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Background: With the increased interest in inter-recti distance measurement using ultrasound imaging, there is a question of measurement reliability, and the importance of the examiner’s experience. Methods: The study aimed to investigate the reliability of the inter-recti distance measurement performed offline by an experienced radiologist on linea alba images captured by two novice examiners. Additionally, it was aimed to determinethe number of image repetitions that provide an acceptable measurement reliability level. Ultrasound images were acquired by two novice examiners on repeated occasions (sessions A and B) in twenty-eight nulliparous women of reproductive age. Five images were captured at supraumbilical, umbilical, and infraumbilical points during each session. Results: The excellent intra-examiner reliability of inter-recti distance measurements was shown at the supraumbilical and umbilical levels (ICC=0.894-0.983). Infraumbilical measurements had good to excellent reliability (ICC=0.894-0.972). Session A inter-examiner reliability was excellent for the mean measurements of two, three, four, and five images taken at each location (ICC=0.913-0.954). Session B inter-examiner reliability was excellent for the mean measurements of two, three, four, and five images taken at the supraumbilical and umbilical (ICC=0.94-0.98) and good (ICC≥0.81) at the infraumbilical locations. Some images were unusable (1.6% of images of Examiner 1 and 2.2% of Examiner 2). Conclusions:Novice examiners were able to capture good-quality ultrasound images of the linea alba that allowed for excellent intra- and inter-examiner reliability of supraumbilical and umbilical measurements, and good to excellent reliability of inframbilical measurements in nulliparas.

Review question / Objective: The research question was defined according to the PICOS criteria: P - participants of any age with a scar / keloid / hypertrophic scar. I - interventions: local management with needling, dry needling, acupuncture or combination of local needling / dry needling / acupuncture with distal acupuncture. C - comparator: local intervention (physical therapy) aimed at scar, keloid or hypertrophic scar treatment or no treatment. O - objectives: changes in pain associated with scar, keloid or hypertrophic scar. Pigmentation, vascularity, height / thickness, pliability / plasticity, itchiness of the scar area. S - study design: The articles were included based on the following inclusion criteria: full text articles in English, randomized controlled trials, clinical trials, case reports, case-series, case control studies.

Review question / Objective: The scoping review aims to identify publications describing the measurement of inter-recti distance (IRD)/diastasis recti abdominis (DRA) using ultrasonographic imaging (USI). The identification is based on the population/concept/context (PCC) framework that concerns human adults that underwent IRD/linea alba width/DRA measurement with USI for physiotherapy/physical exercise purposes. Based on systematically mapped peer-reviewed studies it is aimed to perform data extraction and synthesis of specific aspects of the IRD measurement procedure and discuss their similarities and differences. Related to that the attempt will be made to formulate recommendations on the IRD measurement procedure, which might be considered in future physiotherapy studies and practice. The recommendations will be made based on the synthesis of the results in light of existing literature and as the result of discussions and consensus between the authors (coming from three research centers).

Introduction Excessive body mass index may have adverse effects on the health of women in their perinatal period. Regular physical activity contributes to body mass control. Aim To determine the association of pre-pregnancy and pregnancy BMIs with labor duration in primi- and multiparas. Also, to determine the proportions of pre-pregnancy BMI > 25 in women after cesarean sections and vaginal deliveries. Material and methods Data of 54 women on a postpartum day 3 to 5 (29 primiparas: 17 after vaginal and 12 after cesarean deliveries; 25 multiparas: 15 after vaginal and 10 after cesarean deliveries). Demographic data collected from the patient’s history included body height, pre-pregnancy and pre-labor body mass, mode of delivery, duration of labor and its second stage, number of deliveries. Pre-pregnancy and pre-labor BMIs were calculated. Results In primiparas, there was a moderate positive correlation between pre-pregnancy and pre-labor BMIs and the labor duration (r = 0.56, p = 0.02; r = 0.65, p = 0.005, respectively). Multiparas did not exhibit a significant correlation between the BMIs and the labor duration (p > 0.05). Neither of the subgroups showed a significant correlation between pre-pregnancy and prelabor BMIs and the duration of the second stage of labor (p > 0.05). Among women after vaginal deliveries, 15.6% had pre-pregnancy BMI > 25; the respective proportion was 22.7% in women after cesarean sections. Conclusions Primiparas with greater pre-pregnancy and pre-labor BMIs were more likely to have a longer labor. The proportion of pre-pregnancy BMI > 25 was higher for cesarean compared to vaginal deliveries. Physical activity should be promoted in women planning pregnancy to help control BMI. Keywords: mirror foot, resection of foot radius, deformation classification

Functional stability is necessary for everyday activities. The studies have indicated the deterioration of functional stability during standing in the obese adults. This study aimed to determine whether the three-month weight-loss program that resulted in body mass reduction equal to or greater than 5% of the initial body mass would improve functional stability in young obese women. For the purpose of this study, the data of 30 females were included. Their mean age was 35.8±9.2. The women performed the anterior limit of stability test on the force platform twice: before and after weight-loss program. Their BMI at two sessions was 36.1±5.1 and 32.3±5, respectively. After the weight loss program, the COP velocities were increased in both phases of the anterior limit of stability test: the dynamic transition from standing to maximal forward-leaning and the maintenance of maximal forward-leaning position (p0.05). The results suggest that body mass reduction in young obese women led to improved mobility and postural control when visual cuing was available. The longer-lasting weight-loss program might be necessary to observe this effect under visual deprivation conditions. Body mass should be reduced in obese patients to improve their mobility and functional stability; it may prevent unexpected falls.

It has been speculated that elite athletes are more likely to have obstetric interventions during labor and delivery. So far, the impact of many years of competitive sports participation on childbirth characteristics has not been well-established. This preliminary retrospective case–control study aimed to determine whether the first labors of elite judo competitors required obstetric interventions more frequently and were longer than those of non-athletes. The study comprised 32 parous women: 16 elite judo athletes and 16 non-athletes. Women were included if they had access to the following obstetric data (from their first childbirth hospital discharge reports and/or first child’s health record books): induction and augmentation of labor, mode of delivery, the duration of labor and its second stage, episiotomy, perineal tear, and the neonate’s Apgar score. Electronic surveys were completed concerning childbirth characteristics, level of “eliteness” (judo athletes), and recreational physical activity (non-athletes). The statistical analysis showed no significant between-group differences in any of the first childbirth outcomes under analysis. The preliminary results indicate elite judo practice before first pregnancy had no negative impact on the rates of labor induction and augmentation, delivery mode, duration of labor, the rates of episiotomy and perineal tear, and the neonate’s Apgar score. Due to the small sample size, the conclusions should be considered with caution.

The primary aim of the study was to assess intraday and interday reliability of surface electromyography (sEMG) reflex activity of the pelvic floor muscles during synchronous whole-body vibration (S-WBV) of two intensities (30Hz/2mm; 40Hz/4mm) using band-stop filter and high-pass filter signal processing. The secondary aim of the study was to assess intraday and interday (test-retest) reliability of sEMG obtained from maximal voluntary contraction (MVC) test. We evaluated the intraday reliability of sEMG recordings obtained during sessions 1 and 2 performed on the same day. The sessions consisting of maximal voluntary pelvic floor muscle contraction and synchronous vibration sets with 1-hour rest in-between sessions 1 and 2 in healthy nulliparous women. The next intraday reliability was evaluated between the results of sessions 3 and 4 performed on the same day but followed at an interval of 4 weeks. to include the entire menstrual cycle. The interday reliability was determined based on the results of sessions 1 and 3 using the intraclass correlation coefficient (ICC 3,3). The intraday ICCs for band-stop filtered mean and median sEMG frequency and mean normalized sEMGRMS amplitude of the 30Hz/2mm (ICC = 0.89–0.99) and 40Hz/4mm vibration (ICC = 0.95–0.99) indicated substantial reproducibility. The intraday reliability of high-pass filter at 100-450Hz for these parameters was also substantial (30Hz/2mm ICC of 0.92 to 0.98; 40Hz/4mm ICC of 0.88 to 0.98). The interday reliability (session 1 vs. session 3) of the mean normalized sEMGRMS amplitude for band-stop filtered means of 40 Hz/4mm and 30Hz/2mm vibration recordings was substantial (ICC = 0.82 and 0.93). However, ICCs of the mean and median frequency were indicative of fair reliability (ICC of 0.43 to 0.59). The interday reliability of mean normalized sEMGRMS amplitude for high-pass filter at 100-450Hz was substantial (30Hz/2mm ICC of 0.90; 40Hz/4mm ICC of 0.73) for the 30Hz/2mm S-WBV and moderate (ICC = 0.73) for the 40/4mm S-WBV. The ICCs for mean and median sEMG frequency ICCs indicated slight to fair reproducibility (ICC of 0.16 to 0.56). The intraday reliability of the strongest MVC contraction and average MVC turned out substantial (ICC = 0.91–0.98). The interday reliability coefficients of the strongest MVC contraction and average MVCs were 0.91 and 0.82, respectively. Concluded, the intraday reliability proved satisfactory for all variables; however, the interday comparison showed sufficient ICC levels only for the mean amplitude. We therefore recommend this parameter should be used when analyzing PFM sEMG recorded during vibration. ICCs of the mean and median frequency for both signal processing methods were indicative of insufficient reliability and did not reach the threshold for usefulness. Our study showed similar reliability of PFM sEMG during S-WBV in case of the two filtering methods used.

The impact of pregnancy on the anterior-posterior sacral orientation and its relation to lumbopelvic pain and weight gain has not been fully recognized. This longitudinal study aimed to compare the sacral inclination angle in women between their early and advanced pregnancy and at 6 months postpartum. The authors also searched for a correlation between the sacral inclination and lumbopelvic pain, BMI and change in body mass.Thirteen healthy women participated in the study. Data were collected at 8-16 and 35-38 weeks of gestation, and at 27-31.5 postpartum weeks. At each session, the women's sacral inclination angles were measured using the Saunders digital inclinometer. Data were also collected on lumbopelvic pain, BMI and body mass gain/loss.There was no effect of the evaluation period on the sacral inclination (p0.05); however, various individual values of the sacral inclination in pregnancy and postpartum were noted. In advanced pregnancy, 61.5% of the women had recurrent pain in the lumbopelvic region. The sacral inclination did not correlate with the lumbopelvic pain, BMI and body mass change (p0.05) in the pregnancy and postpartum periods.Advanced pregnancy did not influence sacral inclination. However, individuals varied in their responses. Therefore, we suggest that an individually-based physical therapy approach concerning proper posture during and after pregnancy should be emphasized. The sacral inclination had no impact on the occurrence of recurrent lumbopelvic pain. BMI and changes in body mass did not influence the sacral inclination in advanced pregnancy and at 6 months postpartum.

The aim of the study was to determine whether 10- to 13-year-old, national-level, female acrobatic gymnasts present a different quiet standing postural control (with and without visual cues) than untrained female peers.The mean velocity of the center of pressure (in anterior-posterior and medial-lateral directions) was computed from 60-s long quiet-standing trials on a stationary force plate in fifteen 10- to 13-year-old female acrobatic gymnasts and thirteen sex- and age-matched non-athletes. A two-way repeated measures ANOVA (acrobatic gymnasts vs. non-athletes and eyes open vs. eyes closed) was used for the anterior-posterior and mediallateral COP mean velocity. The relation between subjects' body mass and COP mean velocity was tested with the used Spearman's Rank Correlation Coefficient.Postural sway (represented by COP mean velocity) was not significantly different between the acrobatic gymnasts and the non-athletes ( p0.05), except for the faster medial-lateral sway in eyes-open conditions in the acrobatic gymnasts ( p0.05). The gymnasts' body mass negatively correlated with their anterior-posterior sway velocity in both visual conditions (eyes open: r = -0.7; eyes closed: r = -0.6) and with medial-lateral sway velocity during eyes-closed trials (r = -0.5; p0.05).Results of the study indicate that in quiet standing postural control 10- to 13-year-old acrobatic gymnasts did not make use of their trained abilities. Heavier gymnasts might have been more stable than lighter ones during quiet standing.

It has been documented that pregnancy-related increased connective tissue laxity may persist postpartum; however, it is still unclear for how long. This longitudinal study aimed to compare total trunk forward flexion mobility in women between their first trimester of pregnancy and at 2- and 6-month postpartum follow-ups. We also searched for a correlation between women's trunk flexibility and their postural stability in the sagittal plane.Seventeen healthy women participated in the study. Data were collected at their 7-12 weeks gestation appointments and at 6-10 and 25-28 weeks postpartum. At each session, the women performed a finger floor distance test, and data were collected on their waist circumference and BMI. The women's center of foot pressure mean velocity in the anterior-posterior direction was computed from 30-s long quiet-standing trials on a stationary force plate.Total trunk forward flexion mobility was significantly higher at 2 and 6 months postpartum compared to that in early pregnancy (P 0.05). At 6 months postpartum, a moderate negative correlation between finger floor distance test values and their anterior-posterior center of foot pressure mean velocity was observed (r = -0.6, P 0.05).Increased total trunk flexibility may be present in women 6 months postpartum. During that period, women with higher trunk flexibility may be more likely to present higher anterior-posterior postural sway velocity in quiet standing.

The Influence of Pregnancy on the Location of the Center of Gravity in Standing Position The purpose of the study was to compare the average location of the center of gravity vertical projection in sagittal plane in women at the beginning of and in advanced pregnancy as well as after delivery. The experiment was performed with the use of a force platform during four test sessions. A group of 44 women (8-16 weeks of pregnancy) participated in the initial test session. In the following sessions the number of the subjects reduced mainly due to medical and childcare problems: 33 women were tested in late pregnancy (2-3 weeks before delivery), and 39 women were tested two and six months after delivery. The results showed the statisticaly significant (p We concluded that the change of the center of gravity location in late pregnancy is temporary and two months after delivery the vertical projection of the center of gravity is located as it was at the beginning of pregnancy.

Spatiotemporal gait cycle characteristics were assessed at early (P1), and late (P2) pregnancy, as well as at 2 months (PP1) and 6 months (PP2) postpartum. A substantial decrease in walking speed was observed throughout the pregnancy, with the slowest speed (1±0.2m/s) being during the third trimester. Walking at slower velocity resulted in complex adaptive adjustments to their spatiotemporal gait pattern, including a shorter step length and an increased duration of both their stance and double-support phases. Duration of the swing phase remained the least susceptible to changes. Habitual walking velocity (1.13±0.2m/s) and the optimal gait pattern were fully recovered 6 months after childbirth. Documented here adaptive changes in the preferred gait pattern seem to result mainly from the altered body anthropometry leading to temporary balance impairments. All the observed changes within stride cycle aimed to improve gait safety by focusing on its dynamic stability. The pregnant women preferred to walk at a slower velocity which allowed them to spend more time in double-support compared with their habitual pattern. Such changes provided pregnant women with a safer and more tentative ambulation that reduced the single-support period and, hence, the possibility of instability. As pregnancy progressed a significant increase in stance width and a decrease in step length was observed. Both factors allow also for gait stability improvement.

This longitudinal study aimed to compare static postural stability in women between early pregnancy, advanced pregnancy, and at 2 and 6 months postpartum. Forty-five pregnant women were enrolled and 31 completed the protocol. Data were collected at 7–16 and 34–39 weeks gestation, and at 6–10 and 26–30 weeks postpartum. For each subject, the center of foot pressure path length and mean velocity (with directional subcomponents) were computed from 30-s long quiet-standing trials on a stationary force plate with eyes open or closed. The body mass, stance width, and sleep duration within 24 h before testing were also recorded. Static postural stability was not different between pregnancy and postpartum, except for the anterior posterior sway tested in the eyes-closed condition, which was significantly increased in late pregnancy compared to that at 2 and 6 months postpartum. Pregnant/postpartum women’s body mass weakly positively correlated with anterior-posterior sway in the eyes-closed condition and their stance width weakly positively correlated with the anterior-posterior sway in the eyes-open condition. No effect of sleep duration on postural sway was found. Our findings indicate that under visual deprivation conditions women in advanced pregnancy may have decreased static stability compared to their non-pregnant state.