Biomechanical evaluation of pelvic floor muscle function

压力性尿失禁影响着全球七分之一的女性，每年与这种疾病相关的费用超过10亿美元。盆底肌肉的激活被认为是预防尿失禁最重要的因素，因为当其他机制失效时，这些肌肉产生的力量有助于关闭尿道。因此，盆底肌肉锻炼通常是治疗失禁的第一线方法。然而，这些做法并非在所有情况下都是成功的，人们对其成功所涉及的机制知之甚少。人们怀疑这一成功与腹部、盆底和尿道压力的适当耦合有关，然而这些压力与产生压力的肌肉之间的正常关系目前尚不清楚。本研究计划旨在了解女性在暴露于不同功能压力源时的尿动力学和神经生理学机制。本研究的目的包括模拟大陆女性在自发性宫缩、反射性宫缩和valsalva动作期间记录的腹内、尿道内和阴道内压力升高之间的相互关系，并将这些模式与压力性尿失禁（SUI）女性的记录进行比较。功能活动期间记录的腹内、尿道内和阴道内压力模式与相关肌肉激活模式之间的相关性可能为采用保守方法治疗SUI女性时针对特定运动控制缺陷的不同训练方法的发展提供证据。

Stress urinary incontinence affects one in seven women worldwide, and annual costs associated with this disorder exceed one billion dollars US. Activation of the pelvic floor muscles is claimed to be the most important factor in the prevention of incontinence episodes, as the force generated by these muscles assists with closing the urethra when other mechanisms fail. As such, pelvic floor muscle exercises are often a first line of treatment for incontinence disorders. These exercises, however, are not successful in all cases and little is known about the mechanisms involved in their success. It is suspected that this success is related to the proper coupling of abdominal, pelvic floor and urethral pressures, however the normal relationships among these pressures and the muscles involved in generating them are not currently known. This research proposal is designed to provide an understanding of the urodynamics and neurophysiology of the female continence mechanism when it is exposed to different functional stressors. The objectives of this work include modelling the inter-relationships among rises in intraabdominal, intraurethral, and intravaginal pressure recorded during voluntary contractions, reflex contractions and valsalva maneuvers in continent women and comparing these patterns to those recorded from women with stress urinary incontinence (SUI). The correlatation between patterns of intraabdominal, intraurethral and intravaginal pressure recorded during functional activities and the associated patterns of muscle activation may provide evidence for the development of different training approaches which target specific motor control deficits when treating women suffering from SUI by conservative means.