مقایسه وضعیت راستای ستون فقرات و لگن و عملکرد عضلات کف لگن در زنان با و بدون افتادگی احشاء لگنی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دفتر تحقیقات و فناوری دانشجویی، دانشجوی کارشناسی ارشد فیزیوتراپی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 دکتری تخصصی فیزیوتراپی، استادیار گروه فیزیوتراپی. عضو هیئت علمی دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران. ایران.

3 استادیار گروه زنان و زایمان، دانشکده علوم پزشکی بابل . بابل. ایران

4 دانشیار گروه آمار زیستی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی. تهران. ایران

چکیده

مقدمه و اهداف
افتادگی احشاء لگنی یکی از انواع اختلالات کف لگن و عارضه ای است که کیفیت زندگی فرد مبتلا را تحت تاثیر قرار می دهد. با توجه به شیوع نسبتا بالای افتادگی احشاء لگنی در زنان و لزوم بررسی تاثیر عوامل مستعد کننده این بیماری در جوامع مختلف، این تحقیق با هدف مقایسه وضعیت راستای ستون فقرات و لگن و عملکرد عضلات کف لگن در زنان با و بدون افتادگی احشاء لگنی انجام شد.
مواد و روش­ها
در مجموع 60 نفر، با روش نمونه گیری غیر تصادفی متوالی در این مطالعه توصیفی-تحلیلی که به روش مقطعی انجام شد، شرکت کردند. 30 زن مبتلا به افتادگی احشاء لگنی درجه 2 و 2 به بالا با توجه به معیارهای لحاظ شده، از بین بیماران مراجعه کننده به بیمارستان آیت الله روحانی بابل به عنوان گروه مورد  و 30 زن از مراجعین همان بیمارستان که درجه افتادگی آن ها صفر و یا یک بود به عنوان گروه شاهد انتخاب شدند. پس از گرفتن اطلاعات جمعیت شناختی و سوابق پزشکی، بررسی بالینی شامل ارزیابی وضعیت پوسچرال ستون فقرات، سطح تون واژینال و مقادیر قدرت و استقامت عضلات کف لگن انجام شد.
یافته ها
بین دو گروه تفاوت معنی داری از لحاظ وجود کایفوز پشتی  (0/98=P ) و شیب لگن  (0/06=P)  وجود نداشت. ولی مقادیر زوایای لوردوز کمری و سطح تون واژینال ، قدرت و استقامت عضلات کف لگن درزنان مبتلا به افتادگی احشاء لگنی کمتر از زنان بدون این عارضه بود (0/05>P) .
نتیجه گیری
کاهش لوردوز کمری به عنوان یکی از عوامل خطرزای احتمالی در بیماران با افتادگی احشاء لگنی باید در نظر گرفته شود و مطابق نتایج این مطالعه، احتمال افزایش کایفوز و تیلت خلفی لگن در زنان با افتادگی احشاء لگنی، در یک جامعه بزرگتر آماری، می رود. همچنین در ارایه خدمات درمانی به این بیماران بر تقویت عضلات کف لگن تاکید می شود.

کلیدواژه‌ها


عنوان مقاله [English]

Comparison of the alignment of spine and pelvis and pelvic floor muscles’ function between women with and without pelvic organ prolapse

نویسندگان [English]

  • Mahboubeh Homayounzadeh Ahangar 1
  • Farideh Dehghan Manshadi 2
  • Shahnaz Barat 3
  • Alireza Akbarzadeh Bagheban 4
1 Students` Research Office. Msc in Physiotherapy. School of Rehabilitation Scienses. Shahid Beheshti University of Medical Science. Tehran. Iran
2 Assistant Professor of Physiotherapy. Shcool of Rehabilitation Scienses, Shahid Beheshti University of Medical Science. Tehran. Iran
3 Assistant Professor, Genycologist Department, Faculty of Rehabilitation Scienses, Babol University of Medical Science. Babol. Iran
4 Associate Professor of Biostatistics, Shcool of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
چکیده [English]

Background and Aim: Pelvic Organ Prolapse (POP) is a kind of pelvic floor disorders that affects the quality of life of affected individuals. According to relatively high prevalence of POP in women and the need to review the impact of risk factors in different populations, the present study aimed at compareing the alignment of the spine and pelvis and pelvic floor muscles’ function between women with and without POP.
Material & Methods: Atotal of 60 women with sequential non-random sampling were selected to participate in this descriptive-analytic cross-sectional study. Thirty women with POP who had reffered to Ayatollah Rohani hospital, according to inclusion criteria, were set asas case group and 30 women referring to the same hospital with zero or one degree of prolapse were selected as the control group. After obtaining demographic information, clinical examination including assessment of the spinal posture, state of vaginal rest tone, pelvic floor muscles' strength, and endurance were assessed. Obtained data were analysed by Kolmogorov-Smirnov test, t-test, Logistic Regression, chi-square test and Spearma.
Results: The data showed no significant differences between the two groups in terms of kyphosis (P=0.98) and pelvic tilt (p=0.06). But there is a significant differences in lumbar lordosis (P=0.04). Vaginal tone and pelvic floor muscle strength were significantly lower in patients compared with that in participants without pelvic organ prolapse (p<0.05).
Conclusion: Loss of lumbar lordosis as one of the possible risk factors should be considered in patients with pelvic organ prolapse and, according to the results, the possibility of increase in kyphosis and posterior tilt of the pelvis in women with pelvic organ prolapse is higher in a larger population. Pelvic floor muscles are also emphasized in providing health care services for these patients.

کلیدواژه‌ها [English]

  • Spine alignment
  • pelvic floor muscles
  • pelvic organ prolapsed
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