高频超声观察不同训练动作对产后腹直肌分离间距的即时影响  

Immediate effects of different training movements on inter-rectus distance in postpartum women:a high-frequency ultrasound observation

作　　者：岑婉仪 龚宇萱 黄镇东 胡芯雨 林君[3] 阙可欣 李太良 王润妹[3] 宋成宪[3] Cen Wanyi;Gong Yuxuan;Huang Zhendong;Hu Xinyu;Lin Jun;Que Kexin;Li Tailiang;Wang Runmei;Song Chengxian(Department of Rehabilitation Medicine,Nanfang Hospital,Southern Medical University,Guangzhou 510000,Guangdong Province,China;Rehabilitation College of Hangzhou Medical College,Hangzhou 311399,Zhejiang Province,China;Department of Rehabilitation Medicine,the Third Affiliated Hospital,Guangzhou Medical University,Guangzhou 510000,Guangdong Province,China;Guangzhou Medical University,Guangzhou 510000,Guangdong Province,China)

机构地区：[1]南方医科大学南方医院康复医学科,广东省广州市510000 [2]杭州医学院康复学院,浙江省杭州市311399 [3]广州医科大学附属第三医院康复医学科,广东省广州市510000 [4]广州医科大学,广东省广州市510000

出　　处：《中国组织工程研究》2023年第32期5091-5096,共6页Chinese Journal of Tissue Engineering Research

基　　金：广州市卫生健康科技项目(20181A011086),项目负责人:宋成宪;广州医科大学附属第三医院青年科研项目(2019Q10),项目负责人:李太良。

摘　　要：背景:产后腹直肌分离具有较高的发病率,对产妇的身心健康造成了一定的不良影响。运动疗法是其主要的治疗方法之一,但何种运动方式能更有效地促进其修复,目前尚缺乏共识。目的:通过高频超声检查,观察卷腹运动、腹部中空运动、盆底肌收缩和联合运动4个训练动作对产后腹直肌分离间距的即时影响。方法:招募39例符合条件的腹直肌分离产妇,产后时间2-6个月。在静息状态、卷腹运动、腹式呼吸、盆底收缩、联合运动5个动作模式下,利用高频超声分别在受试者脐上4.5 cm、脐水平和脐下4.5 cm处对腹直肌分离间距进行测量。结果与结论:①脐上4.5 cm处,4个训练动作与静息状态相比,对腹直肌分离间距的影响差异均无显著性意义(均P>0.05);脐水平处,卷腹运动与静息状态相比腹直肌分离间距显著减少(P<0.01),而联合运动与静息状态相比腹直肌分离间距增加(P<0.05);脐下4.5 cm处,卷腹运动与静息状态相比腹直肌分离间距减少(P<0.05),其他3个动作与静息状态相比,腹直肌分离间距虽有增加的趋势,但差异无显著性意义(均P>0.05);②顺产组和剖腹产组相比,静息状态下3个测量位置的腹直肌分离间距差异均无显著性意义(均P>0.05);在脐水平处,经产组腹直肌分离间距较初产组增宽,差异有显著性意义(P<0.05);③脐下4.5 cm处,体质量指数与腹直肌分离间距呈正相关(r=0.359,P=0.025);④在即时效果上,卷腹运动可缩小腹直肌分离的间距,而腹部中空运动、盆底收缩运动和两者的联合运动则具有相反的效果;多次生产和体质量指数高的产妇可能更容易出现腹直肌分离;研究结果可为产后腹直肌分离的康复治疗提供一定的理论依据。BACKGROUND:Postpartum diastasis rectus abdominis have a high incidence,which has a certain adverse effect on the physical and mental health of parturients.Exercise therapy is one of the main treatment methods,but there is still a lack of consensus on which exercise can promote its repair more effectively.OBJECTIVE:To observe the immediate effects of curl-up movement,abdominal breathing,pelvic floor muscle contraction and combined exercise on interrectus distance using high-frequency ultrasound.METHODS:Thirty-nine eligible subjects with postpartum diastasis rectus abdominis were recruited 2-6 months after delivery.Inter-rectus distance was measured using high-frequency ultrasound at 4.5 cm above the umbilicus,at the level of the umbilicus and at 4.5 cm below the umbilicus in five movement patterns:resting state,curl-up movement,abdominal breathing,pelvic floor contraction and combined movement.RESULTS AND CONCLUSION:There was no significant difference in the inter-rectus distance between the resting state and the other four movement patterns at 4.5 cm above the umbilicus(P>0.05).At the level of the umbilicus,the inter-rectus distance was significantly decreased in the curl-up movement compared with the resting state(P<0.01),while the inter-rectus distance significantly increased in the combined exercise compared with the resting state(P<0.05).At the 4.5 cm below the umbilicus,the inter-rectus distance decreased in the curl-up movement compared with the resting state(P<0.05),while the inter-rectus distance tended to increase in the other three movements compared with the resting state,but there was no statistical difference(P>0.05).There was no significant difference in the inter-rectus distance between spontaneous delivery group and cesarean section group at the resting state(all P>0.05).However,at the umbilical level,the inter-rectus distance in the multiparity group was significantly wider than that in the primiparity group(P<0.05).At 4.5 cm below the umbilicus,the body mass index was positively correlated with

关 键 词：产后 腹直肌 腹直肌分离 高频超声 运动训练 卷腹运动 腹部中空运动 盆底收缩运动 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R445.1