Faculty of Physiotherapy, Psychosocial Intervention and Functional Rehabilitation Research Group, University of A Coruña, Campus de Oza, CP 15006, A Coruña, Spain.
Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Real Fábrica de Armas, CP 45071, Toledo, Spain.
Int Urogynecol J. 2022 Aug;33(8):2257-2266. doi: 10.1007/s00192-021-04756-4. Epub 2021 Apr 19.
The effect of different abdominal contractions on the position of pelvic organs in parous women during postpartum exercises has not been sufficiently assessed. The aim of this study was to evaluate the displacement of the bladder base (BB) during different pelvic floor and abdominal contractions in parous women compared to nulliparous women. We hypothesised that abdominal and perineal contractions will produce a disparate effect on the position of the BB between groups.
Cross-sectional study including a convenience sample of 63 volunteers (35 nulliparous vs. 28 postpartum women). Transabdominal ultrasound was used in mode B to image the displacement of the BB. The protocol included six different pelvic floor and abdominal contractions commonly used in postpartum rehabilitation.
The BB elevated significantly more in the postpartum group compared to nulliparous women when performing submaximal contraction of pelvic floor and transversus abdominis muscles simultaneously with axial elongation of the back (0.93 ± 0.55 cm in parous women vs. 0.66 ± 0.46 cm in nulliparous women). In contrast, the BB was found to descend significantly during a curl-up contraction in both groups (0.93 ± 0.55 cm in parous women vs. 0.66 ± 0.46 cm in nulliparous women).
The overall results of this study showed that perineal and superficial abdominal contractions produced different immediate effects compared to deep abdominal contractions on the displacement of BB in parous and nulliparous women. Further research is required to assess the long-term effects of these contractions.
不同的腹部收缩对产后女性盆骨器官位置的影响在产后运动中尚未得到充分评估。本研究旨在评估与未生育女性相比，生育后女性在不同盆底和腹部收缩时膀胱底（BB）的位移。我们假设腹部和会阴收缩会对 BB 的位置产生不同的影响。
横断面研究，包括 63 名志愿者（35 名未生育与 28 名产后女性）的便利样本。采用 B 型模式进行经腹超声检查，以显示 BB 的位移。方案包括产后康复中常用的六种不同的盆底和腹部收缩。
当同时进行盆底和腹横肌的最大收缩以及背部轴向伸展时，BB 在产后组中的升高幅度明显大于未生育女性（产后组中 0.93±0.55cm，未生育组中 0.66±0.46cm）。相比之下，在两组中，在卷腹收缩时 BB 明显下降（产后组中 0.93±0.55cm，未生育组中 0.66±0.46cm）。
本研究的总体结果表明，与深层腹部收缩相比，会阴和浅层腹部收缩对产后和未生育女性 BB 位移的即刻影响不同。需要进一步研究以评估这些收缩的长期影响。
