unstable support surface). Center of pressure (COP) variables were measured: mean COP sway anterior-posterior (AP), mean COP velocity AP, and COP 95% confidence ellipse area (CEA). In the third trimester, PLPP intensity was evaluated with the Numerical Pain Rating Scale (NPRS) to categorize into a no-PLPP subgroup (NPRS=0, N=9) and a PLPP subgroup (NPRS>0, N=16). Linear mixed models or Kruskal-Wallis tests, at nominal significance level 0.05, were used to compare COP variables between the no-PLPP and PLPP subgroups, between pregnant women (first or third trimester) and non-pregnant women, and between trimesters (uncorrected for BMI). Results: No significant differences in COP variables were found between the subgroups with and without PLPP (p>0.05). Pregnant women in the third trimester had significantly greater mean COP sway AP and COP 95% CEA compared to non-pregnant women when standing with feet together (p0.05). There were no significant differences in any COP variable between pregnant women in the first trimester and non-pregnant women, nor between trimesters (p>0.05). Conclusion: Pregnant women in the third trimester demonstrate larger postural sway compared to non-pregnant women, likely due to the biomechanical adaptations associated with advanced pregnancy. However, no direct relationship between these alterations in postural control and PLPP is identified
Post-operative incidence of lymphedema after RARP with or without extended pelvic lymph node dissection in a cohort study
No full textObjectives: Lymphedema of the lower limbs and pubic area is a potential complication following extended pelvic lymph node dissection (ePLND) during robot-assisted radical prostatectomy (RARP). The incidence of lymphedema after ePLND has not been systematically reported in the literature. This study aimed to determine the incidence of lymphedema, describe its clinical characteristics and identify specific risk factors in patients undergoing RARP with or without ePLND. Methods: A retrospective cohort study was conducted at a tertiary referral centre between April 2016 and July 2020. Structured electronic case report forms (eCRFs) integrated into the electronic health record system were used to document intraoperative, perioperative and postoperative data. The primary endpoint was the incidence of lymphedema. Secondary endpoints included risk factors for and localization of the postoperative lymphedema. Results: A total of 500 patients who underwent RARP were included, with 301 patients undergoing ePLND and 199 patients without any form of PLND. Median follow-up period was 18 (range 3-49) months. Seventy-eight out of 301 (26%) of patients who underwent ePLND developed lymphedema, compared to only 2 out of 199 (1%) patients without ePLND. In most patients (49/301, 16%), lymphedema was mild (grade 1), whereas 29 patients (10%) developed grade 2 lymphedema. Twenty-six patients (9%) received decongestive lymphatic therapy. The most frequent site of lymphedema occurrence were the lower (54%) and the upper legs (40%). The number of nodes removed during RARP was identified as a risk factor for post-operative lymphedema (OR 1.04; p < 0.05). Conclusions: In this cohort study, approximately one in four patients undergoing RARP with ePLND developed lower limb and/or midline oedema, whereas one in ten patients started decongestive lymphatic therapy for symptomatic lymphedema. These findings provide valuable information for patient counselling about the potential benefits and risks of ePLND.Fonds Wetenschappelijk Onderzoek, Grant/Award Number: 1804625
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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