Cruz-Medel Inés, Ruiz-Ruiz Elena, García-Luque Lourdes, Alcaraz-Clariana Sandra, Carmona-Pérez María Cristina, Alburquerque-Sendín Francisco, Rodrigues-de-Souza Daiana Priscila
Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004, Córdoba, Spain.
Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain.
Int Urogynecol J. 2025 Feb;36(2):299-306. doi: 10.1007/s00192-024-05964-4. Epub 2024 Nov 1.
High-impact physical activity is a known risk factor for the development of pelvic floor disorders (PFDs) in women, affecting the pelvic floor muscles (PFMs). However, there is insufficient information to determine whether alterations in PFMs, or even in the lumbar muscles, can be detected before the onset of symptoms. The aim of the study was to identify whether high-impact physical activity influences the muscle mechanical properties (MMPs) of the lumbopelvic region in continent nulliparous women.
An observational cross-sectional study with a nonprobabilistic sampling of consecutive cases was designed. Fifty women who had practiced high-impact physical activity at least three times per week for more than 2 years were included in the high-impact group, and 50 women who did not practice high-impact activity were included in the control group. Data collection for both groups included sociodemographic data and MMPs (frequency, characterizing muscle tone; stiffness; logarithmic decrement, characterizing the inverse of the elasticity; relaxation time of stress; creep, characterizing fluidity) of PFMs and lumbar muscles, externally assessed using a hand-held tonometer device. Between-group comparison of the MMPs were calculated, together with intragroup correlations between the outcomes.
The MMPs of PFMs showed statistically significant lower tone (0.76 Hz, 95% CI 0.04, 1.48) and stiffness (23.76 N/m, 95% CI 1.10, 46.42) and were more viscoelastic (relaxation: -1.04 ms, 95% CI -1.98, -0.11; creep: -0.04 De, 95% CI -0.07, -0.02) in women who practiced high-impact physical activity. No lumbar MMPs showed statistically significant between-group differences.
High-impact physical activity alters the MMPs of PFMs in nulliparous women, although not lumbar spinal MMPs, even before the appearance of signs.
高强度体育活动是已知的女性盆底功能障碍（PFDs）发生的风险因素，会影响盆底肌肉（PFMs）。然而，目前尚无足够信息来确定在症状出现之前是否能检测到盆底肌肉甚至腰部肌肉的改变。本研究的目的是确定高强度体育活动是否会影响未生育的无尿失禁女性腰骶部区域的肌肉力学特性（MMPs）。
设计了一项采用连续病例非概率抽样的观察性横断面研究。每周至少进行3次高强度体育活动且持续超过2年的50名女性被纳入高强度组，50名未进行高强度活动的女性被纳入对照组。两组的数据收集包括社会人口统计学数据以及使用手持眼压计设备外部评估的盆底肌肉和腰部肌肉的MMPs（频率，表征肌张力；刚度；对数减量，表征弹性的倒数；应力松弛时间；蠕变，表征流动性）。计算MMPs的组间比较以及结果之间的组内相关性。
在进行高强度体育活动的女性中，盆底肌肉的MMPs显示出在统计学上显著较低的张力（0.76Hz，95%CI 0.04，1.48）和刚度（23.76N/m，95%CI 1.10，46.42），并且更具粘弹性（松弛：-1.04ms，95%CI -1.98，-0.11；蠕变：-0.04De，95%CI -0.07，-0.02）。腰部MMPs在组间未显示出统计学上的显著差异。
高强度体育活动会改变未生育女性盆底肌肉的MMPs，尽管在体征出现之前不会改变腰椎的MMPs。
