Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland -
Department and Clinic of Urology, Faculty of Postgraduate Medical Training, Wroclaw Medical University, Wroclaw, Poland.
Eur J Phys Rehabil Med. 2017 Aug;53(4):564-574. doi: 10.23736/S1973-9087.17.04475-6. Epub 2017 Jan 30.
Menopausal women often experience the prolapse of the uterus, bladder and rectum resulting from the failure and weakening of the pelvic floor muscles (PFM). Strengthening of the PFM through the standard exercises is recognized as an effective way of preventive measures and conservative treatment of the symptoms listed above, but still need to be improved.
The goal was the objective assessment of resting and functional bioelectrical activity of PFM in women during menopause and its comparison in three different positions of the pelvis: anterior pelvic tilt - position 1 (P1), posterior pelvic tilt - position 2 (P2), and neutral pelvic tilt - position 3 (P3).
Prospective, cross-sectional observational study.
Department and Clinic of Urology of a University Hospital.
The target group of this study included women in the menopausal period (inpatient and outpatient).
The study evaluating resting and functional activity of the PFM depending on the orientation of pelvis. Bioelectric activity was assessed with an electromyographic instrument (sEMG) and endovaginal electrodes. The inclination angle was measured with an inclinometer. The comparisons of results between the values obtained in P1, P2, and P3 were performed using one-way Analysis of Variance (ANOVA).
One hundred thirty-one registered for the study were screened for inclusion and exclusion criteria and on the basis of the results 82 participants were enrolled for analysis. The highest mean resting activity of sEMG PFM (µV) was observed in P2 and it amounted to 11.6 µV (SD=5.5 µV) in P1 the value equaled 9.8 µV (SD=4.8 µV) and P3-9.0 µV (SD=4.2 µV). The results revealed a significant statistical difference (main effect: P=0.0007). Considering the functional sEMG activity of PFM (µV), the highest mean value was recorded in P2.
Posterior pelvic tilt position determines higher resting and functional bioelectric activity of PFM. Additionally, electromyographic activity of PFM increases during the pelvic movement backwards.
These positions should be implemented in therapy in order to improve the effectiveness of the effect on the pelvic floor.
绝经后妇女常因盆底肌（pelvic floor muscle，PFM）衰竭和薄弱而出现子宫、膀胱和直肠脱垂。通过标准锻炼增强 PFM 被认为是预防和保守治疗上述症状的有效方法，但仍需改进。
本研究旨在客观评估绝经后妇女在三种不同骨盆位置（骨盆前倾位 1（P1）、骨盆后倾位 2（P2）和骨盆中立位 3（P3）时 PFM 的静息和功能生物电活动，并进行比较。
前瞻性、横断面观察性研究。
大学医院泌尿科系和诊所。
本研究的目标人群包括绝经期间的女性（住院和门诊患者）。
本研究评估了 PFM 随骨盆方向的静息和功能活动。生物电活动通过肌电图仪（sEMG）和阴道内电极进行评估。使用测斜仪测量倾斜角度。通过单因素方差分析（ANOVA）比较 P1、P2 和 P3 中获得的结果之间的差异。
有 131 名符合研究纳入和排除标准的患者进行了筛查，其中 82 名符合纳入标准并参与了分析。P2 时 PFM 的 sEMG 静息活动最高平均（µV）为 11.6 µV（SD=5.5 µV），P1 时为 9.8 µV（SD=4.8 µV），P3 时为 9.0 µV（SD=4.2 µV）。结果显示有显著的统计学差异（主效应：P=0.0007）。考虑到 PFM 的功能 sEMG 活动，P2 时记录到的平均最高值。
骨盆后倾位决定了 PFM 更高的静息和功能生物电活动。此外，骨盆向后移动时 PFM 的肌电图活动增加。
为了提高对盆底的治疗效果，这些姿势应在治疗中实施。
