Doctor of Physical Therapy Program, San Diego State University , San Diego, CA, USA.
Physiother Theory Pract. 2020 Dec;36(12):1340-1347. doi: 10.1080/09593985.2019.1571142. Epub 2019 Feb 1.
: Pelvic Floor Muscle Training (PFMT), an accepted treatment for incontinence and pelvic floor dysfunction, has good evidence, though it is unknown if adjunct therapies can be useful. Strengthening the obturator internus (OI), along with other hip external rotator muscles, may help strengthen the pelvic floor muscles (PFM) through fascial attachment. We hypothesized that strengthening the hip external rotators will improve intravaginal squeeze pressure in older women.: A total of 25 women (with or without pelvic floor dysfunction) greater than 55 years of age participated in monitored and home exercise sessions three times a week for 12 weeks. The exercises included concentric, isometric, and eccentric training of hip external rotators, without instruction to include PFM contraction. A physical therapist performed the assessments of each participant: Pelvic Floor Distress Inventory-20 (PFDI-20), a manual pelvic assessment, hip strength testing using a hand-held dynamometer and maximum intravaginal squeeze pressure using the Peritron PFM manometer (correct PFM contraction was confirmed visually and with palpation). Comparison was made to data obtained in a previous study in young women. Data were analyzed using paired t-tests and mixed model ANOVA.: Average intravaginal squeeze pressure increased from 21.47 ± 2.55 to 29.1 ± 3.15 cm H2O < 0.0001. Hip external rotation strength increased in the right hip from 12.75 ± 0.46 to 15.42 ± 0.63 lbs = 0.0009 and the left hip from 11.43 ± 0.43 to 15.61 ± 0.69 lbs < 0.0001. The PFDI-20 scores decreased from 56.88 ± 10.76 to 40.62 ± 10.63, > 0.05. Compared to a previous study in young women, both hip external rotation strength and intravaginal squeeze pressure increased with no significant difference between groups.: Hip external rotation exercises may be effective as an indirect form of PFM exercise.
: 骨盆底肌肉训练(PFMT)是一种被认可的治疗尿失禁和骨盆底功能障碍的方法,其疗效已得到充分证实,尽管目前尚不清楚辅助治疗是否有用。加强闭孔内肌(OI)以及其他髋关节外旋肌,可能通过筋膜附着来帮助加强骨盆底肌肉(PFM)。我们假设加强髋关节外旋肌将改善老年女性的阴道内挤压压力。: 共有 25 名年龄大于 55 岁的女性(无论是否患有骨盆底功能障碍)参加了每周三次的监测和家庭锻炼,持续 12 周。这些运动包括髋关节外旋肌的向心、等长和离心训练,但没有指导包括 PFM 收缩。一名物理治疗师对每位参与者进行了评估:盆腔窘迫量表 20 项(PFDI-20)、手动盆腔评估、使用手持测力计进行髋关节力量测试以及使用 Peritron PFM 测压器进行最大阴道内挤压压力测试(通过视觉和触诊确认正确的 PFM 收缩)。将结果与先前在年轻女性中获得的数据进行比较。使用配对 t 检验和混合模型方差分析进行数据分析。: 阴道内挤压压力的平均值从 21.47 ± 2.55 增加到 29.1 ± 3.15 cm H2O < 0.0001。右侧髋关节外旋力量从 12.75 ± 0.46 增加到 15.42 ± 0.63 磅 = 0.0009,左侧髋关节外旋力量从 11.43 ± 0.43 增加到 15.61 ± 0.69 磅 < 0.0001。PFDI-20 评分从 56.88 ± 10.76 下降到 40.62 ± 10.63, > 0.05。与年轻女性的先前研究相比,髋关节外旋力量和阴道内挤压压力均增加,两组之间无显著差异。: 髋关节外旋运动可能是一种间接的 PFM 运动形式,其效果是有效的。