Pelvic floor dynamics during high-impact athletic activities: A computational modeling study.
Pelvic floor dynamics during high-impact athletic activities: A computational modeling study.
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DOI：
10.1016/j.clinbiomech.2016.11.003
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发表时间：
2017-01
期刊：
影响因子：
--
通讯作者：
Zhang Y
中科院分区：
文献类型：
--
作者：
Dias N;Peng Y;Khavari R;Nakib NA;Sweet RM;Timm GW;Erdman AG;Boone TB;Zhang Y
压力性尿失禁是年轻女运动员的一个重要问题，但由于对骨盆底支撑功能的了解有限，目前可用的评估工具能力有限，其病理生理学尚不清楚。我们研究的目的是开发一种先进的计算机建模工具，以更好地了解高瞬态运动期间骨盆底内部的动力学。盆腔模型是基于高分辨率核磁共振扫描的健康未婚年轻女性。利用从跳跃实验中获得的真实边界条件，模拟了一个跳跃着陆过程。通过不同程度地减弱或加强提肛肌僵硬度来模拟盆底肌功能的假设改变。在不同程度的虚弱或增强时监测腹内压力和相应的盆底结构变形。结果表明，在跳跃着陆过程中产生的盆底变形与临床常用的Valsalva操作中所见的变形有很大不同。尿道活动仅受提肛肌僵硬度改变的轻微影响。对危险因素和治疗策略的影响也进行了讨论。结果表明，临床诊断应考虑到Valsalva操作和跳跃着陆过程中盆底变形的观察差异，以确保准确性。与固有的括约肌关闭系统相比，尿道过度活动可能是导致年轻女运动员失禁的一个较小的因素。
Stress urinary incontinence is a significant problem in young female athletes, but the pathophysiology remains unclear because of the limited knowledge of the pelvic floor support function and limited capability of currently available assessment tools. The aim of our study is to develop an advanced computer modeling tool to better understand the dynamics of the internal pelvic floor during highly transient athletic activities. Apelvic model was developed based on high-resolution MRI scans of a healthy nulliparous young female. A jump-landing process was simulated using realistic boundary conditions captured from jumping experiments. Hypothesized alterations of the function of pelvic floor muscles were simulated by weakening or strengthening the levator ani muscle stiffness at different levels. Intra-abdominal pressures and corresponding deformations of pelvic floor structures were monitored at different levels of weakness or enhancement. Results show that pelvic floor deformations generated during a jump-landing process differed greatly from those seen in a Valsalva maneuver which is commonly used for diagnosis in clinic. The urethral mobility was only slightly influenced by the alterations of the levator ani muscle stiffness. Implications for risk factors and treatment strategies were also discussed. Results suggest that clinical diagnosis should make allowances for observed differences in pelvic floor deformations between a Valsalva maneuver and a jump-landing process to ensure accuracy. Urethral hypermobility may be a less contributing factor than the intrinsic sphincteric closure system to the incontinence of young female athletes.
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DOI：
10.1115/1.4026436
发表时间：
2014-10-01
影响因子：
1.7
作者：
Dai, Zoujun;Peng, Ying;Royston, Thomas J.
通讯作者：
Royston, Thomas J.
影响因子：
2.4
作者：
Brandao, Sofia;Parente, Marco;Jorge, Renato Natal
通讯作者：
Jorge, Renato Natal
DOI：
10.1196/annals.1389.034
发表时间：
2007-01-01
期刊：
REPRODUCTIVE BIOMECHANICS
影响因子：
--
作者：
Ashton-Miller, James A.;Delancey, John O. L.
通讯作者：
Delancey, John O. L.
影响因子：
3.4
作者：
Bo, Kari
通讯作者：
Bo, Kari
影响因子：
7.2
作者：
Braekken, Ingeborg Hoff;Majida, Memona;Bo, Kari
通讯作者：
Bo, Kari