Correlation and comparison between pelvic position and lumbar lordosis in pregnant women
Corresponding Author(s) : Dr. Shivani Chowdhury Salian
shivani@gmail.com
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 4 No. 2 (2016): 2016 Volume 4- Issue -2
Abstract
Background: The purpose of this study was to determine if posture and back pain changed from the first to the third trimester of pregnancy and whether there was a relationship between the two.
Aim: To measure, correlate and compare lumbar lordosis with pelvic posture in pregnant women of all three trimesters.
Methodology
A cross-sectional study was conducted comprising a total of 160 subjects, with an equal number of subjects (n=40) from 1st trimester, 2nd trimester, 3rd trimester and a control group which included non pregnant healthy individuals. Group 1= Ladies in the First Trimester, Group 2= Ladies in the Second Trimester, Group 3= Ladies in the Third Trimester and Group 4= Age and BMI matched women. Each subject from each group had their pelvic inclination angle, lumbar lordosis angle, height and weight for calculating BMI, and hip circumference measured in relaxed standing posture.
Results
Bonferroni test was used to compare the variables in all the groups of the experiment. A significant difference at p<0.05 was obtained between pelvic inclination angle measured in the pregnant ladies from all trimesters. A non-significant difference was obtained between Women in the first trimester and control group. Significant difference at p<0.05 was obtained in the lumbar lordosis angle measured in the pregnant ladies when mothers in the 1st Trimester were compared with mothers in the 2nd Trimester and 3rd Trimester. However there was no significant difference in the lumbar lordosis angle values in between 2nd Trimester mothers & 3rd Trimester and between 1st Trimester and control group. There was no correlation between lumbar lordosis and pelvic inclination measured in the experimental group. Also no correlation was established between BMI and waist hip ratio when associated with lumbar lordosis and pelvic inclination.
Conclusion
It is made evident that measurement of Lumbar Lordosis angle does not vary significantly in the pregnant women throughout their pregnancy. On the contrary, there was a gradual increase in the measurement of Pelvic inclination angle that was seen from the first through the third trimesters. Also, there was no association obtained between the two measurements denoting the pelvic posture and the lumbar spine posture. ISSN:2347-6567 International Journal of Allied Medical Sciences and Clinical Research (IJAMSCR)
Keywords
Pregnant Women
Lumbar Lordosis Angle
Pelvic Inclination Angle
Pelvic Postures
Sacral Pain
Low Back Pain
1.
Dr. Shivani Chowdhury Salian. Correlation and comparison between pelvic position and lumbar lordosis in pregnant women. Int. J. of Allied Med. Sci. and Clin. Res. [Internet]. 2020 Aug. 5 [cited 2026 Feb. 10];4(2):310-8. Available from: https://ijamscr.com/ijamscr/article/view/273
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References
-
Danforth D.N (1967) , pregnancy and labour from the vantage point of physical therapist , American journal of physical medicine, 46 (1), 633-658.
Shivani CS et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-4(2) 2016 [310-318]
317
[2]. Barry .C. Stillman, (1969), physiology of pregnancy, australian journal of physiotherapy, 15, 1969.
[3]. Andersson GBJ: Low back pain in pregnancy. In: Weinstein IN, Wiesel SW(eds), The Lumbar Spine (3rd Ed), Philadelphia, PA: W.B. Saunders Cornpany,1990
[4]. Black E, Anastasi SC: Pregnancy and the lower extremities. Biomechanics 2(4):22-25, 68- 69, 7995.
[5]. Bushnell L F: The postural pains of pregnancy. West J Surg Obstet Gynecol 57, 1949, 123-127,
[6]. Berg G, Hammar M, Moiler-Nielsen J, Linden U, Thorblad 1: Low back pain during pregnancy. Obstet Gynecol 71, 1988, 77-75,.
[7]. Bullock jE, lull GA, Bullock MI: The relationship of low back pain to postural changes during pregnancy. Aust JPhysiother 33, 1987, 10-7.
[8]. Fast A, Shaperio D, Weiss L, Ducommun El, Friedmann L W, Bouklas T, Floman Y: Low back pain in pregnancy. Spine 12, 1987, 368-371.
[9]. Mantle MJ, Greenwood RM, Currey HLF: Backache in pregnancy. Rheumato1 Rehabil 16:9S-lOl, 1977.
[10]. Ostgaard HC, Andersson GBI, Karlsson K: Prevalence of back pain in pregnancy. Spine 16, 1991, 432-436,
[11]. Ostgaard HC, Zetherstrom G, Roos- Hansson E, Svanberg B: Reduction of back and posterior pelvic pain in pregnancy. Spine 19(8), 1994, 894-900.
[12]. Rungee JL: Low back pain in pregnancy. Orthopedics 16, 1993, 1339-1344.
[13]. Bullock Saxton J.E Changes in posture measured in standing associated with pregnancy & early postnatal period; Physiotherapy Theory Practice. 7(2) , 1991, 103-109
[14]. 16. Dumas G.A., Reid J.G., Wolfe LA et al Exercise &posture pain during pregnancy: Part-I Exercise , posture & back ,Clinical Biomechanics 10, 1995a , 104-109
[15]. 17. Elizabeth Noble: Essential exercises for the Child bearing year [1995], 4th edn , 28
[16]. Snijders G.J, Snijder J D,& Hoest H T Change in the form of the spine as a consequence pregnancy [1976] Digest of the 11th International conference on Medical & Biological Engineering; Ottawa, Canada :670-671.
[17]. Simson S R: Evaluation of flexirular technique for measuring lumbar lordosis in the clinical assessment of low back pin [1989] J Soc Occ Med: 39[1], 25-9
[18]. Wendy L.Gilleard, Jack Crosbie, Richard Smith Static trunk posture in sitting & standing during pregnancy &early post partum .American Academy of Physical medicine &Rehabilitation, 83 (12), 2002, 1739-1744.
[19]. Britnell A.J, Cole J.V & Isherwood L Postural health in women: The role of Physiotherapy [2005] J Obst Gynecol Can: MAI 493-500.
[20]. Hummel P -Changes in posture during pregnancy PhD thesis [1987] Vrije universiteit de Amsterdam Academisch Pragshrift.
[21]. K Moor, GA Dumas, JG Reid; Postural changes during pregnancy & their relationship with low back Pain [1990] Clinical Biomechanics 5[3], 169-174.
[22]. Paul Standerson et al The influence of pregnancy on the development of degenerative spondylolysthesis [1996]- J.Bone Joint Surg ; 78, 951-4.
[23]. Cailliet R.: low back pain syndrome 3rd edition, pp 53-58. philadelphia:F.A davis company , 1981.
[24]. Denslow JS, Chace J.A: machanical stresses in the human lumbar spine and pelvis. j am osteopath assoc 61, 1962, 706-712.
[25]. Kendall HO, Kendall FP, Boynton DA: posture and pain, pp 125-131. Baltimore: Williams and Wilkins, 1977.
[26]. Kisner C, Colby L.A: therapeutic exercise: foundations and techniques (2nd ed), pp 437- 439. Philadelphia: F.A Davis Company, 1990.
[27]. Polster J, Spieker U, Hoefert H.R, Krenz ju: Biomechanics in lumbar lordosis. in: Melson RC, Morehouse ca (eds), biomechanics 4, pp 365-371. Baltimore university press, 1974.
[28]. Thomas P.E: an analysis of the interactions among various assymetric osseous pelvic and lumbar structures. J Am osteopath assoc 64, 1965, 956-957,.
[29]. Kendall FP, MC Creary EK: muscles: testing and function 3rd (ed), pp 189- 192, 219. baltimore : Williams Wilkins 1983.
Shivani CS et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-4(2) 2016 [310-318]
318
[30]. Vismara et al.: Effect of obesity and low back pain on spinal mobility: a cross sectional study in women. Journal of Neuro Engineering and Rehabilitation 2010, 7:3.
[31]. Leboeuf-Yde C: Body weight and low back pain. A systematic literature review of 56 journal articles reporting on 65 epidemiologic studies. Spine 2000, 25:226-237. Fabris de Souza SA, Faintuch J, Valezi AC, Sant’Anna AF, Gama-Rodrigues JJ, de Batista Fonseca IC, de Melo RD: Postural changes in morbidly obese patients. Obes Surg 15(7), 2005, 1013-6.
[32]. O’Sullivan PB, Dankaerts W, Burnett AF, Farrell GT, Jefford E, Naylor CS, O’Sullivan KJ: Effect of different upright sitting postures on spinal-pelvic curvature and trunk muscle activation in a pain-free population. Spine 31(19), 2006, E707-12.
[33]. Whitcome KK, Shapiro JL, Lieberman DL: Fetal load and the evolution of lumbar lordosis in bipedal hominins. Nature 450(7172), 2007, 1075-8.
[34]. Elizabeth Noble-Essential exercises for the Child bearing year [1995], 4th edn Chapter 5-107-146
[35]. Carrie Hall, Lori Thein Broody Therapeutic exercise –moving towards function[1998]-pub-Lippincott Williums & Walkins – 213-231
[36]. Jill Mantle, Jeanette Haslam,, Sue Barton ;Physiotherapy in Obstetrics and Gynecology [2004], 2nd ed-pg-14 1 -164
[37]. Intertester and Intratester Reliability and Validity of Measures of Innominate one Inclination in Standing Using PELVIN®TM , International Journal of Innovative Research in Science, Engineering and Technology, Vol. 4, Issue 7, July 2015, 5069-5077, ISSN(Online) : 2319-8753, ISSN (Print) : 2347-6710, Impact factor 5.4421
[38]. Sapsford R, J Bullock-Saxton,S Markswell Women`s health, [1998] W.B. Sounders company- Indian print14:136-140.
[39]. Wang SM, Dezinno P, Maranets I, Berman MR,Caldwell-Andrews AA, Kain ZN. Low backpain during pregnancy: prevalence, risk factors, and o u t c ome s . (2004) Obstetric Gynecol;104(1), 65-70.
[40]. Borg-Stein J, Dugan SA, Gruber J.Musculoskeletal aspects of pregnancy; Am J Phys Med Rehabil. 84(3), 2005, 180-92.
[41]. Sneag DB, Bendo JA. Pregnancy-related Low Back Pain. Orthopaedics. 30, 2007, 839 - 847.
[42]. Chamberlain WE: The symphysis pubis in the roentgen examination of sacroiliac joint. AM J Roentgenol 24, 1930, 621-625.
[43]. Abramson D et al: relaxation of the pelvic joints during pregnancy. surg gynaecology obstet 58, 1934, 594-613.
[44]. Calguneri m, bird HAWA: changes in joint laxity occurring during pregnancy. Ann Rheum Dis 41, 1982, 126 - 128.
[45]. Krisstiansson P et al: serum relaxin , symphyseal pain , and backpain during pregnancy. Am J Obstet and Gynaec 175, 1996, 1342-1347.
[46]. Soames RW: skeletal system in; Williams PL, ed Grays anatomy. The anatomical basis of medicine and surgery. New York: Churchill Livingstone, 1995, 425- 736.
[47]. Terry RJ, Trotter M the articulations. In schaeffer Jp , ed Morris Human anatomy . New York: Blakiston , 1953 b; 287 - 398.
[48]. Vleeming A, Pool Goudzwaard AL, Hammudoghlu D et al: The function of the long dorsal sacroiliac ligament. Spine 21, 1996, 556-562.
[49]. Vismara et al. Journal of NeuroEngineering and Rehabilitation 2010,7:3 http://www.jneuroengrehab.com/content/7/1/
References
Danforth D.N (1967) , pregnancy and labour from the vantage point of physical therapist , American journal of physical medicine, 46 (1), 633-658.
Shivani CS et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-4(2) 2016 [310-318]
317
[2]. Barry .C. Stillman, (1969), physiology of pregnancy, australian journal of physiotherapy, 15, 1969.
[3]. Andersson GBJ: Low back pain in pregnancy. In: Weinstein IN, Wiesel SW(eds), The Lumbar Spine (3rd Ed), Philadelphia, PA: W.B. Saunders Cornpany,1990
[4]. Black E, Anastasi SC: Pregnancy and the lower extremities. Biomechanics 2(4):22-25, 68- 69, 7995.
[5]. Bushnell L F: The postural pains of pregnancy. West J Surg Obstet Gynecol 57, 1949, 123-127,
[6]. Berg G, Hammar M, Moiler-Nielsen J, Linden U, Thorblad 1: Low back pain during pregnancy. Obstet Gynecol 71, 1988, 77-75,.
[7]. Bullock jE, lull GA, Bullock MI: The relationship of low back pain to postural changes during pregnancy. Aust JPhysiother 33, 1987, 10-7.
[8]. Fast A, Shaperio D, Weiss L, Ducommun El, Friedmann L W, Bouklas T, Floman Y: Low back pain in pregnancy. Spine 12, 1987, 368-371.
[9]. Mantle MJ, Greenwood RM, Currey HLF: Backache in pregnancy. Rheumato1 Rehabil 16:9S-lOl, 1977.
[10]. Ostgaard HC, Andersson GBI, Karlsson K: Prevalence of back pain in pregnancy. Spine 16, 1991, 432-436,
[11]. Ostgaard HC, Zetherstrom G, Roos- Hansson E, Svanberg B: Reduction of back and posterior pelvic pain in pregnancy. Spine 19(8), 1994, 894-900.
[12]. Rungee JL: Low back pain in pregnancy. Orthopedics 16, 1993, 1339-1344.
[13]. Bullock Saxton J.E Changes in posture measured in standing associated with pregnancy & early postnatal period; Physiotherapy Theory Practice. 7(2) , 1991, 103-109
[14]. 16. Dumas G.A., Reid J.G., Wolfe LA et al Exercise &posture pain during pregnancy: Part-I Exercise , posture & back ,Clinical Biomechanics 10, 1995a , 104-109
[15]. 17. Elizabeth Noble: Essential exercises for the Child bearing year [1995], 4th edn , 28
[16]. Snijders G.J, Snijder J D,& Hoest H T Change in the form of the spine as a consequence pregnancy [1976] Digest of the 11th International conference on Medical & Biological Engineering; Ottawa, Canada :670-671.
[17]. Simson S R: Evaluation of flexirular technique for measuring lumbar lordosis in the clinical assessment of low back pin [1989] J Soc Occ Med: 39[1], 25-9
[18]. Wendy L.Gilleard, Jack Crosbie, Richard Smith Static trunk posture in sitting & standing during pregnancy &early post partum .American Academy of Physical medicine &Rehabilitation, 83 (12), 2002, 1739-1744.
[19]. Britnell A.J, Cole J.V & Isherwood L Postural health in women: The role of Physiotherapy [2005] J Obst Gynecol Can: MAI 493-500.
[20]. Hummel P -Changes in posture during pregnancy PhD thesis [1987] Vrije universiteit de Amsterdam Academisch Pragshrift.
[21]. K Moor, GA Dumas, JG Reid; Postural changes during pregnancy & their relationship with low back Pain [1990] Clinical Biomechanics 5[3], 169-174.
[22]. Paul Standerson et al The influence of pregnancy on the development of degenerative spondylolysthesis [1996]- J.Bone Joint Surg ; 78, 951-4.
[23]. Cailliet R.: low back pain syndrome 3rd edition, pp 53-58. philadelphia:F.A davis company , 1981.
[24]. Denslow JS, Chace J.A: machanical stresses in the human lumbar spine and pelvis. j am osteopath assoc 61, 1962, 706-712.
[25]. Kendall HO, Kendall FP, Boynton DA: posture and pain, pp 125-131. Baltimore: Williams and Wilkins, 1977.
[26]. Kisner C, Colby L.A: therapeutic exercise: foundations and techniques (2nd ed), pp 437- 439. Philadelphia: F.A Davis Company, 1990.
[27]. Polster J, Spieker U, Hoefert H.R, Krenz ju: Biomechanics in lumbar lordosis. in: Melson RC, Morehouse ca (eds), biomechanics 4, pp 365-371. Baltimore university press, 1974.
[28]. Thomas P.E: an analysis of the interactions among various assymetric osseous pelvic and lumbar structures. J Am osteopath assoc 64, 1965, 956-957,.
[29]. Kendall FP, MC Creary EK: muscles: testing and function 3rd (ed), pp 189- 192, 219. baltimore : Williams Wilkins 1983.
Shivani CS et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-4(2) 2016 [310-318]
318
[30]. Vismara et al.: Effect of obesity and low back pain on spinal mobility: a cross sectional study in women. Journal of Neuro Engineering and Rehabilitation 2010, 7:3.
[31]. Leboeuf-Yde C: Body weight and low back pain. A systematic literature review of 56 journal articles reporting on 65 epidemiologic studies. Spine 2000, 25:226-237. Fabris de Souza SA, Faintuch J, Valezi AC, Sant’Anna AF, Gama-Rodrigues JJ, de Batista Fonseca IC, de Melo RD: Postural changes in morbidly obese patients. Obes Surg 15(7), 2005, 1013-6.
[32]. O’Sullivan PB, Dankaerts W, Burnett AF, Farrell GT, Jefford E, Naylor CS, O’Sullivan KJ: Effect of different upright sitting postures on spinal-pelvic curvature and trunk muscle activation in a pain-free population. Spine 31(19), 2006, E707-12.
[33]. Whitcome KK, Shapiro JL, Lieberman DL: Fetal load and the evolution of lumbar lordosis in bipedal hominins. Nature 450(7172), 2007, 1075-8.
[34]. Elizabeth Noble-Essential exercises for the Child bearing year [1995], 4th edn Chapter 5-107-146
[35]. Carrie Hall, Lori Thein Broody Therapeutic exercise –moving towards function[1998]-pub-Lippincott Williums & Walkins – 213-231
[36]. Jill Mantle, Jeanette Haslam,, Sue Barton ;Physiotherapy in Obstetrics and Gynecology [2004], 2nd ed-pg-14 1 -164
[37]. Intertester and Intratester Reliability and Validity of Measures of Innominate one Inclination in Standing Using PELVIN®TM , International Journal of Innovative Research in Science, Engineering and Technology, Vol. 4, Issue 7, July 2015, 5069-5077, ISSN(Online) : 2319-8753, ISSN (Print) : 2347-6710, Impact factor 5.4421
[38]. Sapsford R, J Bullock-Saxton,S Markswell Women`s health, [1998] W.B. Sounders company- Indian print14:136-140.
[39]. Wang SM, Dezinno P, Maranets I, Berman MR,Caldwell-Andrews AA, Kain ZN. Low backpain during pregnancy: prevalence, risk factors, and o u t c ome s . (2004) Obstetric Gynecol;104(1), 65-70.
[40]. Borg-Stein J, Dugan SA, Gruber J.Musculoskeletal aspects of pregnancy; Am J Phys Med Rehabil. 84(3), 2005, 180-92.
[41]. Sneag DB, Bendo JA. Pregnancy-related Low Back Pain. Orthopaedics. 30, 2007, 839 - 847.
[42]. Chamberlain WE: The symphysis pubis in the roentgen examination of sacroiliac joint. AM J Roentgenol 24, 1930, 621-625.
[43]. Abramson D et al: relaxation of the pelvic joints during pregnancy. surg gynaecology obstet 58, 1934, 594-613.
[44]. Calguneri m, bird HAWA: changes in joint laxity occurring during pregnancy. Ann Rheum Dis 41, 1982, 126 - 128.
[45]. Krisstiansson P et al: serum relaxin , symphyseal pain , and backpain during pregnancy. Am J Obstet and Gynaec 175, 1996, 1342-1347.
[46]. Soames RW: skeletal system in; Williams PL, ed Grays anatomy. The anatomical basis of medicine and surgery. New York: Churchill Livingstone, 1995, 425- 736.
[47]. Terry RJ, Trotter M the articulations. In schaeffer Jp , ed Morris Human anatomy . New York: Blakiston , 1953 b; 287 - 398.
[48]. Vleeming A, Pool Goudzwaard AL, Hammudoghlu D et al: The function of the long dorsal sacroiliac ligament. Spine 21, 1996, 556-562.
[49]. Vismara et al. Journal of NeuroEngineering and Rehabilitation 2010,7:3 http://www.jneuroengrehab.com/content/7/1/
Shivani CS et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-4(2) 2016 [310-318]
317
[2]. Barry .C. Stillman, (1969), physiology of pregnancy, australian journal of physiotherapy, 15, 1969.
[3]. Andersson GBJ: Low back pain in pregnancy. In: Weinstein IN, Wiesel SW(eds), The Lumbar Spine (3rd Ed), Philadelphia, PA: W.B. Saunders Cornpany,1990
[4]. Black E, Anastasi SC: Pregnancy and the lower extremities. Biomechanics 2(4):22-25, 68- 69, 7995.
[5]. Bushnell L F: The postural pains of pregnancy. West J Surg Obstet Gynecol 57, 1949, 123-127,
[6]. Berg G, Hammar M, Moiler-Nielsen J, Linden U, Thorblad 1: Low back pain during pregnancy. Obstet Gynecol 71, 1988, 77-75,.
[7]. Bullock jE, lull GA, Bullock MI: The relationship of low back pain to postural changes during pregnancy. Aust JPhysiother 33, 1987, 10-7.
[8]. Fast A, Shaperio D, Weiss L, Ducommun El, Friedmann L W, Bouklas T, Floman Y: Low back pain in pregnancy. Spine 12, 1987, 368-371.
[9]. Mantle MJ, Greenwood RM, Currey HLF: Backache in pregnancy. Rheumato1 Rehabil 16:9S-lOl, 1977.
[10]. Ostgaard HC, Andersson GBI, Karlsson K: Prevalence of back pain in pregnancy. Spine 16, 1991, 432-436,
[11]. Ostgaard HC, Zetherstrom G, Roos- Hansson E, Svanberg B: Reduction of back and posterior pelvic pain in pregnancy. Spine 19(8), 1994, 894-900.
[12]. Rungee JL: Low back pain in pregnancy. Orthopedics 16, 1993, 1339-1344.
[13]. Bullock Saxton J.E Changes in posture measured in standing associated with pregnancy & early postnatal period; Physiotherapy Theory Practice. 7(2) , 1991, 103-109
[14]. 16. Dumas G.A., Reid J.G., Wolfe LA et al Exercise &posture pain during pregnancy: Part-I Exercise , posture & back ,Clinical Biomechanics 10, 1995a , 104-109
[15]. 17. Elizabeth Noble: Essential exercises for the Child bearing year [1995], 4th edn , 28
[16]. Snijders G.J, Snijder J D,& Hoest H T Change in the form of the spine as a consequence pregnancy [1976] Digest of the 11th International conference on Medical & Biological Engineering; Ottawa, Canada :670-671.
[17]. Simson S R: Evaluation of flexirular technique for measuring lumbar lordosis in the clinical assessment of low back pin [1989] J Soc Occ Med: 39[1], 25-9
[18]. Wendy L.Gilleard, Jack Crosbie, Richard Smith Static trunk posture in sitting & standing during pregnancy &early post partum .American Academy of Physical medicine &Rehabilitation, 83 (12), 2002, 1739-1744.
[19]. Britnell A.J, Cole J.V & Isherwood L Postural health in women: The role of Physiotherapy [2005] J Obst Gynecol Can: MAI 493-500.
[20]. Hummel P -Changes in posture during pregnancy PhD thesis [1987] Vrije universiteit de Amsterdam Academisch Pragshrift.
[21]. K Moor, GA Dumas, JG Reid; Postural changes during pregnancy & their relationship with low back Pain [1990] Clinical Biomechanics 5[3], 169-174.
[22]. Paul Standerson et al The influence of pregnancy on the development of degenerative spondylolysthesis [1996]- J.Bone Joint Surg ; 78, 951-4.
[23]. Cailliet R.: low back pain syndrome 3rd edition, pp 53-58. philadelphia:F.A davis company , 1981.
[24]. Denslow JS, Chace J.A: machanical stresses in the human lumbar spine and pelvis. j am osteopath assoc 61, 1962, 706-712.
[25]. Kendall HO, Kendall FP, Boynton DA: posture and pain, pp 125-131. Baltimore: Williams and Wilkins, 1977.
[26]. Kisner C, Colby L.A: therapeutic exercise: foundations and techniques (2nd ed), pp 437- 439. Philadelphia: F.A Davis Company, 1990.
[27]. Polster J, Spieker U, Hoefert H.R, Krenz ju: Biomechanics in lumbar lordosis. in: Melson RC, Morehouse ca (eds), biomechanics 4, pp 365-371. Baltimore university press, 1974.
[28]. Thomas P.E: an analysis of the interactions among various assymetric osseous pelvic and lumbar structures. J Am osteopath assoc 64, 1965, 956-957,.
[29]. Kendall FP, MC Creary EK: muscles: testing and function 3rd (ed), pp 189- 192, 219. baltimore : Williams Wilkins 1983.
Shivani CS et al / Int. J. of Allied Med. Sci. and Clin. Research Vol-4(2) 2016 [310-318]
318
[30]. Vismara et al.: Effect of obesity and low back pain on spinal mobility: a cross sectional study in women. Journal of Neuro Engineering and Rehabilitation 2010, 7:3.
[31]. Leboeuf-Yde C: Body weight and low back pain. A systematic literature review of 56 journal articles reporting on 65 epidemiologic studies. Spine 2000, 25:226-237. Fabris de Souza SA, Faintuch J, Valezi AC, Sant’Anna AF, Gama-Rodrigues JJ, de Batista Fonseca IC, de Melo RD: Postural changes in morbidly obese patients. Obes Surg 15(7), 2005, 1013-6.
[32]. O’Sullivan PB, Dankaerts W, Burnett AF, Farrell GT, Jefford E, Naylor CS, O’Sullivan KJ: Effect of different upright sitting postures on spinal-pelvic curvature and trunk muscle activation in a pain-free population. Spine 31(19), 2006, E707-12.
[33]. Whitcome KK, Shapiro JL, Lieberman DL: Fetal load and the evolution of lumbar lordosis in bipedal hominins. Nature 450(7172), 2007, 1075-8.
[34]. Elizabeth Noble-Essential exercises for the Child bearing year [1995], 4th edn Chapter 5-107-146
[35]. Carrie Hall, Lori Thein Broody Therapeutic exercise –moving towards function[1998]-pub-Lippincott Williums & Walkins – 213-231
[36]. Jill Mantle, Jeanette Haslam,, Sue Barton ;Physiotherapy in Obstetrics and Gynecology [2004], 2nd ed-pg-14 1 -164
[37]. Intertester and Intratester Reliability and Validity of Measures of Innominate one Inclination in Standing Using PELVIN®TM , International Journal of Innovative Research in Science, Engineering and Technology, Vol. 4, Issue 7, July 2015, 5069-5077, ISSN(Online) : 2319-8753, ISSN (Print) : 2347-6710, Impact factor 5.4421
[38]. Sapsford R, J Bullock-Saxton,S Markswell Women`s health, [1998] W.B. Sounders company- Indian print14:136-140.
[39]. Wang SM, Dezinno P, Maranets I, Berman MR,Caldwell-Andrews AA, Kain ZN. Low backpain during pregnancy: prevalence, risk factors, and o u t c ome s . (2004) Obstetric Gynecol;104(1), 65-70.
[40]. Borg-Stein J, Dugan SA, Gruber J.Musculoskeletal aspects of pregnancy; Am J Phys Med Rehabil. 84(3), 2005, 180-92.
[41]. Sneag DB, Bendo JA. Pregnancy-related Low Back Pain. Orthopaedics. 30, 2007, 839 - 847.
[42]. Chamberlain WE: The symphysis pubis in the roentgen examination of sacroiliac joint. AM J Roentgenol 24, 1930, 621-625.
[43]. Abramson D et al: relaxation of the pelvic joints during pregnancy. surg gynaecology obstet 58, 1934, 594-613.
[44]. Calguneri m, bird HAWA: changes in joint laxity occurring during pregnancy. Ann Rheum Dis 41, 1982, 126 - 128.
[45]. Krisstiansson P et al: serum relaxin , symphyseal pain , and backpain during pregnancy. Am J Obstet and Gynaec 175, 1996, 1342-1347.
[46]. Soames RW: skeletal system in; Williams PL, ed Grays anatomy. The anatomical basis of medicine and surgery. New York: Churchill Livingstone, 1995, 425- 736.
[47]. Terry RJ, Trotter M the articulations. In schaeffer Jp , ed Morris Human anatomy . New York: Blakiston , 1953 b; 287 - 398.
[48]. Vleeming A, Pool Goudzwaard AL, Hammudoghlu D et al: The function of the long dorsal sacroiliac ligament. Spine 21, 1996, 556-562.
[49]. Vismara et al. Journal of NeuroEngineering and Rehabilitation 2010,7:3 http://www.jneuroengrehab.com/content/7/1/