Harris-Hayes Marcie, Spitznagle Theresa, Probst Daniel, Foster Stefanie N, Prather Heidi
Program in Physical Therapy and Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri.
Division of Physical Medicine and Rehabilitation, Department of Neurology, Washington University School of Medicine, St. Louis, Missouri.
PM R. 2019 Aug;11 Suppl 1(Suppl 1):S73-S82. doi: 10.1002/pmrj.12209. Epub 2019 Jul 25.
The purpose of this narrative review is to present the evidence relating to musculoskeletal impairments found in people with nonspecific chronic pelvic pain (CPP). The musculoskeletal impairments assessed in this review include pelvic floor muscle: performance, resting state, strength, activation, posture and movement patterns. A search was performed systematically using PubMed, Cochrane, CINAHL, Embase, and Web of Science databases from 1998 to 2018 to identify studies reporting the relationship between nonspecific CPP and musculoskeletal impairments of the hip, pelvis, and trunk. The search resulted in 2106 articles that were screened by two authors. Remaining articles were screened by an additional two authors for inclusion in this review. Thirty-one articles remained after initial screening. Full-text publications were reviewed and an additional 25 articles were excluded. Six additional articles were located through review of the reference lists of included articles. The final review included 12 publications. Seven of these studies were cross-sectional cohorts or case-control comparing patients with CPP to asymptomatic controls. The level of evidence for the studies included in this review was low at Levels 4 and 5. We were unable to draw clear conclusions regarding the relationships of musculoskeletal impairments and CPP because validity and use of terms and assessments were inconsistent. Further research is needed with standardized definitions and measurements to better understand the musculoskeletal system as it relates to nonspecific CPP.
本叙述性综述的目的是展示与非特异性慢性盆腔疼痛（CPP）患者中发现的肌肉骨骼损伤相关的证据。本综述中评估的肌肉骨骼损伤包括盆底肌肉：性能、静息状态、力量、激活、姿势和运动模式。使用PubMed、Cochrane、CINAHL、Embase和Web of Science数据库，对1998年至2018年的研究进行了系统检索，以确定报告非特异性CPP与髋部、骨盆和躯干肌肉骨骼损伤之间关系的研究。检索结果为2106篇文章，由两位作者进行筛选。其余文章由另外两位作者筛选以纳入本综述。初步筛选后剩下31篇文章。对全文出版物进行了审查，又排除了25篇文章。通过查阅纳入文章的参考文献列表又找到了6篇文章。最终综述纳入了12篇出版物。其中7项研究为横断面队列研究或病例对照研究，将CPP患者与无症状对照进行比较。本综述中纳入研究的证据水平在4级和5级，较低。由于术语和评估的有效性及使用不一致，我们无法就肌肉骨骼损伤与CPP之间的关系得出明确结论。需要进一步开展具有标准化定义和测量方法的研究，以更好地了解与非特异性CPP相关的肌肉骨骼系统。
