Stuge Britt, Sætre Kaja, Ingeborg Hoff Brækken
Department of Orthopaedics, Oslo University Hospital, Kirkeveien 166, 0407 Oslo, Norway.
Man Ther. 2013 Aug;18(4):327-32. doi: 10.1016/j.math.2012.12.004. Epub 2013 Jan 11.
The active straight leg raise (ASLR) test has been proposed as a clinical test for the assessment of pelvic girdle pain (PGP). Little is known about the activation of the pelvic floor muscles (PFM) during ASLR. The main aim of this study was to examine the automatic PFM contraction during ASLR. Specific aims were to compare automatic contraction to rest and to voluntary contraction, to compare PFM contraction during ASLR with and without compression and to examine whether there were any differences in PFM contraction between women with and without clinically diagnosed PGP during ASLR. Forty-nine pairs of women participated in a cross-sectional study with individual, one-to-one matched cases and controls. PFM was assessed by reliable and valid 3D ultrasound at rest, during voluntary and automatic contraction. Test-retest data for the levator hiatus during ASLR showed good repeatability. Significantly automatic PFM contractions occurred when ASLR tests were performed. There was a strong positive correlation between voluntary and automatic PFM contractions. Manual compression reduced the automatic PFM contraction during ASLR by 62-66%. There were no significant differences between cases and controls in reduction of levator hiatus or muscle length from rest to automatic contractions during ASLR. Interestingly, a significantly smaller levator hiatus was found in women with PGP than in controls, at rest, during an automatic contraction with ASLR and during voluntary contraction. In conclusion, a significant automatic PFM contraction occurred during ASLR, both in cases and in controls. Women with PGP had a significantly smaller levator hiatus than controls.
主动直腿抬高（ASLR）试验已被提议作为评估骨盆带疼痛（PGP）的一项临床检查。关于ASLR期间盆底肌（PFM）的激活情况，人们了解甚少。本研究的主要目的是检测ASLR期间PFM的自动收缩情况。具体目标包括将自动收缩与静息状态及自主收缩进行比较，比较有和没有施加压力时ASLR期间的PFM收缩情况，以及检查在ASLR期间临床诊断为有或没有PGP的女性之间PFM收缩是否存在差异。四十九对女性参与了一项横断面研究，病例与对照为一对一匹配。通过可靠且有效的三维超声在静息、自主收缩和自动收缩期间评估PFM。ASLR期间提肛裂孔的重测数据显示出良好的重复性。进行ASLR试验时出现了显著的PFM自动收缩。PFM的自主收缩与自动收缩之间存在强正相关。手动加压使ASLR期间PFM的自动收缩减少了62%至(66%)。在ASLR期间，从静息到自动收缩，病例组和对照组在提肛裂孔减小或肌肉长度方面没有显著差异。有趣的是，在静息、ASLR自动收缩期间以及自主收缩期间，患有PGP的女性的提肛裂孔明显小于对照组。总之，在ASLR期间，病例组和对照组均出现了显著的PFM自动收缩。患有PGP的女性的提肛裂孔明显小于对照组。
