Department of Health and Kinesiology, University of Utah College of Health, Salt Lake City, UT, USA.
Biostatistics Support Unit, Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
J Sports Sci. 2023 Jan;41(2):141-150. doi: 10.1080/02640414.2023.2202063. Epub 2023 Apr 13.
We evaluated the association between sedentary time and pelvic floor support in primiparas delivered vaginally. The 532 participants (29.2 ± 4.9 years) wore wrist accelerometers 6 months postpartum to assess sedentary time, light physical activity (LPA) and moderate to vigorous physical activity (MVPA). We assessed pelvic floor support 1 year postpartum, considered worse if vaginal walls or apex prolapsed to or beyond the hymen. We used multivariable isotemporal substitution analyses to determine the prevalence of worse support when replacing sedentary time with equal time spent in either LPA or MVPA. In 1 year, 9.4% demonstrated worse pelvic floor support. Decreasing sedentary time by 30 min/day with a concomitant increase in MVPA, controlling for LPA, was associated with increased prevalence of worse support (PR 1.43 (95% CI 1.15, 1.77), < 0.01). Decreasing the sedentary time by 30 min/day with a concomitant increase in LPA, controlling for MVPA, was not significant (PR 0.89 (95% CI 0.80, 0.99), = 0.04, > pre-set alpha of 0.02). Increasing MVPA while decreasing LPA, controlling for sedentary time, also increased the prevalence of worse support (PR 1.66 (95% CI 1.28, 2.16), < 0.001). In conclusion, decreasing sedentary time increased the prevalence of worse pelvic floor support when replaced by MVPA, but not LPA.
我们评估了初产妇经阴道分娩后久坐时间与盆底支持之间的关系。532 名参与者(29.2±4.9 岁)在产后 6 个月佩戴腕部加速度计,以评估久坐时间、轻度体力活动(LPA)和中等到剧烈体力活动(MVPA)。我们在产后 1 年评估了盆底支持,如果阴道壁或顶点脱垂至或超过处女膜,则认为支持更差。我们使用多变量等时替代分析来确定用同等时间的 LPA 或 MVPA 替代久坐时间时,更差的支持的患病率。在 1 年内,9.4%的人出现更差的盆底支持。每天减少 30 分钟的久坐时间,同时增加 MVPA,控制 LPA,与更差的支持的患病率增加相关(PR 1.43(95%CI 1.15, 1.77),<0.01)。每天减少 30 分钟的久坐时间,同时增加 LPA,控制 MVPA,没有显著差异(PR 0.89(95%CI 0.80, 0.99),=0.04,>0.02 的预设α值)。在控制久坐时间的情况下,增加 MVPA 同时减少 LPA,也增加了更差的支持的患病率(PR 1.66(95%CI 1.28, 2.16),<0.001)。总之,用 MVPA 替代久坐时间会增加更差的盆底支持的患病率,但用 LPA 替代则不会。