Leitner Monika, Moser Helene, Taeymans Jan, Kuhn Annette, Radlinger Lorenz
Health Division/Physiotherapy, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland.
Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
Int Urogynecol J. 2015 Nov;26(11):1587-98. doi: 10.1007/s00192-015-2700-2. Epub 2015 May 21.
Investigations of the dynamic function of female pelvic floor muscles (PFM) help us to understand the pathophysiology of stress urinary incontinence (SUI). Displacement measurements of PFM give insight into muscle activation and thus help to improve rehabilitation strategies. This systematic review (PROSPERO 2013: CRD42013006409) was performed to summarise the current evidence for PFM displacement during voluntary and involuntary activation in continent and incontinent women.
MEDLINE, EMBASE, Cochrane and SPORTDiscus databases were searched using selected terminology reflecting the PICO approach. Screening of Google Scholar and congress abstracts added to further information. Original articles investigating PFM displacement were included if they reported on at least one of the aims of the review, e.g., method, test position, test activity, direction and quantification of displacement, as well as the comparison between continent and incontinent women. Titles and abstracts were screened by two reviewers. The papers included were reviewed by two individuals to ascertain whether they fulfilled the inclusion criteria and data were extracted on outcome parameters.
Forty-two predominantly observational studies fulfilled the inclusion criteria. A variety of measurement methods and calculations of displacement was presented. The sample was heterogeneous concerning age, parity and continence status. Test positions and test activities varied among the studies.
The findings summarise the present knowledge of PFM displacement, but still lack deeper comprehension of the SUI pathomechanism of involuntary, reflexive activation during functional activities. We therefore propose that future investigations focus on PFM dynamics during fast and stressful impact tasks.
对女性盆底肌（PFM）动态功能的研究有助于我们理解压力性尿失禁（SUI）的病理生理学。盆底肌的位移测量能深入了解肌肉激活情况，从而有助于改进康复策略。本系统评价（PROSPERO 2013：CRD42013006409）旨在总结目前关于 continent 和 incontinent 女性在自主和非自主激活过程中盆底肌位移的证据。
使用反映 PICO 方法的选定术语检索 MEDLINE、EMBASE、Cochrane 和 SPORTDiscus 数据库。对谷歌学术和会议摘要的筛选补充了更多信息。如果原始文章报告了至少一项本评价的目的，如方法、测试体位、测试活动、位移方向和量化，以及 continent 和 incontinent 女性之间的比较，则纳入研究 PFM 位移的原始文章。两名评审员筛选标题和摘要。两名人员对纳入的论文进行评审，以确定它们是否符合纳入标准，并提取关于结果参数的数据。
42 项主要为观察性的研究符合纳入标准。提出了多种测量方法和位移计算方法。样本在年龄、产次和尿失禁状态方面存在异质性。各研究的测试体位和测试活动各不相同。
这些发现总结了目前关于盆底肌位移的知识，但仍缺乏对功能活动中非自主、反射性激活的压力性尿失禁病理机制的深入理解。因此，我们建议未来的研究集中在快速和应激冲击任务期间的盆底肌动态。
