Physical Activity and Pelvic Floor Disorders

描述（由申请人提供）：身体活动对维持健康至关重要。了解体力活动如何影响骨盆底疾病是很重要的：一半的美国妇女有尿失禁或盆腔器官脱垂，九分之一的妇女因这些疾病接受手术。迄今为止的研究发现，体力活动对骨盆底疾病既有保护作用，也有有害作用。研究人员是一个由泌尿妇科医生、运动科学家和统计学家组成的多学科团队，他们认为这种差异在很大程度上是由于对体力活动数据和盆底结果测量的不充分确定。本研究的主要目的是在两项精心设计的病例对照研究中，在调整混杂因素后，确定1）中度至重度压力性尿失禁（由有效问卷定义）和2）盆腔器官脱垂（由结构化盆腔检查定义）是否与a）当前休闲活动和B）总终身活动的增加或减少相关（休闲，家庭和职业）。参与者将包括650名女性，主要来自初级保健诊所：175名患有中度至重度压力性尿失禁，175名患有盆腔器官脱垂，300名对照组，两种疾病的发生频率与年龄、体重指数和部位不匹配。 本研究的第二个目的是从这些研究筛选的人群中建立一个约1,500名既无脱垂也无尿失禁的妇女的登记处;这将为未来研究这些疾病的发病率提供基础。将使用经验证的问卷测量身体活动，该问卷旨在评估女性当前和累积的终生活动;活动项目将补充额外的负荷和影响身体活动。将使用MET小时/周（最广泛使用和传统上接受的方法）和剧烈活动小时/周来比较患有和不患有每种疾病的女性的终身体力活动。公共卫生相关性：骨盆底疾病包括尿漏和骨盆器官脱垂（子宫等骨盆器官落入阴道或从阴道中脱出）非常常见。迄今为止有限的数据表明，体力活动可能对骨盆底的影响既有益又有害。我们将研究不同水平的活动对骨盆底疾病的长期影响。鉴于活动对健康的益处，我们认为应鼓励妇女积极参加活动，除非有相反的科学证据。

DESCRIPTION (provided by applicant): Physical activity is crucial in maintaining health. Understanding how physical activity impacts pelvic floor disorders is important: half of American women have urinary incontinence or pelvic organ prolapse and one in nine undergoes surgery for these conditions. Studies to date find both protective and harmful effects of physical activity on pelvic floor disorders. The investigators, a multi-disciplinary team of urogynecologists, exercise scientists and statistician, believe this discrepancy is in large part due to inadequate ascertainment of both physical activity data and pelvic floor outcome measures. The primary aims of this study, addressed in two carefully designed case-control studies, are to determine, after adjusting for confounders, whether 1) moderate to severe stress urinary incontinence, defined by a validated questionnaire, and 2) pelvic organ prolapse, defined by structured pelvic examination, are associated with increased or decreased a) current leisure activity and b) total lifetime activity (leisure, household, and occupational). Participants will include 650 women, largely from primary care clinics: 175 with moderate to severe stress urinary incontinence, 175 with pelvic organ prolapse and 300 controls with neither condition frequency matched for age, body mass index and site. A secondary aim of this study is to establish, from the population screened for these studies, a registry of approximately 1,500 women with neither prolapse nor urinary incontinence; this will provide a foundation for future studies on the incidence of these conditions. Physical activity will be measured using validated questionnaires designed to assess current and cumulative lifetime activity in women; activity items will be supplemented with additional loading and impact physical activities. Lifetime physical activity amongst women with and without each condition will be compared using both MET hours/week (the most widely used and traditionally accepted method) and strenuous activity hours/week. PUBLIC HEALTH RELEVANCE: Pelvic floor disorders including urinary leakage and pelvic organ prolapse (dropping of pelvic organs such as the uterus into or out of the vagina) are very common. Limited data to date suggest that physical activity may be both helpful and harmful in terms of its effect on the pelvic floor. We will study the long-term effects of different levels of activity on pelvic floor disorders. Given the health benefits of activity, we believe that women should be encouraged to be active unless there is scientific evidence to the contrary.