Bø Kari, Finckenhagen Hanne Borg
Norwegian University of Sport and Physical Education, Oslo, Norway.
Acta Obstet Gynecol Scand. 2003 Dec;82(12):1120-4. doi: 10.1046/j.1600-0412.2003.00240.x.
Traditionally, pelvic floor muscle function and strength have been measured in a supine position. However, stress urinary incontinence most often occurs in an upright position, and an important clinical question is whether measurement of pelvic floor muscle strength in the supine position reflects strength in standing. The purpose of the present study was to investigate whether there is a significant and clinical difference in pelvic floor muscle strength measurement in supine and standing position.
Eighteen women, mean age 43.4 years (range 31-64 years), with symptoms of stress and mixed incontinence attending a pelvic floor muscle-training program participated in the study. Measurement of pelvic floor muscle strength was conducted with a fiberoptic microtip transducer connected to a balloon catheter inserted into the vagina (Camtech AS, Sandvika, Norway). Measurement of resting pressure, maximum squeeze pressure, and holding period in seconds, were assessed in random order in supine and standing position.
The mean difference between supine and standing resting pressure was 8.6 cmH2O (95% CI 4.9-12.3), p < 0.001, between supine and standing maximum strength 0.3 cmH2O (95% CI - 4.0 to 3.4), p = 0.884, and between supine and standing holding period 0.9 s (95% CI - 3.3 to 1.4), p = 0.409.
Vaginal resting pressure was significantly higher in the standing compared to the supine position. Neither maximal strength nor holding time was different when comparing the two positions. Measurement of vaginal squeeze pressure is easier to perform and standardize in the supine compared to the standing position, and seems to reflect pelvic floor muscle strength in the standing position.
传统上，盆底肌肉功能和力量是在仰卧位进行测量的。然而，压力性尿失禁最常发生在直立位，一个重要的临床问题是仰卧位测量的盆底肌肉力量是否反映站立位的力量。本研究的目的是调查仰卧位和站立位测量盆底肌肉力量是否存在显著的临床差异。
18名年龄平均为43.4岁（范围31 - 64岁）、有压力性和混合性尿失禁症状且参加盆底肌肉训练项目的女性参与了本研究。使用连接到插入阴道的球囊导管的光纤微尖端换能器（挪威桑德维卡的Camtech AS公司）测量盆底肌肉力量。以随机顺序在仰卧位和站立位评估静息压力、最大挤压压力和以秒为单位的保持时间。
仰卧位和站立位静息压力的平均差异为8.6 cmH₂O（95%可信区间4.9 - 12.3），p < 0.001；仰卧位和站立位最大力量的差异为0.3 cmH₂O（95%可信区间 - 4.0至3.4），p = 0.884；仰卧位和站立位保持时间的差异为0.9秒（95%可信区间 - 3.3至1.4），p = 0.409。
与仰卧位相比，站立位时阴道静息压力显著更高。比较两个体位时，最大力量和保持时间均无差异。与站立位相比，仰卧位测量阴道挤压压力更容易操作且标准化，并且似乎能反映站立位时的盆底肌肉力量。
