Berube Marie-Eve, Niederauer Stefan, Graham Ryan, Hitchcock Robert, McLean Linda
School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada.
Department of Bioengineering, University of Utah, Salt Lake City, UT, USA.
BJU Int. 2025 Jun 30. doi: 10.1111/bju.16842.
To investigate whether, among female runners, transient changes in pelvic floor morphometry, pelvic floor muscle (PFM) function, or pad weight gain observed after a standardised running protocol are associated with the exposure of the pelvic floor to loading during the run.
Adult female runners with (n = 19) and without (n = 19) running-induced stress urinary incontinence (RI-SUI) completed a 37-min treadmill-based running protocol with a pressure sensor placed in the posterior fornix of the vagina and a triaxial accelerometer adhered to the pelvis, and an incontinence pad adhered to their undergarment. Pelvic morphometry and PFM function were assessed before and after the run using transperineal ultrasonography and intra-vaginal dynamometry. Urine leakage volume was estimated based on incontinence pad weight gain. Separate linear regression models were used to evaluate the associations between variables representative of pelvic floor load exposure (posterior fornix sensor pressure [PFSP] and pelvic accelerations) and changes in pelvic morphometry, PFM function, and incontinence pad weight observed after the run.
After the run, the levator hiatus was larger and the bladder neck sat lower in the pelvis, but there were no significant differences in PFM active or passive forces measured using dynamometry. These changes were not different between those with and those without RI-SUI. Higher pelvic accelerations were associated with greater reductions in passive PFM stiffness after the run (R = 20%-27%), but not with changes in pelvic morphometry. No associations were found between any measures of pelvic floor load exposure and changes in PFM force-generating capacity. Among runners with RI-SUI, greater pad weight gain occurred among those who ran with slower vector accelerations (R = 0.27).
The magnitude of pelvic floor loading experienced during running does not appear to influence the transient loss in static pelvic organ support observed after running nor urine leakage volume.
研究在女性跑步者中,标准化跑步方案后观察到的盆底形态测量、盆底肌肉(PFM)功能或护垫重量增加的短暂变化是否与跑步过程中盆底所受负荷有关。
有(n = 19)和无(n = 19)跑步引起的压力性尿失禁(RI-SUI)的成年女性跑步者完成了一项基于跑步机的37分钟跑步方案,在阴道后穹窿放置压力传感器,在骨盆上粘贴三轴加速度计,并在其内衣上粘贴失禁护垫。跑步前后使用经会阴超声和阴道内测力计评估盆腔形态和PFM功能。根据失禁护垫重量增加估计尿液漏出量。使用单独的线性回归模型评估代表盆底负荷暴露的变量(后穹窿传感器压力[PFSP]和骨盆加速度)与跑步后观察到的盆腔形态、PFM功能和失禁护垫重量变化之间的关联。
跑步后,提肌裂孔增大,膀胱颈在骨盆中的位置更低,但使用测力计测量的PFM主动或被动力没有显著差异。有和没有RI-SUI的人之间这些变化没有差异。较高的骨盆加速度与跑步后被动PFM僵硬度的更大降低相关(R = 20%-27%),但与盆腔形态变化无关。未发现盆底负荷暴露的任何测量值与PFM力产生能力变化之间存在关联。在患有RI-SUI的跑步者中,向量加速度较慢的跑步者护垫重量增加更大(R = 0.27)。
跑步过程中盆底所受负荷的大小似乎不会影响跑步后观察到的静态盆腔器官支撑的短暂丧失或尿液漏出量。