Tian Tania, Budgett Stephanie, Smalldridge Jackie, Hayward Lynsey, Stinear James, Kruger Jennifer
Auckland Bioengineering Institute, Auckland, New Zealand.
Department of Statistics, University of Auckland, Auckland, New Zealand.
Int Urogynecol J. 2018 Oct;29(10):1447-1454. doi: 10.1007/s00192-017-3473-6. Epub 2017 Sep 13.
There is a widely held, but untested, belief that certain exercises and activities generate intraabdominal pressure (IAP) that may compromise the function of the pelvic floor muscles. Women with, or at risk of, pelvic floor disorders are advised therefore to refrain from these exercises and activities in order to theoretically protect their pelvic floor. The aim of this study was to compare IAPs generated during exercises of different types that are recommended to women as pelvic floor "safe" with those generated during the corresponding conventional exercises that women are typically cautioned against.
This was a cross-sectional cohort study. All participants were guided by a trained exercise practitioner through a series of ten exercise pairs, one version recommended to women as pelvic floor "safe" and one conventional version which women are cautioned against. IAP components were extracted from the pressure traces from a wireless intravaginal pressure sensor and used in multivariate linear regression modelling, canonical discriminant analysis, and linear mixed modelling.
A total of 53 participants were recruited. After adjusting for age, body mass index and parity, there was an exercise type-version effect (p < 0.01). After taking into account all pressure components of the IAP trace, there was a significant difference in IAP between the recommended and discouraged versions of the same exercise for five of the ten exercise types. Coughing and the Valsalva manoeuvre generated IAPs that were distinct from those generated by the exercises.
No differences in IAPs were found between the recommended and discouraged versions of the same exercise for all exercise types. In particular, the IAPs generated during the two versions of ball rotations, lunges, core, push-ups and squats did not differ significantly. Performing the recommended pelvic floor "safe" version instead of the discouraged conventional version of these exercises may not necessarily protect the pelvic floor and vice versa.
有一种广泛存在但未经检验的观点，即某些运动和活动会产生腹内压（IAP），这可能会损害盆底肌肉的功能。因此，建议患有盆底功能障碍或有盆底功能障碍风险的女性避免这些运动和活动，以便从理论上保护她们的盆底。本研究的目的是比较推荐给女性作为盆底“安全”运动的不同类型运动与女性通常被警告不要进行的相应传统运动所产生的腹内压。
这是一项横断面队列研究。所有参与者在一名训练有素的运动教练的指导下，完成一系列十组运动，每组运动都有一个推荐给女性作为盆底“安全”的版本和一个女性应避免的传统版本。从无线阴道内压力传感器的压力轨迹中提取腹内压成分，并用于多变量线性回归建模、典型判别分析和线性混合建模。
共招募了53名参与者。在调整年龄、体重指数和产次后，存在运动类型 - 版本效应（p < 0.01）。在考虑腹内压轨迹的所有压力成分后，十种运动类型中有五种运动的推荐版本和不推荐版本之间的腹内压存在显著差异。咳嗽和瓦尔萨尔瓦动作产生的腹内压与运动产生的腹内压不同。
并非所有运动类型的推荐版本和不推荐版本之间的腹内压都存在差异。特别是，两种版本的转球、弓步、核心训练、俯卧撑和深蹲所产生的腹内压没有显著差异。进行推荐的盆底“安全”版本而不是不推荐的传统版本的这些运动不一定能保护盆底，反之亦然。
