The Impact of Hip Exercises on Pelvic Floor Muscle Strength and Function as a Potential Non-surgical Management for Urinary Incontinence in Older Women

髋部锻炼对盆底肌肉力量和功能的影响作为老年女性尿失禁的潜在非手术治疗方法

• 批准号: 10457461
• 负责人: Isuzu Meyer
• 金额: $ 14.85万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10457461
• 关键词: Address; Adjuvant; Admission activity; Adverse effects; Affect; Age; Aging; Anatomy; Cardiovascular Diseases; Cessation of life; Data; Dementia; Distress; Elderly; Equipment and supply inventories; Exercise; Exercise Physiology; Face; Fall prevention; Future; Genitourinary system; Geriatrics; Goals; Health; Health Priorities; Hip region structure; Hospitalization; Impaired cognition; Impairment; Intervention; Isometric Exercise; Knowledge; Lead; Long-Term Care; Lower Extremity; Measurement; Measures; Mental Depression; Morbidity - disease rate; Muscle; Muscle Contraction; Muscle Weakness; Muscle function; Older Population; Operative Surgical Procedures; Osteoporosis; Pelvic Floor Muscle; Pelvic floor structure; Pharmaceutical Preparations; Physical Function; Physical Performance; Physical therapy; Physiological; Pilot Projects; Play; Postmenopause; Protocols documentation; Questionnaires; Randomized Controlled Trials; Reporting; Resistance; Risk; Risk Factors; Role; Rotation; Safety; Self Efficacy; Severities; Skeletal Muscle; Social Functioning; Standardization; Stroke; Structure; Syndrome; Testing; Time; Training; Training Programs; Urinary Incontinence; Woman; cognitive function; community living; comorbidity; design; disability; evidence base; executive function; exercise intervention; exercise program; exercise regimen; exercise training; fall risk; falls; functional decline; functional status; high risk; human old age (65+); improved; incontinence symptom; innovation; insight; interdisciplinary collaboration; muscle strength; novel; older women; optimal treatments; premature; pressure; protocol development; psychosocial; strength training; trial comparing; young woman

PROJECT ABSTRACT/SUMMARY Urinary incontinence (UI) is a highly prevalent (up to 50% of community-living older women) condition associated with profound morbidity and psychosocial consequences. Treatment options of UI are limited for older women due to adverse effects related to medications or surgery, thus conservative management, including pelvic floor muscle (PFM) exercises, are often the only available option. Despite the unique physiologic changes associated with aging, traditional PFM exercises use the same protocol for women across all ages, failing to address aging-related physical and functional decline. There is growing evidence that the surrounding anatomic structures of the pelvic floor play an important role in maintaining PFM function and strength through dynamic muscle coactivation. The obturator internus (involved in hip external rotation) shares facial attachment with PFMs. Previous studies have demonstrated that strengthening the hip external rotator muscles improved intravaginal squeeze pressures (a validated measurement for voluntary PFM contraction involved in PFM training) in both young and postmenopausal women. However, the impact on UI symptoms was not examined in these studies. Thus, the effect of hip muscle exercises on older women with UI remains unknown. The current preliminary data further demonstrated that older women with UI had significantly lower baseline hip strength compared to those without UI, and hip external rotation had the highest correlation with pelvic floor strength. Thus, the overarching goal of this project is to assess the impact of hip external rotation exercises on pelvic floor strength and function (contributing to the continence mechanism), specifically targeting older women with UI. The proposed study will include 30 older women (ages 65 or older) with UI, aiming to 1) investigate changes in PFM strength from pre- to post-standardized 12-week hip muscle exercises, progressively increasing resistance over time (an evidence-based exercise strategy for aging associated muscle weakness), 2) examine the impact of hip muscle exercises on UI symptoms, and 3) assess barriers in hip muscle exercises, specifically cognitive function, physical function, and self-efficacy. Results from this study will provide insight into the dynamic interaction of anatomic support structures on pelvic floor strength and function and will be utilized to design a future randomized controlled trial comparing the traditional PFM training versus a novel exercise regimen including hip muscle exercises in older women with UI. The long-term goal is to develop an innovative intervention incorporating the potential synergistic effect of intermuscular interactions between hip and pelvic floor muscles as a non-surgical treatment of UI in older women.

项目摘要/摘要 尿失禁（UI）是高度普遍（最多占社区生活的老年妇女的50％） 与深远的发病率和社会心理后果有关。 UI的治疗选择有限 老年妇女由于与药物或手术有关的不良影响，因此，保守管理， 包括骨盆地板肌肉（PFM）练习，通常是唯一可用的选择。尽管有独特之处 与衰老相关的生理变化，传统的PFM练习使用相同的方案为跨越女性 所有年龄段，未能解决与衰老有关的身体和功能下降。越来越多的证据表明 周围骨盆底的解剖结构在维持PFM功能和 通过动态肌肉共激活的力量。闭孔室内（参与髋部外旋）共享 带有PFM的面部附着。先前的研究表明，加强髋关节外旋转器 肌肉改善了阴道挤压压力（经过验证的自愿PFM收缩的测量值 参与年轻和绝经后妇女的PFM培训）。但是，对UI症状的影响 在这些研究中没有检查。因此，臀部肌肉运动对UI的老年女性的影响 未知。当前的初步数据进一步表明，有UI的老年妇女显着降低 与没有UI的基线髋关节强度相比 骨盆底强度。因此，该项目的总体目标是评估髋关节外旋的影响 对骨盆底强度和功能进行练习（有助于连续性机制），特别是 针对用UI的老年妇女。拟议的研究将包括30名老年妇女（65岁或以上）用UI， 目的1）调查PFM强度从前到标准的12周髋关节的变化 练习，随着时间的推移逐渐增加抵抗力（衰老的循证锻炼策略 相关的肌肉无力），2）检查髋部肌肉运动对UI症状的影响，3）评估 髋部肌肉运动的障碍，特别是认知功能，身体功能和自我效能感。结果 从这项研究中，将洞悉骨盆底上解剖支持结构的动态相互作用 力量和功能，并将用于设计未来的随机对照试验，以比较传统 PFM训练与一种新颖的运动方案，包括UI老年女性的髋部肌肉运动。这 长期目标是开发一种创新的干预措施，结合了潜在的协同作用 髋关节和骨盆底肌之间的肌间相互作用是对年龄较大的UI的非手术治疗 女性。