目的:产后腰骨盆痛(PLPP)在女性中很常见。腹部,隔膜,和盆底肌肉(PFM)调节腹内压力作为力闭合机制的一部分。这些肌肉在怀孕期间暴露于损害力闭合机制的变化。假设腹部和PFMs活动,膀胱底座位移的方向,隔膜厚度,在呼吸和姿势任务中,有和没有PLPP的女性之间的旅行可能有所不同。
方法:30名患有PLPP的妇女和30名没有PLPP的妇女参加了这项病例对照研究。超声成像用于评估腹部,隔膜,和PFM在休息时,有或没有骨盆带的主动直腿抬高(ASLR),深呼吸。
结果:在深呼吸和无腰带的ASLR期间,PLPP组的膀胱基底下降明显大于对照组(p=0.026;卡方=6.40)。两组之间的腹肌活动和diaphragm肌厚度没有显着差异。组和任务对膈肌偏移(F(2,116)=6.08;p=0.00)和PFM活性(F(2,116)=5.22;p=0.00)有显著的交互效应。在PLPP组中,戴皮带受损,改变了PFM激活和膀胱基部位移的方向。
结论:PFM活性,气囊基部位移的方向,在姿势和呼吸任务期间,两组之间的the肌偏移有所不同。因此,建议在PLPP女性的康复中对PFMs和diaphragm肌进行再训练。
OBJECTIVE: Postpartum lumbopelvic pain (PLPP) is common among women. Abdominal, diaphragm, and pelvic floor muscles (PFMs) modulate intraabdominal pressure as a part of the force closure mechanism. These muscles are exposed to changes during pregnancy that compromise the force closure mechanism. It was hypothesized that abdominal and PFMs activity, the direction of bladder base displacement, diaphragm thickness, and excursion might differ between women with and without PLPP during respiratory and postural tasks.
METHODS: Thirty women with and 30 women without PLPP participated in this case-control study. Ultrasound imaging was used to assess the abdominal, diaphragm, and PFMs during rest, active straight leg raising (ASLR) with and without a pelvic belt, and deep respiration.
RESULTS: The bladder base descent was significantly greater in the PLPP group than in the controls during deep respiration and ASLR without a belt (p = 0.026; Chi-squared = 6.40). No significant differences were observed between the groups in the abdominal muscles activity and diaphragm muscle thickness. There was a significant interaction effect of the group and the task for diaphragm excursion (F (2, 116) = 6.08; p = 0.00) and PFM activity (F (2, 116) = 5.22; p = 0.00). In the PLPP group, wearing a belt compromised altered PFM activation and direction of bladder base displacement.
CONCLUSIONS: The PFM activity, direction of bladder base displacement, and diaphragm excursion differed between groups during postural and respiratory tasks. Therefore, it is recommended to involve retraining of the PFMs and diaphragm muscle in the rehabilitation of women with PLPP.