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子宫内膜异位症女性下盆腔复合体的肌肉骨骼评估:一项病例对照研究。

Musculoskeletal evaluation of the lower pelvic complex in women with endometriosis: A case-control study.

作者信息

Silva de Barros Adriana, Mesquita Magalhães Germana, Darc de Menezes Braga Luana, Oliveira Veloso Mariana, Olavo de Paula Lima Pedro, Moreira da Cunha Rayane, Soares Coutinho Samuel, Lira do Nascimento Simony, Robson Pinheiro Sobreira Bezerra Leonardo

机构信息

Federal University of Ceara, Brasil.

Federal University of Ceara, Brasil.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2024 Aug;299:317-321. doi: 10.1016/j.ejogrb.2024.04.030. Epub 2024 Apr 29.

Abstract

OBJECTIVE

Use clinical pain measurement tools to investigate and compare the prevalence of pelvic loin disoders in women with and without endometriosis.

STUDY DESIGN

Chronic pelvic pain (CPP) associated with endometriosis has diverse origins, including musculoskeletal factors. Musculoskeletal dysfunction in the pelvic region is theorized to result from sustained muscular contraction, triggered by altered visceral stimuli and adoption of antalgic postures, causing secondary damage to muscles, ligaments, and joints. CPP significantly impacts quality of life, relationships, sexuality, and mental health. However, limited data exists on musculoskeletal impacts of endometriosis and CPP. It was made a case-control study at Maternidade Escola Assis Chateaubriand from August 2017 to January 2021. Evaluated 71 women: 41 in endometriosis group (EG) and 30 in control group (CG). Data collection included sociodemographic questionnaires, musculoskeletal physiotherapeutic evaluations, pain mapping, pressure pain thresholds, kinesiophobia, and disability measurements. Statistical analysis was performed using Spearman's Rho test to determine correlations.

RESULTS

Mean age of participants was 31 years. EG exhibited lower pain threshold variations in lumbopelvic trigger points than CG (P < .05). Significant muscle flexibility differences between groups were observed; EG had reduced flexibility (P < .05). Most common pain areas were hypogastrium in EG (48.78 %) and left lumbar in CG (30 %). EG had higher kinesiophobia values (P = .009). There was a weak association between kinesiophobia-pressure threshold association observed in CG's lumbar pelvic region.

CONCLUSION

Women with Endometriosis and CPP exhibit higher prevalence of musculoskeletal disorder, lower pain thresholds, decreased lumbopelvic muscle range of motion, higher kinesiophobia scores, and increased disability indices with low back pain compared to healthy women.

摘要

目的

使用临床疼痛测量工具调查并比较患有和未患有子宫内膜异位症的女性盆腔腰部疾病的患病率。

研究设计

与子宫内膜异位症相关的慢性盆腔疼痛(CPP)有多种起源,包括肌肉骨骼因素。盆腔区域的肌肉骨骼功能障碍理论上是由持续的肌肉收缩导致的,这种收缩由内脏刺激改变和采取止痛姿势引发,会对肌肉、韧带和关节造成继发性损伤。CPP对生活质量、人际关系、性功能和心理健康有显著影响。然而,关于子宫内膜异位症和CPP对肌肉骨骼影响的数据有限。2017年8月至2021年1月在阿西斯·夏多布里昂妇产学校进行了一项病例对照研究。评估了71名女性:子宫内膜异位症组(EG)41名,对照组(CG)30名。数据收集包括社会人口统计学问卷、肌肉骨骼物理治疗评估、疼痛定位、压痛阈值、运动恐惧和残疾测量。使用Spearman秩相关检验进行统计分析以确定相关性。

结果

参与者的平均年龄为31岁。与CG组相比,EG组腰盆腔触发点的疼痛阈值变化更低(P < 0.05)。观察到两组之间存在显著的肌肉柔韧性差异;EG组的柔韧性降低(P < 0.05)。最常见的疼痛区域在EG组是下腹部(48.78%),在CG组是左腰部(30%)。EG组的运动恐惧值更高(P = 0.009)。在CG组的腰盆腔区域观察到运动恐惧与压力阈值之间存在弱关联。

结论

与健康女性相比,患有子宫内膜异位症和CPP女性的肌肉骨骼疾病患病率更高、疼痛阈值更低、腰盆腔肌肉活动范围减小、运动恐惧评分更高且腰痛残疾指数增加。

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