مقایسه شاخص‌های تعادل پویا در زنان با و بدون بیرون زدگی احشای لگنی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد فیزیوتراپی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 دانشیار گروه فیزیوتراپی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 استادیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی تهران، تهران، ایران.

4 استاد گروه آمار زیستی، مرکز تحقیقات پروتئومیکس، دانشکده پیراپزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: بیرون‌زدگی احشای لگنی، یکی از اختلالات عملکردی عضلات کف لگن به‌همراه پایین آمدن احشای کف لگن، دیواره واژن، رحم، مثانه و انتهای روده می‌باشد. با توجه به نقش عضلات کف لگن به‌عنوان بخشی از عضلات مرکزی بدن در کنترل تعادل، این احتمال مطرح شده که زنان با اختلال عملکردی عضلات کف لگن از تعادل ضعیف‌تری برخوردار هستند، لذا مطالعه حاضر با هدف مقایسه سطح تعادل پویا در زنان غیر‌یائسه با و بدون بیرون‌زدگی احشای لگنی و در دو وضعیت مثانه پر و خالی انجام شد.
روش‌کار: این مطالعه مقطعی- مقایسه‌ای در سال ۱۳۹۷ بر روی 30 زن متأهل غیر‌باردار در دانشکده توانبخشی دانشگاه علوم پزشکی شهید بهشتی انجام شد. افراد در سه گروه ۱۰ نفره با بیرون‌زدگی با علامت بالینی، با بیرون‌زدگی بدون علامت بالینی و بدون بیرون‌زدگی احشای لگنی قرار گرفتند. پس از جمع‌آوری اطلاعات جمعیت‌شناختی، زاویه شیب لگن، سطح تعادل پویا در صفحات قدامی- خلفی و داخلی- خارجی و نیز شاخص کلی تعادل ارزیابی شدند. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 22) و آزمون‌های کولموگروف اسمیرنوف، آنالیز کوواریانس یک طرفه و آزمون دقیق فیشر انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته‌ها: بین شاخص‌های تعادل پویا، چه با مثانه پر و چه با مثانه خالی، بین سه گروه مورد مطالعه تفاوت معنی‌داری مشاهده نشد (05/0<p). همچنین مقادیر زاویه شیب لگن بین سه گروه تفاوت معنی‌داری را نشان نداد (05/0p<).
نتیجه‌گیری: ارتباط بیرون زدگی احشای لگنی، به‌عنوان یکی از اختلالات عملکردی عضلات کف لگن، با ثبات پوسچرال تأیید نمی‌شود. انجام مطالعات بیشتر با استفاده از سیستم آنالیز حرکت و ثبت همزمان فعالیت الکتریکی عضلات توصیه می‌شود.

کلیدواژه‌ها


عنوان مقاله [English]

Dynamic Balance Indices in women with and without Pelvic Organ Prolapse

نویسندگان [English]

  • Hamideh Raoufpanah 1
  • Farideh Dehghan Manshadi 2
  • Nasim Shokouhi 3
  • Alireza Akbarzadeh Bagheban 4
1 M.Sc. of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Associate Professor, Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Assistante Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
4 Professor, Department of Biostatistics, Proteomics Research Center, School of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Pelvic Organ Prolapse (POP) is one of the dysfunctions of the Pelvic Floor Muscles (PFM), with descending of pelvic viscera, vaginal wall, uterus, bladder and rectum. Regarding the role of PFM as part of the core muscles in body balance, it has been suggested that women with PFM dysfunctions may have a lower level of balance. Therefore, this study was performed with aim to compare the level of dynamic balance in non-postmenopausal women with and without POP in two positions of full and empty bladder.
Methods: This cross-sectional comparative study was performed in 2018 on 30 non-pregnant married women in the Rehabilitation School of Shahid Beheshti University of Medical Sciences. The subjects were divided in to three groups (n=10 in each group): with symptomatic POP, asymptomatic POP and without POP. After collecting demographic information, the pelvic inclination angle, and the dynamic balance in Antero-Posterior, Medio-Lateral planes as well as total balance index were assessed. Data were analyzed using SPSS statistical software (version 22) and Kolmogorov-Smirnov, one-way ANCOVA and Fisher's exact test. P<0.05 was considered statistically significant.
Results: No significant differences were not found among three groups in terms of dynamic balance index with both full and empty bladder (p<0.05). Moreover, there were no significant differences among three groups regarding the pelvic inclination angle (p<0.05).
Conclusion: The association of POP as one of the dysfunctions of pelvic floor muscle is not confirmed by postural stability. Further studies using the motion analysis system and simultaneous recording of electrical muscle activity are recommended.

کلیدواژه‌ها [English]

  • Dynamic Balance
  • Pelvic inclination angle
  • Pelvic organ prolapse
  • Pelvic Floor muscles
  • Women
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