Department of Kinesiology, The Pennsylvania State University, State College, USA.
Southhills School¡ of Business and Technology, Diagnostic Medical Sonography, State College, USA.
Int Urogynecol J. 2020 Dec;31(12):2645-2652. doi: 10.1007/s00192-020-04461-8. Epub 2020 Aug 26.
Pelvic floor physical therapists have long utilized breathing cues with exercises and are beginning to incorporate vocalization tasks. To date, there have been no publications describing pelvic floor displacement during vocalization tasks. This study is a preliminary investigation into the changes in bladder shape distortion as a proxy for pelvic floor muscle displacement during respiratory and phonatory tasks.
Bladders were imaged using two-dimensional ultrasound in standing position. Measurement consisted of a diagonal line from the most anterior-superior aspect of the bladder to the most inferior-posterior aspect of the bladder. Length was measured at baseline and maximum distortion for each task. The first two tasks cued pelvic floor muscles to contract and then strain. Subsequent tasks only cued glottis function. A linear regression tested correlation between bladder distortion response to glottis tasks and cued pelvic floor tasks. The hypothesis was that diagonal would shorten with contraction, lengthen with strain, and follow a similar pattern seen in respiration for phonation tasks.
Ten asymptomatic participants (5 men, 5 women) showed bladder diagonal shortening when cuing pelvic floor contraction for all participants and lengthening for 7 of the 10 participants when cued to strain the pelvic floor. The response of bladder length change was variable for glottis tasks, trending toward lengthening and significantly different in response to contraction.
When cuing pelvic floor to contract, healthy individuals showed shortening of bladder length and most lengthened during strain. When cuing phonation and respiration tasks, there was a tendency toward bladder lengthening.
盆底物理治疗师长期以来一直将呼吸提示与运动结合使用，并开始将发声任务纳入其中。迄今为止，还没有描述在发声任务期间盆底位移的出版物。本研究初步探讨了在呼吸和发音任务期间，作为盆底肌肉位移替代指标的膀胱形状变形的变化。
使用二维超声在站立位对膀胱进行成像。测量包括从膀胱最前上到膀胱最下后之间的对角线。在每个任务的基线和最大变形时测量长度。前两个任务提示盆底肌肉收缩然后紧张。随后的任务仅提示声门功能。线性回归测试了声门任务对膀胱变形反应与提示盆底任务之间的相关性。假设是对角线会随着收缩而缩短，随着紧张而延长，并遵循与发音任务呼吸相似的模式。
10 名无症状参与者（5 名男性，5 名女性）在提示所有参与者盆底收缩时显示出膀胱对角线缩短，在提示 10 名参与者中的 7 名盆底紧张时膀胱长度延长。声门任务中膀胱长度变化的反应是可变的，趋向于延长，并且对收缩的反应明显不同。
当提示盆底收缩时，健康个体显示出膀胱长度缩短，而在紧张时大多数个体膀胱长度延长。当提示发声和呼吸任务时，膀胱有变长的趋势。
