Læknablaðið - 01.03.2018, Blaðsíða 22

138 LÆKNAblaðið 2018/104
R A N N S Ó K N
Heimildir
1. Bø K. Urinary incontinence, pelvic floor dysfunction,
exercise and sport. Sports Med 2004; 34: 451-64.
2. Bø K, Sundgot-Borgen J. Are former female elite athletes
more likely to experience urinary incontinence later in life
than non-athletes? Scand J Med Sci Sports 2010; 20: 100-4.
3. Eliasson K, Nordlander I, Mattsson E, Larson B,
Hammarstrom M. Prevalence of urinary leakage in
nulliparous women with respect to physical activity and
micturition habits. Int Urogynecol J Pelvic Floor Dysfunct
2004; 15: 149-53.
4. Eliasson K, Larsson T, Mattson E. Prevalence of stress
incontinence in nulliparous elite trampolinist. Scand J
Med Sci Sports 2002; 12: 106-10.
5. Thyssen HH, Clevin L, Olesen S, Lose G. Urinary
incontinence in elite female athletes and dancers. Int
Urogynecol J Pelvic Floor Dysfunct 2002; 13: 15-7.
6. Andersen JC, Andersen B. Screening for Urinary
Incontinence in Female Athletes. Athletic Training &
Sports Health Care 2011; 3: 206.
7. Bø K, Finckenhagen, HB. Vaginal palpation of pelvic floor
muscle strength: inter-test reproducibility and comparison
between palpation and vaginal squeeze pressure. Acta
Obstet Gynecol Scand 2001; 80: 883-7.
8. Bø K, Sherburn M. Evaluation of female pelvic-floor
muscle function and strength. Phys Ther 2005; 85: 269-82.
9. Sigurdardottir T, Steingrimsdottir T, Arnason A, Bø K.
Pelvic floor muscle function before and after first child-
birth. Int Urogynecol J 2011; 22: 1497-503.
10. Bø K. Urinary incontinence; Female elite athletes require
stronger pelvic floor muscles to prevent UI. Life Sci 2004;
12: 67-71.
11. Eliasson K, Edner A, Mattsson E. Urinary incontinence in
very young and mostly nulliparous women with a history
of regular organised high-impact trampoline training:
occurrence and risk factors. Int Urogynecol J Pelvic Floor
Dysfunct 2008; 19: 687-96.
12. Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo
L, Chapple C, et al. Fourth International Consultation
on Incontinence Recommendations of the International
Scientific Committee: Evaluation and treatment of
urinary incontinence, pelvic organ prolapse, and fecal
incontinence. Neurourol Urodyn 2010; 29: 213-40.
13. Nygaard I, DeLancey JO, Arnsdorf L, Murphy E. Exercise
and incontinence. Obstet Gynecol 1990; 75: 848-51.
14. Rivalta M, Sighinolfi MC, Micali S, De Stefani S, Torcasio
F, Bianchi G. Urinary incontinence and sport: first and
preliminary experience with a combined pelvic floor
rehabilitation program in three female athletes. Health
Care Women Int 2010; 31: 435-43.
15. Hägglund D, Wadensten B. Fear of humiliation inhibits
women´s care-seeking behaviour for long-term urinary
incontinence. Scand J Caring Sci 2007; 21: 305-12.
16. Ree ML, Nygaard I, Bø K. Muscular fatigue in the pelvic
floor muscles after strenuous physical activity. Acta
Obstet Gynecol Scand 2007; 86: 870-6.
17. Bø K, Stien R. Needle EMG registration of striated urethral
wall and pelvic floor muscle activity patterns during
cough, Valsalva, abdominal, hip adductor and gluteal
muscle contractions in nulliparous healthy females.
Neurourol Urodynam 1994; 13: 35-41.
18. Li X, Kruger JA, Chung JH, Nash MP, Nielsen PM.
Modelling childbirth: comparing athlete and non-athlete
pelvic floor mechanics. Med Image Comput Comput
Assist Interv 2008; 11: 750-7.
19. Sigurdardottir T, Steingrimsdottir T, Arnason A, Bø K.
Test-retest intra-rater reliability of vaginal measurement
of pelvic floor muscle strength using Myomed 932. Acta
Obstet Gynecol Scand 2009; 88: 939-43.
20. Kegel AH. Progressive Resistance Exercise in the
Functional Restoration of the Perineal Muscles. Am J
Obstet Gynecol 1948; 56: 238-49.
21. Powers SK, Howley ET. Exercise Physiology. Theory and
Application to Fitness and Performance. McGraw-Hill,
New York 2009.
22. Kruger JA, Dietz HP, Murphy BA. Pelvic floor function in
elite nulliparous athletes. Ultrasound Obst Gynecol 2007;
30: 81-5.
23. Borin LC, Nunes FR, Guirro EC. Assessment of pelvic
floor muscle pressure in female athletes. PM R 2013; 5:189-
93.
24. Figuers CC, Boyle KL, Caprio KM, Weidner AC. Pelvic
Floor Muscle Activity and Urinary Incontinence in Weight
Bearing Female Athletes vs. Non-Athletes. J Women´s
Health Physical Ther 2008; 32: 7-10.
25. Bø K, Sundgot-Borgen J. Prevalence of stress and urge
urinary incontinence in elite nulliparous athletes. Med Sci
Sports Exerc 2001; 33: 1797-802.
26. Saleme CS, Rocha DN, Del Vecchio S, Silva Filho AL,
Pinotti M. Multidirectional pelvic floor muscle strength
measurement. Ann Biomed Eng 2009; 37: 1594-600.
Introduction: Exercise can stress the pelvic floor muscles. Numerous
women experience urinary incontinence while exercising or competing
in sports. This study investigated pelvic floor muscle strength, urinary
incontinence, and knowledge in contracting pelvic floor muscles among
female athletes and untrained women.
Materials and methods: This was a prospective case-control study
measuring pelvic floor muscle strength using vaginal pressure meas-
urement. Participants answered questions regarding general health,
urinary incontinence, and knowledge on pelvic floor muscles. Partici-
pants were healthy nulliparous women aged 18-30 years, athletes
and untrained women. The athletes had competed in their sport for at
least three years; including handball, soccer, gymnastics, badminton,
BootCamp and CrossFit.
Results: The women were comparable in age and height. The athletes
(n=18) had a body mass index (BMI) of 22.8 kg/m² vs. 25 kg/m² for the
untrained (n=16); p<0.05. The athletes trained on average 11.4 hours/
week while the untrained women participated in some activity on
average for 1.3 hours/week; p<0.05. Mean pelvic floor strength was 45±2
hPa in the athletes vs. 43±4 hPa in the untrained; p=0.36 for whether
the athletes were stronger. Of the athletes, 61.1% experienced urinary
incontinence (n=11) compared with 12.5% of the untrained women (n=2);
p<0.05. Incontinence usually occurred during high intensity exercise.
The athletes were more knowledgeable about the pelvic floor muscles;
p<0.05.
Conclusion: There was not a significant difference in the strength of
pelvic floor muscles of athletes and untrained women. This suggests
that pelvic floor muscles are not strengthened during general training
but require specific exercises. This holds especially for football, handball
and sports with high physical intensity. Coaches need to pay special
attention to training and strengthening women’s pelvic floor muscles to
reduce the occurrence of urinary incontinence.
Comparison of pelvic floor muscle strength in competition-level athletes and untrained women
Ingunn Lúðvíksdóttir1, Hildur Harðardóttir2,3, Þorgerður Sigurðardóttir2,4, Guðmundur F. Úlfarsson5
1CrossFit Sport, Sporthúsið, 2Faculty of Medicine, University of Iceland, 3Landspitali, University Hospital, Department of Obstetrics and Gynecology, 4Táp, Physical Therapy Clinic,
5Faculty of Civil and Environmental Engineering, University of Iceland.
Key words: pelvic floor, exercise, training, urinary incontinence.
Correspondence: Hildur Harðardóttir, hhard@landspitali.is
ENGLISH SUMMARY
Heilmildir. 1: Samantekt á eiginleikum lyfs fyrir Ganfort® dags. 1. júní 2017. 2: Leske MC et al. Arch Ophthalmol 2003; 121: 48-56.
Þegar meðferðarmarkmið næst ekki
með einlyfjameðferð1
Hver einasti mmHg skiptir máli2 (bimatoprost/timolol) augndropar, lausn 0,3+5 mg/ml
Stytt samantekt á eiginleikum lyfs (SmPC) fyrir Ganfort augndropa, lausn:
GANFORT 0,3 mg/ml + 5 mg/ml augndropar, lausn. Virkt innihaldsefni: Hver ml af lausn inniheldur 0,3 mg bimatoprost og 5 mg timolol (sem 6,8 mg timololmaleat). Ábendingar: Til að lækka augnþrýsting hjá
fullorðnum sjúklingum með gleiðhornsgláku (open-angle glaucoma) eða hækkaðan augnþrýsting, sem svara ekki nægilega vel meðferð með beta-blokkandi augnlyfjum eða prostaglandinhliðstæðum. Frábendingar:
Ofnæmi fyrir virka efninu / virku efnunum eða einhverju hjálparefnanna. Teppusjúkdómur í öndunarvegum (reactive airway disease), þ.e. astmi eða saga um astma, alvarlegur langvinnur teppulungnasjúkdómur.
Gúlshægsláttur, sjúkur sínushnútur, leiðslurof í gáttum, annarrar eða þriðju gráðu gáttasleglarof án gangráðs. Greinileg hjartabilun, hjartalost. Markaðsleyfishafi: Allergan Pharmaceuticals Ireland. Fyrir frekari
upplýsingar um lyfið má hafa samband við Actavis Pharmaceuticals Iceland ehf., Dalshrauni 1, 220 Hafnarfjörður, sími 550 3300, www.actavis.is. Dagsetning síðustu samantektar um eiginleika
lyfsins: 1. júní 2017. Október 2017. Nálgast má upplýsingar um Ganfort, fylgiseðil lyfsins og gildandi samantekt á eiginleikum þess á vef Lyfjastofnunar, www.serlyfjaskra.isActa
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