Physical Activity and Pelvic Floor Disorders

描述（由申请人提供）：体育活动对保持健康至关重要。了解体育活动如何影响盆底疾病是很重要的：一半的美国女性有尿失禁或盆腔器官脱垂，九分之一的女性为此接受过手术。迄今为止的研究发现，体育活动对盆底疾病既有保护作用，也有有害作用。由泌尿妇科医生、运动科学家和统计学家组成的多学科研究小组认为，这种差异在很大程度上是由于对身体活动数据和骨盆底结果测量的不充分确定。本研究的主要目的是通过两项精心设计的病例对照研究来确定，在调整混杂因素后，1)通过有效问卷定义的中度至重度压力性尿失禁，2)通过结构化盆腔检查定义的盆腔器官脱垂，是否与a)当前休闲活动和b)终生活动（休闲、家庭和职业）的增加或减少有关。参与者将包括650名妇女，主要来自初级保健诊所：175名中度至重度压力性尿失禁，175名盆腔器官脱垂，300名对照组，两种情况的频率与年龄、体重指数和部位都不匹配。

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.