Physical Activity and Pelvic Floor Disorders

描述(由申请者提供)：体力活动对保持健康至关重要。了解体力活动对盆底疾病的影响是很重要的：一半的美国女性有尿失禁或盆腔器官脱垂，九分之一的女性因这些疾病接受手术。迄今为止的研究发现，体力活动对盆底疾病既有保护作用，也有有害影响。由泌尿外科医生、运动科学家和统计学家组成的多学科团队的研究人员认为，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结果的确定不足。这项研究的主要目的是通过两个精心设计的病例对照研究，在调整混杂因素后，确定是否1)由有效问卷定义的中到重度压力性尿失禁，以及2)由结构性盆腔检查定义的盆腔器官脱垂，与a)当前休闲活动的增加或减少以及b)一生的全部活动(休闲、家庭和职业)相关。参与者将包括650名女性，主要来自初级保健诊所：175名患有中重度压力性尿失禁，175名患有盆腔器官脱垂，以及300名对照组，这些患者的病情频率在年龄、体重指数和部位上都不匹配。 这项研究的第二个目的是从这些研究的筛查人群中建立一个大约1500名既没有脱垂也没有尿失禁的妇女的登记；这将为未来对这些疾病的发病率的研究提供基础。体力活动将使用经过验证的问卷来衡量，该问卷旨在评估妇女目前和累积的终身活动；活动项目将补充额外的负荷和影响体力活动。对患有和不患有这两种疾病的女性一生的体力活动进行比较，使用MET小时/周(最广泛使用和传统上被接受的方法)和剧烈活动小时/周两种方法。与公共卫生相关：盆底疾病非常常见，包括尿漏和盆腔器官脱垂(如子宫等盆腔器官掉入或掉出阴道)。到目前为止，有限的数据表明，就其对盆底的影响而言，体育活动可能是有益的，也可能是有害的。我们将研究不同活动水平对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.