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（高达50%的社区老年妇女）的条件 与严重的发病率和心理社会后果有关。UI的治疗选择有限， 老年妇女由于药物或手术相关的不良反应，因此保守治疗， 包括骨盆底肌肉（PFM）锻炼，通常是唯一可用的选择。尽管独特的 随着年龄的增长，传统的PFM练习对女性使用相同的协议， 所有年龄段，未能解决与年龄相关的身体和功能衰退。越来越多的证据表明， 骨盆底周围的解剖结构在维持PFM功能方面起着重要作用， 通过动态肌肉协同激活来增强力量。闭孔内肌（参与髋关节外旋） 带PFMs的面部附件。以前的研究表明，加强髋关节外旋， 肌肉改善阴道内挤压压力（一个有效的测量自愿PFM收缩 参与PFM培训）在年轻和绝经后妇女。但是，对UI症状的影响 在这些研究中没有被检查。因此，臀部肌肉锻炼对老年UI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的老年妇女的 基线髋关节强度与无UI的患者相比，髋关节外旋与 骨盆底力量因此，本项目的首要目标是评估髋关节外旋的影响 练习骨盆底的力量和功能（有助于骨盆机制），特别是 专门针对老年女性使用UI拟议的研究将包括30名患有UI的老年女性（65岁或以上）， 目的是1）研究从标准化前到标准化后12周的髋关节肌肉的PFM强度变化 运动，随着时间的推移逐渐增加阻力（一种基于证据的衰老运动策略 相关的肌肉无力），2）检查臀部肌肉锻炼对UI症状的影响，以及3）评估 髋关节肌肉锻炼的障碍，特别是认知功能，身体功能和自我效能。结果 从这项研究将提供洞察的动态相互作用的解剖支持结构对骨盆底 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训练与一种新的运动方案，包括髋关节肌肉锻炼的老年妇女与UI。的 长期目标是开发一种创新的干预措施， 髋关节和骨盆底肌肉之间的肌间相互作用作为老年UI的非手术治疗 妇女