By dembones, Sep 12 2018 07:21PM
Osteopathy hits the irish press
Osteopathy hits the irish press
Carnes D, Plunkett A, Ellwood J, et al. Manual therapy for unsettled, distressed and excessively crying infants: a systematic review and meta-analyses. BMJ Open 2018;8:e019141. doi: 10.1136/bmjopen 2017-019141
Just had a paper published from my Doctorate in the European Journal of Pediatrics. Here is the Abstract.
Unsettled infant behaviour is a common problem of infancy without known aetiology or clearly effective management. Some manual therapists propose that musculoskeletal dysfunction contributes to unsettled infant behaviour, yet reported improvement following treatment is anecdotal. The infantile postural asymmetry measurement scale is a tool which measures infantile asymmetry, a form of musculoskeletal dysfunction. The first part of the study aimed to investigate its reliability and validity for measuring infantile postural asymmetry. This study also aimed to investigate whether there was an association between infantile postural asymmetry and unsettled infant behaviour and whether an association was mediated by, or confounded with, the demographic variables of age, sex, parity, birth weight and weight gain in twelve- to sixteen-week-old infants. Fifty-eight infants were recruited and a quantitative cross-sectional observational design was used. An association between unsettled behaviour and infantile postural asymmetry was not found. A significant difference between high and low cervical rotation deficit groups for Surgency was detected in female babies and needs further examination. Conclusion: Questions remain regarding the construct validity of the infantile postural asymmetry scale. No association between unsettled infant behaviour and infantile postural asymmetry was found in twelve- to sixteen-week-old infants. The influence of sex on the interaction between infantile postural asymmetry and infant behaviour needs further examination. An association between unsettled infant behaviour and infantile postural asymmetry is still unproven.
Considerable postural changes are necessary to accommodate the increasing size and weight of the uterus. At the same time hormonal changes cause ligaments all over the body to soften and stretch in preparation for labour. Any pre-existing back problems may make it more difficult for the body to adapt and may result in aches and pains in any area of the body.
Postural difficulties generally increase from around 20 weeks as the uterus becomes heavier and starts to take up more space in the abdomen. This may cause back or neck aching or pain, tension headaches, general aching and undue fatigue.
The uterus can be visualised as a bag, like a hot air balloon, that is tethered low down into the pelvis by ligaments. Movements such as bending down picking up shopping, or another child, can strain these uterine ligaments causing abdominal discomfort, groin pain or back ache.
Symphysis Pibic Dysfunction (SPD) or Pelvic Girdle Dysfunction - The two pubic bones meet at the front of the pelvis at the pubic symphysis. The joint is held together by ligaments. In pregnancy all ligaments soften and this can lead to painful stretching or separation of the pubic symphysis. This causes pain at the front of the pelvis which worsens on exercise and towards the end of the day.
Osteopathic treatment aims to balance and release any restrictions in the lower spine and sacrum that disturb normal pelvic mechanics and put more strain on the pubic area. Care of posture while the body changes shape plays an important role staying pain free and comfortable throughout.
- Try to keep as active as possible throughout the pregnancy
- 'Walk tall', pushing your head upwards as if suspended by a string
- Try to hold your tummy in to avoid excessive hollowing of your back
- Avoid sitting slouched in soft chairs. Whenever possible sit with your bottom well back in the chair and the lower back supported. Better still, sit on a seat that tilts forward (or a wedge)
- Spend some time each day in an 'all fours' position
- Avoid standing for long periods and try not to overtire yourself.
The use of a gym ball through the pregnancy and after the birth can give great benefits as the body moves from normal to pregnancy and back to normal again. As individual ability varies from one person to the next, it is advisable to seek the advice of a practitioner trained in the use of gym balls for pregnancy, such as an osteopath.