Neuromuscular and biomechanical mechanisms associated with PFM function in humans

与人类 PFM 功能相关的神经肌肉和生物力学机制

• 批准号: RGPIN-2016-05256
• 负责人: McLean, Linda
• 金额: $ 2.99万
• 依托单位: University of Ottawa
• 依托单位国家: 加拿大
• 项目类别: Discovery Grants Program - Individual
• 财政年份: 2020
• 资助国家: 加拿大
• 起止时间: 2020-01-01 至 2021-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=708497
• 关键词: Neuromuscular; biomechanical; mechanisms; associated; PFM

The long term objective of my research program is to understand the normal function of the pelvic floor muscles (PFMs) in terms of their contributions to continence function, sexual function, pelvic organ support, and postural control in both women and men. Despite their obvious and important roles in each of these systems, the normative function of the PFMs is poorly understood. In part, this knowledge gap is related to the limited availability of tools and techniques because the physiological and mechanical properties of the PFMs cannot be studied using traditional electromyographic, kinematic and kinetic approaches. Further, the PFMs are involved in multiple functions, and, at times, have competing demands for contraction and relaxation. To date, my research has followed three distinct, but complementary pathways to the achieve my long-term objective. These are: (1) the development of novel measurement tools and techniques to study PFM function, (2) understanding the neuromuscular control of the PFMs in the context of their need to support multiple systems, and (3) understanding the biomechanical properties of the PFMs and how these relate to their role within different human systems . Over the past five years, we have made significant gains in all of these areas, and my proposed research program will build on these achievements under the same general pathways: (1) Novel tools and techniques: (i) we will complete in-vivo testing of a new intravaginal dynamometer designed to measure PFM contractile force and passive stiffness properties, (ii) we will automate our sagittal plane ultrasound image analysis to study urethral kinematics and kinetics during dynamic tasks, (iii) We will develop and evaluate shear wave elastography methods to measure PFM tissue stiffness in-vivo. We will evaluate how these properties relate to active and passive tissue properties measured using our vaginal dynamometer. (2) PFM neuromuscular control: We will use dual and higher order task paradigms to investigate the ways in which the PFMs and their synergists respond to concurrent challenges. We will investigate how the human systems prioritize PFM activation and the effect of age on PFM function in this context. Finally, we will investigate proprioceptive sensation from the PFMs and investigate the relationship between proprioceptive outcomes and capacity for PFM activation. (3) PFM biomechanics: We will build a normative dataset to investigate the biomechanical properties of the PFMs in vivo and will study how these properties change with age. This work will culminate in a clear understanding of the motor control and biomechanics of PFM function in women, with the view to understanding how the PFMs simultaneously support continence and motor functions. This work will pave the way to follow-on steps including the study of sex differences in pelvic floor structure and function and the role of the PFMs in sexual function.

我的研究计划的长期目标是了解盆底肌肉 (PFM) 的正常功能，以及它们对女性和男性的节制功能、性功能、盆腔器官支持和姿势控制的贡献。 尽管公共财政管理在这些系统中发挥着明显且重要的作用，但人们对公共财政管理的规范功能却知之甚少。在某种程度上，这种知识差距与工具和技术的有限可用性有关，因为无法使用传统的肌电图、运动学和动力学方法来研究 PFM 的生理和机械特性。 此外，PFM 涉及多种功能，并且有时具有收缩和松弛的竞争需求。 迄今为止，我的研究遵循了三种不同但互补的途径来实现我的长期目标。这些是：（1）开发新的测量工具和技术来研究 PFM 功能，（2）在需要支持多个系统的背景下了解 PFM 的神经肌肉控制，以及（3）了解 PFM 的生物力学特性以及这些特性如何与其在不同人体系统中的作用相关。在过去的五年里，我们在所有这些领域都取得了重大进展，我提出的研究计划将在相同的一般途径下以这些成就为基础： (1) 新工具和技术：(i) 我们将完成新型阴道测力计的体内测试，该测力计旨在测量 PFM 收缩力和被动刚度特性，(ii) 我们将自动化矢状面超声图像分析，以研究动态任务期间的尿道运动学和动力学，(iii) 我们将开发和评估剪切波弹性成像方法来测量 PFM 组织刚度 体内。 我们将评估这些特性与使用阴道测力计测量的主动和被动组织特性之间的关系。 (2) PFM 神经肌肉控制：我们将使用双重和高阶任务范式来研究 PFM 及其协同剂应对并发挑战的方式。 我们将研究人类系统如何优先考虑 PFM 激活以及年龄对 PFM 功能的影响。 最后，我们将研究 PFM 的本体感觉，并研究本体感觉结果与 PFM 激活能力之间的关系。 (3) PFM 生物力学：我们将建立一个规范的数据集来研究 PFM 体内的生物力学特性，并研究这些特性如何随年龄变化。 这项工作最终将清楚地了解女性 PFM 功能的运动控制和生物力学，以了解 PFM 如何同时支持节制和运动功能。 这项工作将为后续步骤铺平道路，包括研究盆底结构和功能的性别差异以及 PFM 在性功能中的作用。