WIRELESS REMOTE ABDOMINAL PRESSURE SYSTEM: DEVELOPING A MORE COMPREHENSIVE UNDERS

描述(由申请者提供)：盆底疾病影响四分之一的美国女性。几乎没有可改变的危险因素被确定可以降低盆底疾病的发生率或进展。流行的智慧和缺乏的临床数据表明，剧烈运动导致或促进了盆底疾病。考虑到运动对健康的好处，应该鼓励妇女最大限度地活跃起来，除非有科学证据表明这一点。现有的体力活动仪器主要设计用于评估心血管消耗，并使用活动日记、加速计和步数计数器进行验证。这样的测量可能不能准确地测量增加盆底负荷的活动(如抬起)。在研究了可用的技术后，我们得出结论，在现实世界中，不存在了解身体活动如何影响腹压的工具。在过去的18个月里，我们由生物工程师、泌尿外科医生、电气工程师和运动科学家组成的跨学科团队开发并验证了阴道内腹压传感器的原型性能，该传感器可以准确测量上阴道内的压力，这是一个易于接近的空间，可以记录与真实腹内压相似的压力。在这项提案中，我们计划首先进一步开发一个集成系统(“WRIPS”，无线远程腹压系统)，以监测临床环境外的腹内压力。该系统将由三个关键要素组成：具有无线数据传输能力的阴道内压力传感器，小型便携式数据监测和存储单元，以及用于下载和管理压力数据的基于计算机的数据转换软件。在受控运动实验室环境中，我们将使用WRAP生成的腹内压数据来确定在特定类型的体力活动中测量的腹内压的重复性，并最终制定一份有效问卷，对活动期间腹内压的大小进行分类。最后，在一个真实的环境中，参与者在一年中的四个一周的时间里，在清醒的时间里佩戴阴道内传感器，我们将描述不同程度习惯性体力活动的女性感受到的腹内压力，并使用WRIPS数据作为金标准，通过自我管理的问卷，即目前的标准，确定活动是否可以根据骨盆负荷进行适当的分类。未来获得物理应激源对盆底疾病影响的证据依赖于我们测量相关危险因素的能力。这一创新的翻译合作将消除在了解女性盆底疾病病因方面取得进展的关键障碍。 公共卫生相关性：剧烈体力活动对新发或复发的盆底疾病的影响尚不清楚。我们开发了一种阴道内压力传感器来测量腹内压力。我们将完善远程使用传感器所需的无线技术，以便我们能够了解在现实世界环境中进行的不同活动如何影响腹内压和盆底疾病。

DESCRIPTION (provided by applicant): Pelvic floor disorders affect one in four American women. Few modifiable risk factors have been identified that might reduce the incidence or progression of pelvic floor disorders. Popular wisdom and scant clinical data suggest that strenuous activity causes or promotes pelvic floor disorders. Given the health benefits of activity, women should be encouraged to be maximally active unless there is scientific evidence to the contrary. Existing physical activity instruments are largely designed to assess cardiovascular exertion and are validated using activity diaries, accelerometers, and step counters. Such measures may not accurately measure activities that increase loading on the pelvic floor (such as lifting). After researching available technologies, we concluded that a tool to understand how physical activities impact abdominal pressure in the real world does not exist. Over the past 18 months, our interdisciplinary team of bioengineers, urogynecologists, electrical engineers, and exercise scientists developed and validated the performance of a prototype for an intravaginal abdominal pressure sensor that accurately measures pressure in the upper vagina, an easily accessible space that records pressures similar to the true intraabdominal pressure. In this proposal, we plan first to further develop an integrated system (the "WRAPS", Wireless Remote Abdominal Pressure System) to monitor intraabdominal pressure outside of the clinical setting. This system will consist of three key elements: an intravaginal pressure sensor with wireless data transmission capability, a small portable data monitoring and storage unit, and computer based data translation software for downloading and managing the pressure data. In a controlled exercise laboratory setting, we will then use intraabdominal pressure data generated by the WRAPS to determine the reproducibility of intraabdominal pressures measured during specific types of physical activity and will finalize development of a valid questionnaire that categorizes the magnitude of intraabdominal pressures during activities. Finally, in a real-world setting in which participants wear the intravaginal sensor during waking hours for four 1-week periods over the course of a year, we will characterize intraabdominal pressures experienced by women of varying degrees of habitual physical activity and, using WRAPS data as the gold standard, determine whether activity can be appropriately categorized in terms of pelvic loading by means of self-administered questionnaires, the current standard. Obtaining future evidence about the impact of physical stressors on pelvic floor disorders relies on our ability to measure the risk factor in question. This innovative translational collaboration will remove a critical barrier to progress in understanding the etiology of pelvic floor disorders in women. PUBLIC HEALTH RELEVANCE: The effect of strenuous physical activity on new or recurrent pelvic floor disorders is unknown. We developed an intravaginal pressure sensor to measure intraabdominal pressure. We will perfect the wireless technology needed to use the sensor remotely so that we can understand how different activities done during real world settings affect intraabdominal pressures and pelvic floor disorders.