Division of Physiotherapy, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.
Faculty of Sport and Rehabilitation Sciences, Vrije Universiteit Brussel, Brussels, Belgium.
Neurourol Urodyn. 2019 Nov;38(8):2374-2382. doi: 10.1002/nau.24161. Epub 2019 Sep 7.
The prevalence of stress urinary incontinence during high-impact activities is high. Enhanced comprehension of pelvic floor muscle (PFM) displacement and activity is clinically relevant for the development of specific approaches in rehabilitation. The aim of the study is to investigate and to compare PFM displacement between the continent and incontinent women during jumps.
A cross-sectional, exploratory design was applied to investigate PFM displacement during drop jumps (DJ) and countermovement jumps (CMJ). PFM displacement was assessed in craniocaudal translation and forward-backward rotation with an electromagnetic tracking system.
Twenty-eight continent and 22 incontinent women were included. During the first landing of DJ, a primary caudal, during the second landing of DJ/CMJ a primary cranial translation and during all jump a primary backward rotation was observed. No significant difference between the groups was found.
PFM displacement during running demonstrated caudal translation/forward rotation before and cranial translation/backward rotation after heel strike. During the second landing of DJ/CMJ a cranial translation/backward rotation and during the first landing of DJ a caudal translation/backward rotation has been observed after ground contact. This may be due to the longer lasting bodyweight force in the first landing of DJ. No eccentric-concentric stretch-shortening cycle could be seen.
This study indicates that during jumps two opposite reactions of involuntary PFM displacement happen, but no stretch-shortening cycle with an eccentric-concentric contraction could be found. Jumping stimuli inducing involuntary PFM displacement should be used for future investigations to consider a beneficial effect concerning continence.
高强度活动期间发生压力性尿失禁的患病率很高。深入了解盆底肌(PFM)的位移和活动对于康复中特定方法的发展具有重要的临床意义。本研究旨在探讨和比较在跳跃过程中,有控尿能力和无控尿能力的女性的 PFM 位移。
采用横断面、探索性设计,研究了在跳下跳(DJ)和反向跳(CMJ)中 PFM 的位移。使用电磁跟踪系统评估了在头-尾方向平移和前-后旋转方向上的 PFM 位移。
共纳入 28 名有控尿能力的女性和 22 名无控尿能力的女性。在 DJ 的第一次着陆时,观察到主要是尾向位移;在 DJ/CMJ 的第二次着陆时,观察到主要是头向平移;在所有跳跃中,观察到主要是向后旋转。组间无显著差异。
在跑步过程中,PFM 位移表现为在脚跟触地前,呈尾向平移/前向旋转,在脚跟触地后,呈头向平移/后向旋转。在 DJ/CMJ 的第二次着陆和 DJ 的第一次着陆时,观察到了在触地后,出现头向平移/后向旋转和尾向平移/后向旋转。这可能是由于 DJ 的第一次着陆中,持续时间更长的体重力。没有观察到离心-向心的伸展-缩短周期。
本研究表明,在跳跃过程中,会发生两种相反的 PFM 位移反应,但没有发现具有离心-向心收缩的伸展-缩短周期。应使用诱发 PFM 位移的跳跃刺激进行未来的研究,以考虑对控尿能力有益的效果。