Siracusa Carina, Gray Amelia
Department of Rehabilitation, OhioHealth, Columbus, Ohio.
J Womens Health Phys Therap. 2020 Oct;44(4):144-151. doi: 10.1097/JWH.0000000000000180. Epub 2020 Oct 14.
Much of the research and clinical commentary on COVID-19 have been focused on respiratory function. Pelvic floor therapists understand that both respiratory dysfunction and hospitalization can have an impact on pelvic floor function. This clinical commentary provides context as to how the long-term effects of COVID-19 could affect the pelvic floor as well as some generalized treatment considerations.
The respiratory diaphragm has an impact on the ability of the pelvic floor to contract and relax in a manner that will allow for both continence and elimination. COVID-19 survivors often have disability in this muscle of respiration that can lead to implications for both overactive and underactive pelvic floor. Commonly, this population is hospitalized for long periods of time, which can have long-term consequences on both bladder and bowel functioning including, but not limited to, incontinence, urinary retention, and constipation. Pelvic floor therapists must be prepared to adjust both their evaluation and treatment methods in consideration of this novel treatment population.
Because of the pervasive nature of this virus, pelvic floor physical therapists should be a part of the rehabilitation team treating these patients once they have become medically stable. http://links.lww.com/JWHPT/A36.
关于新型冠状病毒肺炎(COVID-19)的许多研究和临床评论都集中在呼吸功能上。盆底治疗师了解呼吸功能障碍和住院治疗都可能对盆底功能产生影响。这篇临床评论阐述了COVID-19的长期影响如何影响盆底以及一些一般的治疗考虑因素。
呼吸膈肌会影响盆底以一种既能实现控尿又能实现排便的方式收缩和放松的能力。COVID-19幸存者通常在这块呼吸肌上存在功能障碍,并可能导致盆底过度活跃和活动不足。通常,这一群体需要长时间住院,这可能对膀胱和肠道功能产生长期影响,包括但不限于尿失禁、尿潴留和便秘。考虑到这一新型治疗人群,盆底治疗师必须准备好调整他们的评估和治疗方法。
由于这种病毒的普遍性,一旦患者病情稳定,盆底物理治疗师应成为治疗这些患者的康复团队的一员。http://links.lww.com/JWHPT/A36