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患有急迫性尿失禁和无急迫性尿失禁的女性盆底肌和腰背肌的肌肉力学特性:一项病例对照研究。

Muscle mechanical properties of pelvic floor and paravertebral muscles in women with and without urge urinary incontinence: a case-control study.

机构信息

Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, Córdoba, Spain.

Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain; Department of Computer Science and Numerical Analysis, Rabanales Campus, University of Córdoba, Córdoba, Spain.

出版信息

Braz J Phys Ther. 2024 Sep-Oct;28(5):101114. doi: 10.1016/j.bjpt.2024.101114. Epub 2024 Sep 6.

Abstract

BACKGROUND

Muscle mechanical properties (MMPs) are relevant in the pathophysiology of lumbopelvic disorders. However, they have not been described in the pelvic floor muscles (PFM) and lumbar paravertebral muscles (LPM) of women with urge urinary incontinence (UUI).

OBJECTIVE

To identify differences between MMPs of PFM and LPM in patients with UUI and healthy controls. Secondarily also aimed to observe the relationship between sociodemographic and clinical variables with the PFM and LPM MMPs.

METHODS

The participants of this case-control study comprised 34 women with UUI (UUI group) and 34 continent women (control group). Sociodemographic variables were obtained together with data on the clinical status of the pelvic floor. The MMPs, i.e., frequency (tone), stiffness, decrement (inverse of elasticity), and viscoelastic properties (VP), such as relaxation time and creep, of PFM and LPM were assessed with a hand-held tonometer. Between-group differences and intra-group correlations were identified.

RESULTS

The UUI group presented higher frequency and stiffness, as well as lower relaxation time in PFM, whereas the LPM had lower tone and stiffness, and higher VP, compared to the control group (p < 0.05). The UUI group showed a pattern of moderate correlations (|0.403|<r<|0.600|) among all MMPs of PFM and tone, stiffness, and VP of LPM, which did not appear in the control group.

CONCLUSION

The presence of UUI may influence MMPs at PFM and LPM levels, increasing the tone and stiffness of PFM, whereas these properties are reduced in LPM. These findings emphasize the clinical interest of the lumbopelvic determination of MMPs, obtained through externally applied hand-held instruments, in the pathophysiology of UUI.

摘要

背景

肌肉力学特性(MMPs)与腰骶部疾病的病理生理学有关。然而,它们在患有急迫性尿失禁(UUI)的女性的盆底肌(PFM)和腰椎旁肌(LPM)中尚未被描述。

目的

确定 UUI 患者与健康对照组之间 PFM 和 LPM 的 MMPs 之间的差异。其次,还旨在观察社会人口统计学和临床变量与 PFM 和 LPM 的 MMPs 之间的关系。

方法

本病例对照研究的参与者包括 34 名 UUI 患者(UUI 组)和 34 名无尿失禁的女性(对照组)。获得了社会人口统计学变量以及盆底功能障碍的临床数据。使用手持张力计评估了 PFM 和 LPM 的 MMPs,即频率(张力)、僵硬度、衰减(弹性的倒数)和粘弹性特性(VP),如弛豫时间和蠕变。确定了组间差异和组内相关性。

结果

UUI 组的 PFM 频率和僵硬度较高,弛豫时间较短,而 LPM 的张力和僵硬度较低,VP 较高,与对照组相比差异具有统计学意义(p<0.05)。UUI 组在 PFM 的所有 MMPs 之间以及 LPM 的张力、僵硬度和 VP 之间表现出中度相关性(|0.403|<r<|0.600|),而对照组则没有。

结论

UUI 的存在可能会影响 PFM 和 LPM 水平的 MMPs,增加 PFM 的张力和僵硬度,而 LPM 的这些特性则降低。这些发现强调了通过外部应用手持仪器进行腰骶部 MMPs 测定在 UUI 病理生理学中的临床意义。

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Int Urogynecol J. 2025 Feb;36(2):299-306. doi: 10.1007/s00192-024-05964-4. Epub 2024 Nov 1.

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