Intra-abdominal Pressure and Pelvic Floor Health: Should We Be Thinking About This Relationship Differently?
Intra-abdominal Pressure and Pelvic Floor Health: Should We Be Thinking About This Relationship Differently?
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DOI：
10.1097/spv.0000000000000799
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发表时间：
2020-07
影响因子：
1.6
通讯作者：
Shaw JM
中科院分区：
文献类型：
--
作者：
Dietze-Hermosa M;Hitchcock R;Nygaard IE;Shaw JM
腹内压（IAP）在体力活动期间增加。由于潜在的骨盆底过载，具有高IAP的活动通常限制女性。研究人员使用绝对值（cmH 20）对高IAP活性进行分类。虽然绝对IAP对于描述性目的是必要的，但对于个性化的锻炼建议可能并不理想。对于氧消耗量，一种公认的健身措施，运动科学家使用运动期间观察到的最大值的百分比来为个体创建相对运动强度处方。相对运动强度与观察到的最大值呈负相关。我们探讨这种方法和反应模式是否延伸到IAP运动过程中观察到的。55名女性在佩戴阴道传感器测量IAP的同时完成了16项练习。最高平均IAP发生在坐位Valsalva/应变期间（IAPSTRAIN）。我们通过将每次运动期间的最大IAP除以IAPSTRAIN来计算每个参与者的相对IAP（%）。我们使用Pearson r相关性检查了每种活性的相对IAP和IAPSTRAIN之间的关系。平均年龄为30.4±9.4岁，体重指数为22.4±2.6 kg/m2。对于大多数女性来说，IAP在紧张期间比在锻炼期间更大。相对IAP与IAPSTRAIN呈负相关。由于样本量小，排除了一项练习，所有其他练习的r范围为-0.35至0.80，均具有统计学显著性。许多运动的相对IAP响应表现出与应变期间的最高IAP值成反比关系，与运动期间测量的其他变量一致。相对IAP可能为了解IAP对盆底健康的影响提供一种替代绝对IAP的方法。相对腹内压（IAP）是一种个体化的测量方法，可以提供一种独特的方法来了解IAP对盆底健康的影响。
Intra-abdominal pressure (IAP) increases during physical activity. Activities with high IAP are often restricted for women because of potential pelvic floor overloading. Researchers categorize high IAP-activities using absolute values (cmH20). While essential for descriptive purposes, absolute IAP may not be ideal for individualized exercise recommendations. For oxygen consumption, a well-established measure of fitness, exercise scientists use a percentage of the maximal value observed during exercise to create relative exercise intensity prescriptions for an individual. Relative exercise intensity correlates inversely to the maximal value observed. We explore whether this approach and response pattern extends to IAP observed during exercise. 55 women completed 16 exercises while wearing a vaginal sensor to measure IAP. The highest mean IAP occurred during seated Valsalva/strain (IAPSTRAIN). We calculated relative IAP (%) for each participant by dividing the maximal IAP during each exercise by IAPSTRAIN. We examined relationships between relative IAP and IAPSTRAIN for each activity using Pearson r correlations. Mean age was 30.4±9.4 years and body mass index 22.4±2.6 kg/m2. For most women, IAP was greater during strain than during exercises. Relative IAPs negatively correlated with IAPSTRAIN. Excluding one exercise due to small sample sizes, r for all others ranged from −0.35 to −0.80, all statistically significant. The relative IAP responses to many exercises exhibit an inverse relationship to the highest IAP values during strain, consistent with other variables measured during exercise. Relative IAP may provide an alternative to absolute IAP in understanding IAP’s effect on pelvic floor health. Relative intra-abdominal pressure (IAP) is an individualized measure that may provide a unique approach to understanding IAP’s effect on pelvic floor health.