Marshall K, Walsh D M, Baxter G D
Rehabilitation Sciences Research Group, University of Ulster at Jordanstown, Northern Ireland.
Clin Rehabil. 2002 Nov;16(7):795-9. doi: 10.1191/0269215502cr556oa.
To assess the specific effect of delivery of the first child on the integrity of the pelvic floor musculature.
A prospective study of two groups of females with no symptoms of urinary incontinence.
Physiotherapy Department, Rotunda Lying In Hospital, Dublin.
Two groups of healthy female physiotherapists (age range 20-28 years) were recruited for the study: group 1 consisted of nulliparous females (n = 10) and group 2 consisted of primiparous females who were 9-10 months post delivery (n = 10).
Assessment of the pelvic floor musculature was performed by digital assessment, electromyography and perineometry.
For all data, the nulliparous group showed evidence of greater pelvic floor strength and endurance. Analysis of anterior and posterior electromyography data showed significantly stronger contractions in the nulliparous group (p = 0.0001 and 0.044). During a maximum contraction of the pelvic floor muscles, the anterior resting EMG activity increased by 9 +/- 6 microV (mean +/- SD) in the primiparous group compared with an increment of 22.3 +/- 4.74 microV in the nulliparous group. Posterior EMG resting activity increased by 19.7 +/- 7.65 microV (mean +/- SD) in the nulliparous group compared with 13.8 +/- 8.19 microV in the primiparous group. There were significant differences between the two groups for the four types of digital muscle assessment (p < 0.0013). In addition, there was a greater increase in perineometry readings in the nulliparous group (increment = 5.6 +/- 2.5, mean +/- SD) compared with the primiparous group (increment = 3.1 +/- 0.9; mean +/- SD).
This study suggests that irrespective of lack of symptoms of urinary incontinence, it would appear advisable that all women should undertake a prescribed programme of pelvic floor rehabilitation exercises after childbirth.
评估首次分娩对盆底肌肉组织完整性的具体影响。
对两组无尿失禁症状女性进行的前瞻性研究。
都柏林罗通达妇产医院理疗科。
招募两组健康的女性理疗师（年龄范围20 - 28岁）参与研究：第1组由未生育女性组成（n = 10），第2组由产后9 - 10个月的经产妇组成（n = 10）。
通过指诊评估、肌电图检查和会阴测量法对盆底肌肉组织进行评估。
对于所有数据，未生育组显示出更强的盆底力量和耐力。对前后肌电图数据的分析表明，未生育组的收缩明显更强（p = 0.0001和0.044）。在盆底肌肉最大收缩时，经产妇组的前静息肌电图活动增加了9±6微伏（平均值±标准差），而未生育组增加了22.3±4.74微伏。未生育组的后肌电图静息活动增加了19.7±7.65微伏（平均值±标准差），而经产妇组增加了13.8±8.19微伏。两组在四种指诊肌肉评估类型上存在显著差异（p < 0.0013）。此外，未生育组的会阴测量读数增加幅度更大（增加量 = 5.6±2.5，平均值±标准差），而经产妇组为（增加量 = 3.1±0.9；平均值±标准差）。
本研究表明，无论是否有无尿失禁症状，但似乎所有女性在产后都应进行规定的盆底康复锻炼计划。
