{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T11:45:36Z","timestamp":1768995936071,"version":"3.49.0"},"reference-count":47,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T00:00:00Z","timestamp":1684368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["UIDB\/05210\/2020"],"award-info":[{"award-number":["UIDB\/05210\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Background: Scars interfere with the motor system; however, the influence of c-section scars has not been described yet. The aim of this study is to relate the presence of abdominal scars from a caesarean section with changes in postural control\u2014stability and orientation and abdominal and lumbar neuromuscular control in the orthostatic position. Methods: Cross-sectional analytical observational study comparing healthy primiparous women with caesarean delivery (n = 9) and physiologic delivery (n = 12) who have delivered more than one year before. The relative electromyographic activity of the rectus abdominis, transverse abdominis\/oblique internus and lumbar multifidus muscles, antagonist co-activation, the ellipse area, amplitude, displacement, velocity, standard deviation, and spectral power of the centre of pressure, and thoracic and lumbar curvatures, were evaluated in the standing position in both groups, through an electromyographic system, a pressure platform and spinal mouse system. In the \u201ccaesarean delivery\u201d group, scar mobility was evaluated using a modified adheremeter. Results: Significant differences in CoP medial-lateral velocity and mean velocity were observed between groups (p &lt; 0.050), while no significant differences were in the level of muscle activity, antagonist co-activation, and thoracic and lumbar curvatures (p &gt; 0.05). Conclusions: The information provided by the pressure signal seems to identify postural impairments in women with c-sections.<\/jats:p>","DOI":"10.3390\/s23104878","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T00:55:29Z","timestamp":1684457729000},"page":"4878","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Could Electromyographic and Pressure Related Signals Identify Differences in Abdominal Activity and Postural Control between Women with and without C-Section?"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2168-1135","authenticated-orcid":false,"given":"Ana","family":"Figueiredo","sequence":"first","affiliation":[{"name":"Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, rua Dr. Ant\u00f3nio Bernardino de Almeida, 4200-072 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0949-0918","authenticated-orcid":false,"given":"Maria","family":"Lopes","sequence":"additional","affiliation":[{"name":"Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, rua Dr. Ant\u00f3nio Bernardino de Almeida, 4200-072 Porto, Portugal"}]},{"given":"Ana","family":"Pereira","sequence":"additional","affiliation":[{"name":"Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, rua Dr. Ant\u00f3nio Bernardino de Almeida, 4200-072 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9528-1463","authenticated-orcid":false,"given":"Andreia","family":"Sousa","sequence":"additional","affiliation":[{"name":"Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, rua Dr. Ant\u00f3nio Bernardino de Almeida, 4200-072 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1484-1893","authenticated-orcid":false,"given":"Cl\u00e1udia","family":"Silva","sequence":"additional","affiliation":[{"name":"Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, rua Dr. Ant\u00f3nio Bernardino de Almeida, 4200-072 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2590-962X","authenticated-orcid":false,"given":"Andreia","family":"Noites","sequence":"additional","affiliation":[{"name":"Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, rua Dr. Ant\u00f3nio Bernardino de Almeida, 4200-072 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,18]]},"reference":[{"key":"ref_1","first-page":"3","article-title":"Altera\u00e7\u00f5es fisiol\u00f3gicas maternas da gravidez","volume":"43","author":"Reis","year":"2020","journal-title":"Braz. J. Anesth."},{"key":"ref_2","unstructured":"King, T.L., Brucker, M.C., Jevitt, C., and Osborne, K. (2019). Varney\u2019s Midwifery, Jones & Bartlett Learning. [6th ed.]."},{"key":"ref_3","first-page":"93","article-title":"Resposta materno-fetal resultante da pr\u00e1tica de exerc\u00edcio f\u00edsico durante a gravidez: Uma revis\u00e3o sistem\u00e1tica","volume":"25","author":"Velloso","year":"2015","journal-title":"Rev. Med. Minas Gerais"},{"key":"ref_4","unstructured":"Sung, S., and Mahdy, H. (2022). StatPearls, StatPearls Publishing."},{"key":"ref_5","first-page":"CD004662","article-title":"Techniques for caesarean section","volume":"1","author":"Hofmeyr","year":"2008","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1016\/j.ajog.2005.03.063","article-title":"Evidence-based surgery for cesarean delivery","volume":"193","author":"Berghella","year":"2005","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.ajog.2013.02.043","article-title":"Evidence-based surgery for cesarean delivery: An updated systematic review","volume":"209","author":"Dahlke","year":"2013","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_8","unstructured":"Campos, D., Furtado, J., Cris\u00f3stomo, M., Carrapato, R., Cunha, E., and Concei\u00e7\u00e3o, M. (2010). Medidas para Reduzir a Taxa de Cesarianas na Regi\u00e3o Norte de Portugal, Minist\u00e9rio da Sa\u00fade\u2013ARS Norte."},{"key":"ref_9","unstructured":"PORDATA (2021, December 05). Cesarianas nos Hospitais. Available online: https:\/\/www.pordata.pt\/Portugal\/Cesarianas+nos+hospitais+(percentagem)-1985."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1e-S","DOI":"10.1097\/01.prs.0000225428.38108.67","article-title":"Wound healing: An overview","volume":"117","author":"Janis","year":"2006","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.jmpt.2004.05.004","article-title":"Clinical importance of active scars: Abnormal scars as a cause of myofascial pain","volume":"27","author":"Lewit","year":"2004","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.jbmt.2013.03.012","article-title":"\u2018The core\u2019: Understanding it, and retraining its dysfunction","volume":"17","author":"Key","year":"2013","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_13","first-page":"97","article-title":"Diastasis recti abdominis\u2014A review of treatment methods","volume":"89","author":"Michalska","year":"2018","journal-title":"J. Pol. Soc. Ginecol. Obstet."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1080\/09593985.2016.1228722","article-title":"Defining a Bobath clinical framework\u2014A modified e-Delphi study","volume":"32","author":"Cott","year":"2016","journal-title":"Physiother. Theory Pract."},{"key":"ref_15","unstructured":"Richardson, C. (2004). Therapeutic Exercise for Lumbopelvic Stabilization: A Motor Control Approach for the Treatment and Prevention of Low Back Pain, Churchill Livingstone."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1590\/S1413-35552010000300003","article-title":"Revision of posturography based on force plate for balance evaluation","volume":"14","author":"Duarte","year":"2010","journal-title":"Braz. J. Phys. Ther."},{"key":"ref_17","unstructured":"Horak, F.B. (1996). The Acquisition of Motor Behavior in Vertebrates, MIT Press."},{"key":"ref_18","first-page":"2500109","article-title":"The Compressiometer: Toward a New Skin Tensiometer for Research and Surgical Planning","volume":"10","author":"Scheepens","year":"2021","journal-title":"IEEE J. Transl. Eng. Health Med."},{"key":"ref_19","unstructured":"Dire\u00e7\u00e3o-Geral da Sa\u00fade (2013). Avalia\u00e7\u00e3o Antropom\u00e9trica no Adulto, Orienta\u00e7\u00e3o no 017\/2013."},{"key":"ref_20","unstructured":"(2022, January 20). COMED. Available online: https:\/\/www.comed.fr\/fr\/produits\/117-Metre-ruban."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"776","DOI":"10.2522\/ptj.20090048","article-title":"Validation of a new device to measure postsurgical scar adherence","volume":"90","author":"Ferriero","year":"2010","journal-title":"Phys. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1016\/j.jbmt.2018.02.017","article-title":"Reliability of modified adheremeter and digital pressure algometer in measuring normal abdominal tissue and C-section scars","volume":"22","author":"Doughty","year":"2018","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1001\/archderm.1988.01670060015008","article-title":"The validity and practicality of sun-reactive skin types I through VI","volume":"124","author":"Fitzpatrick","year":"1988","journal-title":"Arch. Dermatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1249\/01.MSS.0000078924.61453.FB","article-title":"International Physical Activity Questionnaire: 12- Country Reliability and Validity","volume":"35","author":"Craig","year":"2003","journal-title":"Med. Sci. Sport. Exerc."},{"key":"ref_25","unstructured":"Sousa, S.G. (2012). Depress\u00e3o P\u00f3s-Parto: Estudo de Preval\u00eancia e Dete\u00e7\u00e3o de Fatores de Risco. [Master\u2019s Thesis, Universidade da Beira Interior]. Available online: http:\/\/hdl.handle.net\/10400.6\/116319."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1192\/bjp.169.1.30","article-title":"Comparative incidence of depression in women and men, during pregnancy and after childbirth: Validation of the Edinburgh Postnatal Depression Scale in Portuguese mothers","volume":"169","author":"Areias","year":"1996","journal-title":"Br. J. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1016\/j.clinbiomech.2015.07.002","article-title":"Clinical Biomechanics Ankle anticipatory postural adjustments during gait initiation in healthy and post-stroke subjects","volume":"30","author":"Sousa","year":"2015","journal-title":"Clin. Biomech."},{"key":"ref_28","unstructured":"(2022, January 10). Physiosensing. Available online: https:\/\/www.physiosensing.net\/."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1007\/s00586-015-3945-7","article-title":"The validity and reliability of \u201cSpinal Mouse\u201d assessment of spinal curvatures in the frontal plane in pediatric adolescent idiopathic thoraco-lumbar curves","volume":"25","author":"Livanelioglu","year":"2016","journal-title":"Eur. Spine J."},{"key":"ref_30","unstructured":"ACSM (2014). Guidelines for Exercise Testing and Prescription, Wolters Kluwer. [9th ed.]."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/j.1475-097X.2004.00534.x","article-title":"Comparison of hand-to-hand bioimpedance and anthropometry equations versus dual-energy X-ray absorptiometry for the assessment of body fat percentage in 17\u201318-year-old conscripts","volume":"24","author":"Lintsi","year":"2004","journal-title":"Clin. Physiol. Funct. Imaging"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1590\/S1983-51752012000200003","article-title":"Distribui\u00e7\u00e3o de queloide e cicatriz hipertr\u00f3fica segundo fototipos de pele de Fitzpatrick","volume":"27","author":"Hochman","year":"2012","journal-title":"Rev. Bras. Cir. Pl\u00e1stica"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.physio.2013.11.006","article-title":"Inter-rectus distance in postpartum women can be reduced by isometric contraction of the abdominal muscles: A preliminary case\u2013control study","volume":"100","author":"Pascoal","year":"2014","journal-title":"Physiotherapy"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.math.2012.10.013","article-title":"Reliability of the inter-rectus distance measured by palpation. Comparison of palpation and ultrasound measurements","volume":"18","author":"Mota","year":"2013","journal-title":"Man. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1002\/ca.20836","article-title":"The normal width of the linea alba in nulliparous women","volume":"22","author":"Beer","year":"2009","journal-title":"Clin. Anat."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1097\/JWH.0b013e318276f35f","article-title":"Diastasis recti abdominis: A survey of women\u2019s health specialists for current physical therapy clinical practice for postpartum women","volume":"36","author":"Keeler","year":"2012","journal-title":"J. Women\u2019s Health Phys. Ther."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S1050-6411(00)00027-4","article-title":"Development of recommendations for SEMG sensors and sensor placement procedures","volume":"10","author":"Hermens","year":"2000","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_38","unstructured":"(2022, January 10). SENIAM. Available online: http:\/\/www.seniam.org."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/S1050-6411(03)00027-0","article-title":"The validity and reliability of surface EMG to assess the neuromuscular response of the abdominal muscles to rapid limb movement","volume":"13","author":"Marshall","year":"2003","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Esteban-Garc\u00eda, P., Rubio-Arias, J.\u00c1., Abi\u00e1n-Vicen, J., S\u00e1nchez-Infante, J., and Jim\u00e9nez-D\u00edaz, J.F. (2020). Core Stability and Electromyographic Activity of the Trunk Musculature in Different Woman\u2019s Sports. Sustainability, 12.","DOI":"10.3390\/su12239880"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.humov.2015.11.015","article-title":"Influence of prolonged wearing of unstable shoes on upright standing postural control","volume":"45","author":"Sousa","year":"2016","journal-title":"Hum. Mov. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.jelekin.2018.10.006","article-title":"Antagonist co-activation during short and medium latency responses in subjects with chronic ankle instability","volume":"43","author":"Sousa","year":"2018","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/S0268-0033(02)00107-9","article-title":"Stabilometric parameters are affected by anthropometry and foot placement","volume":"17","author":"Chiari","year":"2002","journal-title":"Clin. Biomech."},{"key":"ref_44","unstructured":"Sensing Future Technologies (2018). Manual do Software PhysioSensing 19.0.1.0, Sensing Future Technologies."},{"key":"ref_45","unstructured":"Lee, D.G. (2011). The Pelvic Girdle: An Integration of Clinical Expertise and Research, Elsevier Health Sciences."},{"key":"ref_46","first-page":"89","article-title":"Power spectral density in balance assessment. Description of methodology","volume":"12","author":"Syczewska","year":"2010","journal-title":"Acta Bioeng. Biomech"},{"key":"ref_47","unstructured":"Konrad, P. (2006). The ABC of EMG, Noraxon USA Inc."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/10\/4878\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:37:57Z","timestamp":1760125077000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/10\/4878"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,18]]},"references-count":47,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["s23104878"],"URL":"https:\/\/doi.org\/10.3390\/s23104878","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,18]]}}}