Item – Thèses Canada

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Numéro d'OCLC
633141578
Lien(s) vers le texte intégral
Exemplaire de BAC
Exemplaire de BAC
Auteur
Morin, Mélanie,1979-
Titre
Propriétés passives des muscles du plancher pelvien dans le maintien de la continence urinaire chez la femme.
Diplôme
Thèse (Ph. D.)--Université de Montréal, 2008.
Éditeur
Ottawa : Library and Archives Canada = Bibliothèque et Archives Canada, [2009]
Description
3 microfiches
Notes
Comprend des références bibliographiques
Résumé
It has been suggested that the pelvic floor muscles (PFM) play a crucial role in female urinary continence since they participate in urethral support. A handful of studies have compared the PFM passive properties (also called tonicity) in continent and stress urinary incontinent (SUI) women but produced controversial results. These studies may be explained by methodological issues related to the assessment of PFM passive properties. The main objective of this thesis was to determine the importance of PFM passive properties in the maintenance of urinary continence. Considering the involvement of the PFM in pelvic-organ support and in the optimal positioning of the urethra for continence, we believed that SUI postmenopausal women will present alterations in PFM passive properties. Passive parameters were assessed during four different conditions: (1) initial passive resistance; (2) passive resistance at maximal aperture; (3) forces, passive elastic stiffness and hysteresis during five lengthening and shortening cycles; (4) percentage loss of resistance after 1 min of sustained stretch. As preliminary steps, the first study aimed at developing a methodology to rigorously evaluate the PFM passive properties. This innovative approach differed from current assessment techniques since the dynamometric assessment was combined to electromyography to control for involuntary PFM activity. Moreover, our protocol included both static and dynamic stretches. The goal of the second study was to assess the test- retest reliability of the PFM passive parameters. The reliability was confirmed in postmenopausal SUI women. The objective of the third study was to compare PFM passive properties in postmenopausal continent and SUI women. SUI women showed lower initial passive resistance. However, the differences between the two groups could not be confirmed at larger vaginal apertures because a potential bias related to the slightly higher apertures found in continent women. A higher contribution of the passive forces to maximal total strength was demonstrated in SUI women. This underlines the importance of the passive parameters in the maintance of continence. Furthermore, the results suggest that age was related to PFM passives properties, but not to maximal voluntary strength. No significant relation was found between the number of vaginal delivery and PFM function. Lastly, significant relations between the passives properties and maximal voluntary strength were observed. This doctorate project stresses the importance of the passive parameters in maintaining continence. With the help of the innovative approach developed for assessing PFM passive properties, our results paved the way for a better understanding of mechanisms underlying SUI physiotherapy treatment. 'Keywords'. Incontinence, levator ani, passive forces, stiffness, tonicity, reliability, dynamometry, electromyography, women's health, menopause
ISBN
9780494477052
0494477059