Can women correctly contract their pelvic floor muscles without formal instruction?
Can women correctly contract their pelvic floor muscles without formal instruction?
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DOI：
10.1097/spv.0b013e31827ab9d0
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发表时间：
2013-01
影响因子：
1.6
通讯作者：
Nygaard I
中科院分区：
文献类型：
--
作者：
Henderson JW;Wang S;Egger MJ;Masters M;Nygaard I
目前尚不清楚有多少接受初级保健的妇女可以适当地收缩她们的盆底肌肉(PFM)，或者这种能力在有或没有盆底疾病的妇女中是否有所不同。我们试图描述最初错误地接触PFM的女性比例，以及有多少人在接受基本指导后可以学习。这项横断面研究招募了779名参加社区初级保健实践的妇女。在PFM评估期间，研究护士记录了女性在简短的口头提示后是否能正确地收缩PFM。我们将POP定义为脱垂到或超过处女膜，SUI定义为失禁严重指数中的>；3分。分别有85.5%、83.4%、68.6%和85.8%的POP、SUI、既有POP和SUI、既没有POP又有SUI的PFM收缩正确(P=0.01，POP和SUI与POP和SUI都不同)。在最初错误地感染了烤瓷冠的120名妇女中，94名(78%)在简短的指导后学会了这一点。患有POP的女性比没有POP或SUI的女性更不容易学习(54.3%比85.7%，p=0.001)。阴道分娩增加和咖啡因摄入量减少(但与年龄或其他人口统计因素无关)与不正确的PFM收缩有关；多变量分析显示，只有咖啡因摄入量减少仍然显著。大多数没有盆底疾病或有轻微盆底疾病的女性在经过简单的口头提示后就可以正确地收缩PFM，这表明可以在没有临床确认正确的PFM技术的情况下启动基于人群的预防干预。
It is unknown how many women presenting for primary care can appropriately contract their pelvic floor muscle (PFM) or whether this ability differs between women with or without pelvic floor disorders. We sought to describe the proportion of women who initially incorrectly contract the PFM, and how many can learn after basic instruction. This cross-sectional study enrolled 779 women presenting to community based primary care practices. During PFM assessment, research nurses recorded whether women could correctly contract their PFM after a brief verbal cue. We defined POP as prolapse to or beyond the hymen and SUI as a score of > 3 on the Incontinence Severity Index. PFM contraction was done correctly on first attempt in 85.5%, 83.4%, 68.6%, and 85.8% of women with POP, SUI, both POP and SUI and neither POP nor SUI, respectively (p=0.01 for difference between POP and SUI versus neither POP nor SUI). Of 120 women who initially incorrectly contracted the PFM, 94 (78%) learned after brief instruction. Women with POP were less likely to learn than women with neither POP nor SUI (54.3% vs. 85.7%, p=0.001). Increasing vaginal delivery and decreasing caffeine intake (but not age or other demographic factors) were associated with incorrect PFM contraction; only decreased caffeine intake remained significant on multivariable analysis. Most women with no or mild pelvic floor disorders can correctly contract their PFM after a simple verbal cue, suggesting that population-based prevention interventions can be initiated without clinical confirmation of correct PFM technique.