Talasz Helena, Kremser Christian, Talasz Heribert Johannes, Kofler Markus, Rudisch Ansgar
Department of Internal Medicine, Hochzirl Hospital, 6170 Zirl, Austria.
Department of Radiology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Healthcare (Basel). 2022 Jun 2;10(6):1035. doi: 10.3390/healthcare10061035.
The current scientific literature is inconsistent regarding the potential beneficial or deleterious effects of high-intensity physical activities on the pelvic floor (PF) in women. So far, it has not been established with certainty whether disparate breathing mechanisms may exert short- or long-term influence on the PF function in this context, although based on the established physiological interrelationship of breathing with PF activation, this seems plausible.
To propose a basic concept of the influence of different breathing patterns on the PF during strenuous physical efforts. Methodical approaches: Review of the recent literature, basic knowledge of classical western medicine regarding the principles of muscle physiology and the biomechanics of breathing, additional schematic illustrations, and magnetic resonance imaging (MRI) data corroborate the proposed concept and exemplify the consequences of strenuous efforts on the PF in relation to respective breathing phases.
The pelvic floor muscles (PFMs) physiologically act as expiratory muscles in synergy with the anterolateral abdominal muscles, contracting during expiration and relaxing during inspiration. Obviously, a strenuous physical effort requires an expiratory motor synergy with the PFM and abdominal muscles in a co-contracted status to train the PFM and protect the PF against high intra-abdominal pressure (IAP). Holding breath in an inspiratory pattern during exertion stresses the PF because the high IAP impinges on the relaxed, hence insufficiently protected, PFMs. It seems conceivable that such disadvantageous breathing, if performed regularly and repeatedly, may ultimately cause PF dysfunction. At any rate, future research needs to take into account the respective breathing cycles during measurements and interventions addressing PFM function.
目前的科学文献对于高强度体育活动对女性盆底（PF）的潜在有益或有害影响尚无定论。到目前为止，虽然基于已确立的呼吸与盆底激活之间的生理相互关系，不同的呼吸机制在此背景下是否可能对盆底功能产生短期或长期影响尚未确定，但这似乎是合理的。
提出在剧烈体育活动期间不同呼吸模式对盆底影响的基本概念。方法：回顾近期文献、西方传统医学关于肌肉生理学原理和呼吸生物力学的基础知识、补充示意图以及磁共振成像（MRI）数据，以证实所提出的概念，并举例说明在剧烈活动中与各个呼吸阶段相关的盆底所受影响。
盆底肌肉（PFMs）在生理上作为呼气肌与前外侧腹肌协同作用，在呼气时收缩，吸气时放松。显然，剧烈的体育活动需要盆底肌肉和腹肌在共同收缩状态下形成呼气运动协同作用，以训练盆底肌肉并保护盆底免受高腹内压（IAP）的影响。在用力时以吸气模式屏气会给盆底造成压力，因为高腹内压会作用于松弛的、因此保护不足的盆底肌肉。可以想象，这种不利的呼吸方式如果经常且反复进行，最终可能导致盆底功能障碍。无论如何，未来的研究在测量和干预盆底肌肉功能时需要考虑各自的呼吸周期。
