Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Murtenstrasse 10, 3008, Bern, Switzerland.
Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
Int Urogynecol J. 2021 Feb;32(2):335-343. doi: 10.1007/s00192-020-04334-0. Epub 2020 May 29.
Running is known to cause urinary leakage in women with stress urinary incontinence (SUI). Task-specific fiber-type recruitment while running can be estimated using wavelets. The aim of this study was to compare the effect of a new physiotherapy program including involuntary, reflexive training with a standard physiotherapy program on pelvic floor muscle (PFM) activation patterns and fiber-type recruitment behavior while running.
In this triple-blinded randomized controlled trial, women with SUI were randomly allocated to the control group (CON), which performed a standard physiotherapy program, or the experimental group (EXP), which received additional involuntary, reflexive training. PFM electromyography (EMG) was recorded during 10 s at three running speeds and analyzed using Morse wavelets. The relative distribution of power (%) over the frequencies from 20 to 200 Hz was extracted and analyzed within six-time intervals of 30 ms. Statistical nonparametric mapping was performed to identify power spectra differences.
Thirty-nine (CON) and 38 (EXP) women were included. The power spectra showed no statistically significant group differences. The time intervals from 30 ms before to 30 ms after initial contact showed significantly lower intensities than the intervals from 30 to 150 ms after initial contact in the lowest and higher intensities in the highest frequencies for all running speeds and both groups.
Power spectra shifts toward higher frequency bands in the pre-initial contact phase could indicate a feed-forward anticipation and a muscle tuning for the expected impact of initial contact event in order to maintain continence.
众所周知，跑步会导致患有压力性尿失禁（SUI）的女性出现尿失禁。使用子波可以估计跑步时特定于任务的纤维类型募集。本研究的目的是比较包括非自愿、反射性训练的新物理治疗方案与标准物理治疗方案对盆底肌（PFM）在跑步时的激活模式和纤维募集行为的影响。
在这项三盲随机对照试验中，患有 SUI 的女性被随机分配到对照组（CON），接受标准物理治疗方案，或实验组（EXP），接受额外的非自愿、反射性训练。在三种跑步速度下，使用 Morse 子波记录 PFM 肌电图（EMG），并在 10 秒内进行分析。从 20 到 200 Hz 的频率提取相对功率分布（%），并在 30 毫秒的六个时间间隔内进行分析。进行统计非参数映射以识别功率谱差异。
共有 39 名（CON）和 38 名（EXP）女性入选。功率谱显示组间无统计学差异。在初始接触前 30 毫秒到初始接触后 30 毫秒的时间间隔内，所有跑步速度和两组的最低和最高强度的最低频率以及最高频率的强度均显著低于初始接触后 30 至 150 毫秒的间隔。
在初始接触前阶段，向更高频带的功率谱转移可能表明存在前馈预测和肌肉调整，以应对初始接触事件的预期影响，从而保持尿控。
