The Impact of Hip Exercises on Pelvic Floor Muscle Strength and Function as a Potential Non-surgical Management for Urinary Incontinence in Older Women

髋部锻炼对盆底肌肉力量和功能的影响作为老年女性尿失禁的潜在非手术治疗方法

• 批准号: 10301551
• 负责人: Isuzu Meyer
• 金额: $ 14.85万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10301551
• 关键词: Address; Adjuvant; Admission activity; Adverse effects; Affect; Age; Aging; Anatomy; Cardiovascular Diseases; Cessation of life; Data; Dementia; Distress; Elderly; Equipment and supply inventories; Exercise; Exercise Physiology; Face; Fall prevention; Future; Genitourinary system; Geriatrics; Goals; Health; Health Priorities; Hip region structure; Hospitalization; Impaired cognition; Impairment; Intervention; Isometric Exercise; Knowledge; Lead; Long-Term Care; Lower Extremity; Measurement; Measures; Mental Depression; Morbidity - disease rate; Muscle; Muscle Contraction; Muscle Weakness; Muscle function; Older Population; Operative Surgical Procedures; Osteoporosis; Pelvic Floor Muscle; Pelvic floor structure; Pharmaceutical Preparations; Physical Function; Physical Performance; Physical therapy; Physiological; Pilot Projects; Play; Postmenopause; Protocols documentation; Questionnaires; Randomized Controlled Trials; Reporting; Resistance; Risk; Risk Factors; Role; Rotation; Safety; Self Efficacy; Severities; Skeletal Muscle; Social Functioning; Standardization; Stroke; Structure; Syndrome; Testing; Time; Training; Training Programs; Urinary Incontinence; Woman; cognitive function; community living; comorbidity; design; disability; evidence base; executive function; exercise intervention; exercise program; exercise regimen; exercise training; fall risk; falls; functional decline; functional status; high risk; human old age (65+); improved; incontinence symptom; innovation; insight; interdisciplinary collaboration; muscle strength; novel; older women; optimal treatments; premature; pressure; protocol development; psychosocial; strength training; trial comparing; young woman

PROJECT ABSTRACT/SUMMARY Urinary incontinence (UI) is a highly prevalent (up to 50% of community-living older women) condition associated with profound morbidity and psychosocial consequences. Treatment options of UI are limited for older women due to adverse effects related to medications or surgery, thus conservative management, including pelvic floor muscle (PFM) exercises, are often the only available option. Despite the unique physiologic changes associated with aging, traditional PFM exercises use the same protocol for women across all ages, failing to address aging-related physical and functional decline. There is growing evidence that the surrounding anatomic structures of the pelvic floor play an important role in maintaining PFM function and strength through dynamic muscle coactivation. The obturator internus (involved in hip external rotation) shares facial attachment with PFMs. Previous studies have demonstrated that strengthening the hip external rotator muscles improved intravaginal squeeze pressures (a validated measurement for voluntary PFM contraction involved in PFM training) in both young and postmenopausal women. However, the impact on UI symptoms was not examined in these studies. Thus, the effect of hip muscle exercises on older women with UI remains unknown. The current preliminary data further demonstrated that older women with UI had significantly lower baseline hip strength compared to those without UI, and hip external rotation had the highest correlation with pelvic floor strength. Thus, the overarching goal of this project is to assess the impact of hip external rotation exercises on pelvic floor strength and function (contributing to the continence mechanism), specifically targeting older women with UI. The proposed study will include 30 older women (ages 65 or older) with UI, aiming to 1) investigate changes in PFM strength from pre- to post-standardized 12-week hip muscle exercises, progressively increasing resistance over time (an evidence-based exercise strategy for aging associated muscle weakness), 2) examine the impact of hip muscle exercises on UI symptoms, and 3) assess barriers in hip muscle exercises, specifically cognitive function, physical function, and self-efficacy. Results from this study will provide insight into the dynamic interaction of anatomic support structures on pelvic floor strength and function and will be utilized to design a future randomized controlled trial comparing the traditional PFM training versus a novel exercise regimen including hip muscle exercises in older women with UI. The long-term goal is to develop an innovative intervention incorporating the potential synergistic effect of intermuscular interactions between hip and pelvic floor muscles as a non-surgical treatment of UI in older women.

项目摘要/总结 尿失禁 (UI) 是一种非常普遍的疾病（高达 50% 的社区老年女性） 与严重的发病率和社会心理后果有关。 UI 的治疗选择仅限于 老年女性由于药物或手术相关的不良反应，因此采取保守治疗， 包括骨盆底肌肉 (PFM) 锻炼，通常是唯一可用的选择。尽管独一无二 与衰老相关的生理变化，传统的 PFM 练习对世界各地的女性使用相同的方案 所有年龄段的人都无法解决与衰老相关的身体和功能衰退问题。越来越多的证据表明 盆底周围的解剖结构在维持 PFM 功能和 通过动态肌肉协同激活来增强力量。闭孔内肌（参与髋部外旋）共享 与 PFM 的面部附件。先前的研究表明，加强髋部外旋肌 肌肉改善阴道内挤压压力（经验证的自愿 PFM 收缩测量 参与针对年轻和绝经后女性的 PFM 培训）。然而，对 UI 症状的影响 这些研究中没有进行检查。因此，臀部肌肉锻炼对患有 UI 的老年女性的影响仍然存在 未知。目前的初步数据进一步表明，患有 UI 的老年女性的死亡率显着降低 与那些没有 UI 的人相比，基线髋部力量，髋部外旋与 盆底力量。因此，该项目的总体目标是评估髋部外旋的影响 骨盆底力量和功能的练习（有助于节制机制），特别是 UI 瞄准老年女性。拟议的研究将包括 30 名患有 UI 的老年女性（65 岁或以上）， 旨在 1) 研究 12 周髋肌标准化前后 PFM 强度的变化 锻炼，随着时间的推移逐渐增加阻力（一种基于证据的衰老锻炼策略 相关的肌肉无力），2）检查髋部肌肉锻炼对 UI 症状的影响，以及 3）评估 髋部肌肉锻炼障碍，特别是认知功能、身体功能和自我效能。结果 这项研究将深入了解骨盆底解剖支撑结构的动态相互作用 强度和功能，并将用于设计未来的随机对照试验，比较传统的 PFM 训练与新型锻炼方案（包括患有 UI 的老年女性的臀部肌肉锻炼）的比较。这 长期目标是开发一种创新的干预措施，结合潜在的协同效应 髋部和盆底肌肉之间的肌肉相互作用作为老年 UI 的非手术治疗 女性。