Stefanie N Foster1, Theresa M Spitznagle1,2, Lori J Tuttle3, Siobhan Sutcliffe4,2, Karen Steger-May5, Jerry L Lowder2,6, Melanie R Meister2,6, Chiara Ghetti2,6, Jinli Wang5, Michael J Mueller1,7, Marcie Harris-Hayes1,8. 1. Program in Physical Therapy, Washington University in St. Louis, St Louis, MO. 2. Department Obstetrics and Gynecology, Washington University in St. Louis, St Louis, MO. 3. Doctor of Physical Therapy Program, San Diego State University, San Diego, CA. 4. Department of Surgery, Washington University in St. Louis, St Louis, MO. 5. Division of Biostatistics, Washington University in St. Louis, St Louis, MO. 6. Division of Female Pelvic Medicine & Reconstructive Surgery, Washington University in St. Louis, St Louis, MO. 7. Department of Radiology, Washington University in St. Louis, St Louis, MO. 8. Department Orthopedic Surgery, Washington University in St. Louis, St Louis, MO.
Abstract
BACKGROUND: Urgency and frequency are common lower urinary tract symptoms (UF-LUTS) in women. There is limited evidence to guide physical therapist-led treatment. OBJECTIVES: To compare hip and pelvic floor muscle strength between women with and without UF-LUTS. We hypothesized women with UF-LUTS would demonstrate 1) diminished hip external rotator and abductor strength and 2) equivalent pelvic floor strength and diminished endurance compared to controls. STUDY DESIGN: A matched case-control study. METHODS: Women with UF-LUTS (cases) and controls were matched on age, body mass index (BMI), vaginal parity. Examiner measured participants' 1) hip external rotator and abductor strength via dynamometry (maximum voluntary effort against fixed resistance) and 2) pelvic floor muscle strength (peak squeeze pressure) and endurance (squeeze pressure over a 10 second hold) via vaginal manometry. Values compared between cases and controls with paired-sample t-tests (hip) or Wilcoxon signed rank tests (pelvic floor). RESULTS: 21 pairs (42 women): Hip external rotation (67.0 ± 19.0 N vs 83.6 ± 21.5 N; P=0.005) and hip abduction strength (163.1 ± 48.1 N vs 190.1 ± 53.1 N; P=0.04) were significantly lower in cases than controls. There was no significant difference in pelvic floor strength (36.8 ± 19.9 cmH20 vs 41.8 ± 21.0 cmH20; P=0.40) or endurance (234.0 ± 149.6 cmH20*seconds vs 273.4 ± 149.1 cmH20*seconds; P=0.24). CONCLUSION: Women with UF-LUTS had weaker hip external rotator and abductor muscles, but similar pelvic floor strength and endurance compared to controls. Hip strength may be important to assess in patients with UF-LUTS, further research is needed.
BACKGROUND: Urgency and frequency are common lower urinary tract symptoms (UF-LUTS) in women. There is limited evidence to guide physical therapist-led treatment. OBJECTIVES: To compare hip and pelvic floor muscle strength between women with and without UF-LUTS. We hypothesized women with UF-LUTS would demonstrate 1) diminished hip external rotator and abductor strength and 2) equivalent pelvic floor strength and diminished endurance compared to controls. STUDY DESIGN: A matched case-control study. METHODS: Women with UF-LUTS (cases) and controls were matched on age, body mass index (BMI), vaginal parity. Examiner measured participants' 1) hip external rotator and abductor strength via dynamometry (maximum voluntary effort against fixed resistance) and 2) pelvic floor muscle strength (peak squeeze pressure) and endurance (squeeze pressure over a 10 second hold) via vaginal manometry. Values compared between cases and controls with paired-sample t-tests (hip) or Wilcoxon signed rank tests (pelvic floor). RESULTS: 21 pairs (42 women): Hip external rotation (67.0 ± 19.0 N vs 83.6 ± 21.5 N; P=0.005) and hip abduction strength (163.1 ± 48.1 N vs 190.1 ± 53.1 N; P=0.04) were significantly lower in cases than controls. There was no significant difference in pelvic floor strength (36.8 ± 19.9 cmH20 vs 41.8 ± 21.0 cmH20; P=0.40) or endurance (234.0 ± 149.6 cmH20*seconds vs 273.4 ± 149.1 cmH20*seconds; P=0.24). CONCLUSION: Women with UF-LUTS had weaker hip external rotator and abductor muscles, but similar pelvic floor strength and endurance compared to controls. Hip strength may be important to assess in patients with UF-LUTS, further research is needed.
Authors: Melanie R Meister; Siobhan Sutcliffe; Chiara Ghetti; Christine M Chu; Theresa Spitznagle; David K Warren; Jerry L Lowder Journal: Am J Obstet Gynecol Date: 2018-12-07 Impact factor: 8.661
Authors: Robert E Gutman; Daniel E Ford; Lieschen H Quiroz; Stuart H Shippey; Victoria L Handa Journal: Am J Obstet Gynecol Date: 2008-10-01 Impact factor: 8.661
Authors: Stefanie N Foster; Theresa M Spitznagle; Lori J Tuttle; Jerry L Lowder; Siobhan Sutcliffe; Karen Steger-May; Chiara Ghetti; Jinli Wang; Taylor Burlis; Melanie R Meister; Michael J Mueller; Marcie Harris-Hayes Journal: J Womens Health Phys Therap Date: 2022 Apr-Jun