WIRELESS REMOTE ABDOMINAL PRESSURE SYSTEM: DEVELOPING A MORE COMPREHENSIVE UNDERS

描述（由申请人提供）：骨盆底疾病影响四分之一的美国妇女。很少有可改变的危险因素被确定，可能会减少骨盆底疾病的发病率或进展。大众的智慧和缺乏临床数据表明，剧烈的活动会导致或促进骨盆底疾病。鉴于活动对健康有益，应鼓励妇女尽可能多地活动，除非有相反的科学证据。现有的身体活动仪器主要设计用于评估心血管运动，并使用活动日记、加速度计和步数计数器进行验证。这些测量可能无法准确测量增加骨盆底负荷的活动（如举重）。 在研究了可用的技术后，我们得出结论，在真实的世界中，不存在了解身体活动如何影响腹压的工具。在过去的18个月里，我们的生物工程师，妇科泌尿科医生，电气工程师和运动科学家的跨学科团队开发并验证了阴道内腹部压力传感器原型的性能，该传感器可以准确测量上阴道的压力，这是一个容易接近的空间，记录的压力与真实的腹腔内压力相似。在本提案中，我们计划首先进一步开发一个集成系统（“WRAPS”，无线远程腹部压力系统），以监测临床环境之外的腹内压。该系统将由三个关键要素组成：具有无线数据传输能力的阴道内压力传感器、小型便携式数据监测和存储单元以及用于下载和管理压力数据的基于计算机的数据转换软件。在受控运动实验室环境中，我们将使用WRAPS生成的腹内压数据来确定特定类型体力活动期间测量的腹内压的再现性，并最终完成有效问卷的开发，该问卷对活动期间腹内压的大小进行分类。最后，在现实世界中，参与者在一年中的四个1周的清醒时间内佩戴阴道内传感器，我们将描述不同程度的习惯性体力活动的女性所经历的腹内压力，并使用WRAPS数据作为金标准，通过自我管理问卷确定活动是否可以根据骨盆负荷进行适当分类，目前的标准。获得未来的证据，对骨盆底疾病的身体压力的影响依赖于我们的能力，以衡量危险因素的问题。这种创新的翻译合作将消除一个关键的障碍，在了解妇女盆底疾病的病因进展。 公共卫生相关性：剧烈体力活动对新发或复发性盆底疾病的影响尚不清楚。我们开发了一种阴道内压力传感器来测量腹腔内压力。我们将完善远程使用传感器所需的无线技术，以便我们能够了解在真实的世界环境中进行的不同活动如何影响腹内压和骨盆底疾病。

DESCRIPTION (provided by applicant): Pelvic floor disorders affect one in four American women. Few modifiable risk factors have been identified that might reduce the incidence or progression of pelvic floor disorders. Popular wisdom and scant clinical data suggest that strenuous activity causes or promotes pelvic floor disorders. Given the health benefits of activity, women should be encouraged to be maximally active unless there is scientific evidence to the contrary. Existing physical activity instruments are largely designed to assess cardiovascular exertion and are validated using activity diaries, accelerometers, and step counters. Such measures may not accurately measure activities that increase loading on the pelvic floor (such as lifting). After researching available technologies, we concluded that a tool to understand how physical activities impact abdominal pressure in the real world does not exist. Over the past 18 months, our interdisciplinary team of bioengineers, urogynecologists, electrical engineers, and exercise scientists developed and validated the performance of a prototype for an intravaginal abdominal pressure sensor that accurately measures pressure in the upper vagina, an easily accessible space that records pressures similar to the true intraabdominal pressure. In this proposal, we plan first to further develop an integrated system (the "WRAPS", Wireless Remote Abdominal Pressure System) to monitor intraabdominal pressure outside of the clinical setting. This system will consist of three key elements: an intravaginal pressure sensor with wireless data transmission capability, a small portable data monitoring and storage unit, and computer based data translation software for downloading and managing the pressure data. In a controlled exercise laboratory setting, we will then use intraabdominal pressure data generated by the WRAPS to determine the reproducibility of intraabdominal pressures measured during specific types of physical activity and will finalize development of a valid questionnaire that categorizes the magnitude of intraabdominal pressures during activities. Finally, in a real-world setting in which participants wear the intravaginal sensor during waking hours for four 1-week periods over the course of a year, we will characterize intraabdominal pressures experienced by women of varying degrees of habitual physical activity and, using WRAPS data as the gold standard, determine whether activity can be appropriately categorized in terms of pelvic loading by means of self-administered questionnaires, the current standard. Obtaining future evidence about the impact of physical stressors on pelvic floor disorders relies on our ability to measure the risk factor in question. This innovative translational collaboration will remove a critical barrier to progress in understanding the etiology of pelvic floor disorders in women. PUBLIC HEALTH RELEVANCE: The effect of strenuous physical activity on new or recurrent pelvic floor disorders is unknown. We developed an intravaginal pressure sensor to measure intraabdominal pressure. We will perfect the wireless technology needed to use the sensor remotely so that we can understand how different activities done during real world settings affect intraabdominal pressures and pelvic floor disorders.