Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey.
Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey.
Int Urogynecol J. 2023 Nov;34(11):2725-2736. doi: 10.1007/s00192-023-05597-z. Epub 2023 Jul 7.
The aim of our study is to examine the changes in core muscle functions during pregnancy.
Our study was carried out in 67 primigravida pregnant women. Superficial electromyography (EMG) and non-invasive 2D/3D ultrasonography (USG) were used to evaluate core muscle (diaphragm, transversus abdominus [TA], internal oblique [IO]-external oblique [EO] muscles, pelvic floor muscles, multifidus) function during pregnancy. Pelvic floor muscle strength was also measured by a digital palpation method (PERFECT system). USG was used to measure expected fetal weight and the diastasis recti (DR) distance. Mann-Whitney U test was used to show changes in trimesters in the core muscles, and Spearman correlation analysis was used to determine the relationship.
In the third trimester, an nonsignificant increase in EMG parameters was observed in all of the core muscles. Although a statistically significant decrease was observed in muscle thickness values measured by EO and IO USG in the third trimester, DR was found to increase at all levels (p < 0.005). When we evaluated both trimesters and all pregnant women together, no relationship was found between all core muscles and pelvic floor muscles in the data evaluated by EMG and USG. We found a negative correlation in USG values between fetal weight and IO and the upper part of the rectus abdominus muscle, and a positive correlation between the EMG data of the EO and rectus abdominus muscles.
In women, the coactivation relationship between the core muscles may disappear during pregnancy. As the trimesters progress during pregnancy, a decrease in thickness and an increase in muscle activity can be observed in the core muscles. Pregnant women can be given exercise training for core muscles for protection in both the prenatal and postnatal periods. But more research needs to be done.
本研究旨在探讨妊娠期间核心肌群功能的变化。
我们的研究对象为 67 名初产妇。采用表面肌电图（EMG）和无创二维/三维超声（USG）评估妊娠期间核心肌群（膈肌、腹横肌[TA]、内斜肌[IO]-外斜肌[EO]、盆底肌、多裂肌）的功能。还采用数字触诊法（PERFECT 系统）测量盆底肌肌力。USG 用于测量预期胎儿体重和腹直肌分离（DR）距离。采用 Mann-Whitney U 检验显示各孕期核心肌群的变化，采用 Spearman 相关分析确定其相关性。
在孕晚期，所有核心肌群的 EMG 参数均出现无统计学意义的增加。虽然第三孕期 EO 和 IO 的 USG 肌厚度值明显下降，但 DR 各水平均增加（p < 0.005）。当我们综合评估两个孕期和所有孕妇时，EMG 和 USG 评估数据中，所有核心肌群与盆底肌之间均未发现相关性。我们发现 USG 数值中胎儿体重与 IO 和腹直肌上半部分呈负相关，EO 和腹直肌 EMG 数据呈正相关。
在女性中，妊娠期间核心肌群的协同收缩关系可能会消失。随着孕期的进展，核心肌群的厚度会减少，肌肉活动会增加。孕妇可以在产前和产后进行核心肌群的运动训练以进行保护。但需要进一步研究。
