Chhibber Bhumika, Sethi Jasobanta, Chhabra Harvinder Singh, Jain Ankit
Department of Physiotherapy, Amity Institute of Health Allied Sciences, Amity University, Noida, IND.
Department of Rehabilitation, Indian Spinal Injuries Center, New Delhi, IND.
Cureus. 2022 Dec 23;14(12):e32869. doi: 10.7759/cureus.32869. eCollection 2022 Dec.
Introduction Maintaining continence and providing support to the abdominal contents and sexual functioning are among the primary roles of pelvic floor muscles. The pelvic floor muscles work in synergy with the abdominal muscle to perform these functions. Abdominal muscle activation in the sagittal plane is influenced by the lumbar spine posture. As pelvic floor dysfunction is common among post-menopausal women, this study aims to find out the relationship between lumbar posture and electromyographic (EMG) activity of the rectus abdominis (RA) muscle and vaginal pressure (VP) as a functioning of the pelvic floor muscles among osteoporotic post-menopausal females. Methods A total of 78 osteoporotic post-menopausal women were recruited and allocated into three groups depending on lumbar lordotic angle, namely normal lordosis (n=26) hyperlordosis (n=26), and hypolordosis (n=26). All the subjects were recorded for RA EMG activity and VP for pelvic floor function in the quiet standing (QS) position, and voluntary dynamic tasks such as maximal coughing (MC) and Valsalva maneuver (VM). Data were analyzed using one-way analysis of variance (ANOVA) and post hoc analysis. A 5% probability level was considered statistically significant, i.e., p<0.05. Results The results showed a significant reduction in the RA activity and VP during the dynamic tasks (MC and VM) among subjects with the altered lumbar lordotic angle (p<0.05). The reduction in RA activity and VP was found to be significantly higher (p<0.05) in subjects with hyperlordotic lumbar spine than in those with hypolordotic lumbar spine as compared to normal lordosis during QS, MC, and VM. Conclusion We conclude that osteoporotic post-menopausal women with different lumbar lordotic angle show variations in RA activity and pressure generated by the vagina as a function of the pelvic floor during voluntary dynamic tasks.
引言
维持大小便失禁、为腹部脏器提供支撑以及维持性功能是盆底肌肉的主要功能。盆底肌肉与腹部肌肉协同工作以执行这些功能。矢状面内的腹部肌肉激活受腰椎姿势影响。由于盆底功能障碍在绝经后女性中很常见,本研究旨在探讨骨质疏松性绝经后女性的腰椎姿势与腹直肌(RA)肌电图(EMG)活动及作为盆底肌肉功能指标的阴道压力(VP)之间的关系。
方法
共招募了78名骨质疏松性绝经后女性,并根据腰椎前凸角度分为三组,即正常前凸(n = 26)、前凸过大(n = 26)和前凸过小(n = 26)。记录所有受试者在安静站立(QS)姿势下的RA肌电活动和盆底功能的VP,以及诸如最大咳嗽(MC)和瓦尔萨尔瓦动作(VM)等自主动态任务时的数据。使用单因素方差分析(ANOVA)和事后分析对数据进行分析。5%的概率水平被认为具有统计学意义,即p < 0.05。
结果
结果显示,腰椎前凸角度改变的受试者在动态任务(MC和VM)期间RA活动和VP显著降低(p < 0.05)。与正常前凸相比,在QS、MC和VM期间,腰椎前凸过大的受试者的RA活动和VP降低幅度明显高于腰椎前凸过小的受试者(p < 0.05)。
结论
我们得出结论,不同腰椎前凸角度的骨质疏松性绝经后女性在自主动态任务期间,RA活动和盆底功能产生的阴道压力存在差异。