Smith Michelle D, Coppieters Michel W, Hodges Paul W
Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Queensland, Australia.
Neurourol Urodyn. 2008;27(1):71-8. doi: 10.1002/nau.20476.
This study investigated whether there are differences in center of pressure (COP) displacement, trunk motion, and trunk muscle activity in women with and without stress urinary incontinence (SUI) during static balance tasks when the bladder is empty and moderately full.
Subjects stood on a force plate during six static balance conditions: eyes open, eyes closed, standing on foam with eyes open, standing on foam with eyes closed, tandem stance, and standing on a short base. Electromyographic activity (EMG) of the pelvic floor (PF), abdominal, and erector spinae muscles were recorded using surface electrodes. Motion of the lumbar spine, pelvis, and hips was measured with four inclinometers. Trials were performed with the bladder empty, and when the subject reported a sensation of moderate bladder fullness after drinking 250-1,000 ml of water.
Women with SUI had greater COP displacement (range and root mean square), and increased trunk muscle EMG during static balance tests compared to continent women. When tasks were performed with the bladder moderately full, COP displacement and abdominal muscle EMG were increased in both groups.
This study demonstrates that women with SUI have decreased balance ability compared to continent women. Increased activity of the PF and trunk muscles in women with SUI may impair balance as a result of a reduced contribution of trunk movement to postural correction or compromised proprioceptive acuity. As compromised balance has been linked to falls risk, further research into balance deficits and falls prevalence in this population is warranted.
本研究调查了在膀胱排空和适度充盈状态下,压力性尿失禁(SUI)女性与非SUI女性在静态平衡任务期间,其压力中心(COP)位移、躯干运动和躯干肌肉活动是否存在差异。
受试者在六种静态平衡条件下站立在测力板上:睁眼、闭眼、睁眼站在泡沫垫上、闭眼站在泡沫垫上、串联站立以及窄基底站立。使用表面电极记录盆底(PF)、腹部和竖脊肌的肌电图活动(EMG)。用四个倾角仪测量腰椎、骨盆和髋关节的运动。在膀胱排空时以及受试者饮用250 - 1000毫升水后报告有中度膀胱充盈感时进行试验。
与无尿失禁女性相比,SUI女性在静态平衡测试中COP位移更大(范围和均方根),且躯干肌肉EMG增加。当膀胱适度充盈时进行任务时,两组的COP位移和腹部肌肉EMG均增加。
本研究表明,与无尿失禁女性相比,SUI女性的平衡能力下降。SUI女性PF和躯干肌肉活动增加可能会损害平衡,这是由于躯干运动对姿势矫正的贡献减少或本体感觉敏锐度受损所致。由于平衡受损与跌倒风险相关,因此有必要对该人群的平衡缺陷和跌倒发生率进行进一步研究。