Diggles Alexandra
Int J Sports Phys Ther. 2023 Feb 1;18(1):228-239. doi: 10.26603/001c.65894. eCollection 2023.
Increasing numbers of elite female athletes are competing in professional sport, and many wish to become pregnant and return to competitive sport after childbirth. Athletes have a higher risk of pelvic floor dysfunction (PFD) than non-athletes (54% versus 7%) and there is also an increased prevalence in post-partum women compared to nulliparous women (35% versus 2.8-7.9%). Additionally, PFD has been shown to influence athletic performance. High quality evidence for elite athletes is lacking, and there are no exercise guidelines specifically for these women to prepare or effectively guide their safe return to sport (RTS). The purpose of this case report is to detail the management of an elite athlete who presented following cesarean section (CS) with the goal of RTS within 16 weeks.
A 27-year-old primiparous Caucasian professional netballer presented at four weeks post- caesarean section (CS) for RTS screening and assessment of pelvic floor muscle (PFM) function. Assessment included readiness and fear of movement screening, dynamic pelvic floor muscle function, structural integrity of the CS wound, levator hiatal dimensions, bladder neck descent, and early global neuromuscular screening. Measures were collected at four weeks, eight weeks, and six months post-partum. The post-partum athlete demonstrated alterations in pelvic floor muscle function, reduced lower limb power and psychological readiness. A functionally staged dynamic and sport specific pelvic floor muscle training program was implemented and adapted to the patient for her early post-partum timeline.
Rehabilitation strategies were effective in achieving the primary outcome of RTS at 16 weeks post-partum with no adverse events reported at 6 months follow-up.
This case highlights the need for a holistic and individualised RTS management approach that includes women's and pelvic health risk factors in a professional athlete.
越来越多的精英女性运动员参与职业体育赛事，许多人希望在产后怀孕并重返竞技体育。与非运动员相比，运动员发生盆底功能障碍（PFD）的风险更高（54% 对 7%），并且与未生育女性相比，产后女性的患病率也有所增加（35% 对 2.8 - 7.9%）。此外，PFD 已被证明会影响运动表现。目前缺乏针对精英运动员的高质量证据，也没有专门针对这些女性的运动指南来帮助她们为安全重返运动（RTS）做好准备或有效指导她们安全重返运动。本病例报告的目的是详细介绍一名精英运动员在剖宫产（CS）后 16 周内以 RTS 为目标的管理情况。
一名 27 岁的初产白种人职业无挡板篮球运动员在剖宫产（CS）后四周前来进行 RTS 筛查和盆底肌肉（PFM）功能评估。评估包括运动准备情况和运动恐惧筛查、动态盆底肌肉功能、CS 伤口的结构完整性、提肌裂孔尺寸、膀胱颈下降以及早期整体神经肌肉筛查。在产后四周、八周和六个月收集相关数据。产后运动员表现出盆底肌肉功能改变、下肢力量下降和心理准备不足。实施了一个功能分级的动态且针对特定运动的盆底肌肉训练计划，并根据患者产后早期的时间安排进行了调整。
康复策略有效地实现了产后 16 周 RTS 的主要目标，在 6 个月的随访中未报告不良事件。
本病例强调了需要一种全面且个性化的 RTS 管理方法，该方法应考虑职业运动员的女性和盆底健康风险因素。
5 级。
