Do Measures of Muscular Fitness Modify the Effect of Intra-abdominal Pressure on Pelvic Floor Support in Postpartum Women?
| Autor: | Ingrid Nygaard, Xiaoming Sheng, Stefan Niederauer, Meng Yang, Robert W. Hitchcock, Jie Wang, Janet M. Shaw |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Urology 030232 urology & nephrology Isometric exercise Pelvic Floor Muscle Article Young Adult 03 medical and health sciences Grip strength 0302 clinical medicine Pregnancy Odds Ratio Pressure medicine Humans Muscle Strength 030219 obstetrics & reproductive medicine Pelvic floor Vaginal delivery business.industry Obstetrics and Gynecology Pelvic Floor Trunk Biomechanical Phenomena body regions Parity Cross-Sectional Studies Logistic Models medicine.anatomical_structure Physical Fitness Hymen Physical therapy Vagina Female Surgery business |
| Zdroj: | Female Pelvic Med Reconstr Surg |
| ISSN: | 2151-8378 |
| DOI: | 10.1097/spv.0000000000000901 |
| Popis: | Objective This study aimed to determine whether measures of muscular fitness modify the effect of intra-abdominal pressure (IAP) during lifting on pelvic floor support. Methods Participants, primiparous women 1 year after vaginal delivery, underwent the Pelvic Organ Prolapse Quantification examination, measurement of IAP via a vaginal sensor while lifting a weighted car seat, pelvic floor muscle force assessment using an instrumented speculum, grip strength using a hand dynamometer, and trunk flexor endurance by holding an isometric contraction while maintaining a 60-degree angle to the table. We dichotomized pelvic floor support as worse (greatest descent of the anterior, posterior, or apical vagina during maximal strain at or below the hymen) versus better (all points above the hymen). Results Of 825 participants eligible after delivery, 593 (71.9%) completed a 1-year study visit. Mean (SD) age was 29.6 (5.0) years. One year postpartum, 55 (9.3%) demonstrated worse support. There were no differences in IAP during lifting or in other measures of pelvic floor loading between women with better and worse support. In multivariable analyses, neither grip strength nor pelvic floor muscle force modified the effect of IAP on support. In women with trunk flexor endurance duration ≥13 minutes, the odds of worse support increased significantly as IAP increased. No fitness measure modified the effect of other measures of pelvic floor loading on support. Conclusions Primiparous women with higher IAP during lifting and greater muscular fitness did not have reduced odds of worse pelvic floor support compared with those with lower IAP at the same muscular fitness. |
| Databáze: | OpenAIRE |
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