产后女性盆底肌和腹横肌收缩对耻直肌间距的影响：一项横断面实验研究。

Effect of pelvic floor and transversus abdominis muscle contraction on inter-rectus distance in postpartum women: a cross-sectional experimental study.

机构信息

Physiotherapy Research Group, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.

出版信息

Physiotherapy. 2019 Sep;105(3):315-320. doi: 10.1016/j.physio.2018.08.009. Epub 2018 Oct 25.

DOI:10.1016/j.physio.2018.08.009

PMID:30808514

Abstract

OBJECTIVES

To investigate the effect of acute isometric contraction of the pelvic floor muscles (PFM) and transversus abdominis muscle (TrAM) on inter-rectus distance (IRD) from resting values in postpartum women with diastasis rectus abdominis (DRA).

DESIGN

Cross sectional experimental study.

SETTING

Physiotherapy clinic.

PARTICIPANTS

Thirty eight postpartum women presenting with DRA of at least two finger widths.

METHODS

Two dimensional ultrasound images of IRD were recorded using a linear probe (5 to 10MHz) at rest, during PFM contraction, during TrAM contraction, and during combined PFM and TrAM contraction. IRD data were normally distributed.

MAIN OUTCOME MEASURE

Change in IRD.

RESULTS

There was a significant increase in IRD during PFM and TrAM contraction compared with IRD at rest. At 2cm above the umbilicus, mean PFM was 26.9 [standard deviation (SD) 8.8] mm vs rest 25.7 (SD 8.5) mm {mean difference 1.2 [95% confidence interval (CI) 0.7 to 1.7] mm}; and mean TrAM was 28.4 (SD 9.0) mm vs rest 25.7 (SD 8.5) mm [mean difference 2.8 (95% CI 1.9 to 3.6) mm]. Similarly, 2cm below the umbilicus, mean PFM was 22 (SD 8.3) mm vs rest 21 (SD 7.9) mm [mean difference 0.9 (95% CI 0.4 to 1.6) mm]; and mean TrAM was 23.3 (SD 8.7) mm vs rest 21 (SD 7.9) mm [mean difference 2.3 (95% CI 1.5 to 3.1) mm]. Combined TrAM and PFM contraction measured 2cm above the umbilicus caused the greatest increase in IRD: mean PFM+TrAM 29.6 (SD 9.4) mm vs rest 25.7 (SD 8.5) mm [mean difference 3.9 (95% CI 2.8 to 5.0) mm].

CONCLUSION

Both PFM and TrAM contraction, and combined PFM and TrAM contraction increased IRD in postpartum women with DRA.

摘要

目的

研究急性等长收缩盆底肌（PFM）和腹横肌（TrAM）对产后腹直肌分离（DRA）患者静息状态下耻骨直肠间距（IRD）的影响。

设计

横断面实验研究。

地点

物理治疗诊所。

参与者

38 名产后出现至少两指宽 DRA 的女性。

方法

使用线性探头（5-10MHz）在静息、PFM 收缩、TrAM 收缩和 PFM 和 TrAM 联合收缩时记录 IRD 的二维超声图像。IRD 数据呈正态分布。

主要观察指标

IRD 的变化。

结果

与静息时相比，PFM 和 TrAM 收缩时 IRD 显著增加。在脐上 2cm 处，PFM 的平均收缩值为 26.9[标准差（SD）8.8]mm，静息时为 25.7（SD 8.5）mm{平均差值 1.2[95%置信区间（CI）0.7 至 1.7]mm}；TrAM 的平均收缩值为 28.4（SD 9.0）mm，静息时为 25.7（SD 8.5）mm[平均差值 2.8（95%CI 1.9 至 3.6）mm]。同样，在脐下 2cm 处，PFM 的平均收缩值为 22（SD 8.3）mm，静息时为 21（SD 7.9）mm[平均差值 0.9（95%CI 0.4 至 1.6）mm]；TrAM 的平均收缩值为 23.3（SD 8.7）mm，静息时为 21（SD 7.9）mm[平均差值 2.3（95%CI 1.5 至 3.1）mm]。在脐上 2cm 处测量时，PFM 和 TrAM 联合收缩引起的 IRD 增加最大：PFM+TrAM 平均收缩值为 29.6（SD 9.4）mm，静息时为 25.7（SD 8.5）mm[平均差值 3.9（95%CI 2.8 至 5.0）mm]。