Sling-based infant carrying affects lumbar and thoracic spine neuromechanics during standing and walking

Background

Regular infant carrying might be a contributing factor for the development and progression of low back and pelvic girdle pain in mothers after childbirth. However, the neuromechanical adaptations of the spine due to different sling-based carrying techniques are not sufficiently well understood in order to provide evidence-based carrying recommendations.

Research question

What are the immediate effects of different sling-based infant carrying techniques on trunk neuromechanics?

Methods

Using a Vicon motion capture and a wireless surface electromyography system, three-dimensional pelvis and spinal kinematics as well as activation patterns of eight trunk muscles were derived from fifteen healthy young women during upright standing and level walking without carrying a load and while carrying a 6 kg-dummy with a sling in front and on either side. Data were analyzed using Statistical Parametric Mapping, allowing group comparisons of discrete parameters (standing) as well as continuous data (walking). To distinguish between clinically relevant and clinically not relevant kinematic findings, statistically significant differences were only considered in case of ≥5°.

Results

Compared to unloaded walking, carrying the dummy in front was mainly associated with increased lumbar lordosis (standing: (Δ8.8°, p = 0.006; walking: (Δ ≥ 8.2°, 1–100% of gait cycle [%GC], p < 0.001). When carrying the dummy on the preferred side, increased thoracic kyphosis (standing: ≥6.4°, p ≤ 0.003; walking: Δ ≥ 5.6°, 1–100%GC, p < 0.001) and axial rotation towards the ipsilateral side (standing: Δ5.3°, p = 0.003; walking: Δ ≥ 5.0°, 46–58%GC, p = 0.002) were observed. All three conditions entailed increased paraspinal muscle activity during walking, although only unilaterally in side carrying (lumbar, preferred condition: Δ ≥ 13.2%maxMVIC, 49–57%GC, p < 0.001; thoracic, non-preferred condition: Δ ≥ 5.3%maxMVIC, 47–58%GC, p < 0.001).

Significance

Carrying an infant alternating on both sides using a sling could be advantageous for preventing musculoskeletal pain resulting from excessive lumbar hyperextension and paraspinal muscle hyperactivation in women after childbirth.

Keywords

Trunk ; Kinematics ; Gait ; Electromyography ; Statistical parametric mapping