nach oben

Erschienen in:

2023 | OriginalPaper | Buchkapitel

9. Beckenboden

verfasst von : Birgit Schulte-Frei, Rebecca Böwe, Lars Jäger, Astrid Landmesser

Erschienen in: Sport in der Schwangerschaft

Verlag: Springer Berlin Heidelberg

Einloggen, um Zugang zu erhalten

Zusammenfassung

Sowohl Schwangerschaft als auch Geburt stellen große Herausforderungen für den Beckenboden dar. Die Auswirkungen der körperlichen Veränderungen in der Schwangerschaft auf den Beckenboden sind nur vor dem Hintergrund der anatomischen und funktionellen Besonderheiten zu verstehen. Die potentiellen Dysfunktionen des Beckenbodens werden dargestellt. Besonders hervorgehoben wird die Inkontinenz. Die Inkontinenz als Symptom der Beckenbodendysfunktion ist besonders häufig und sehr belastend für die Betroffenen. Der Einfluss von sportlicher Aktivität auf den Beckenboden im Verlauf der Schwangerschaft sowie in der Zeit nach der Geburt ist bisher wenig erforscht. Der Einfluss von sportlichem Training auf den Beckenboden allgemein wird inzwischen durch Forschungsergebnisse besser verstanden. In diesem Kapitel werden Forschungsergebnisse zur Prävalenz und zu Ursachen von Inkontinenz bei Leistungs- und Breitensportlerinnen dargestellt und analysiert. Aus der Erkenntnis über besonders belastende Situationen und Auslöser im Sport werden Rückschlüsse abgeleitet, die wiederum in einer Empfehlung für beckenbodenschonenden Sport in der Schwangerschaft resultieren. Die Möglichkeiten der Physiotherapie während und nach der Schwangerschaft werden dargestellt.

Afshar A, Tabrizi A (2021) Pregnancy-related hand and wrist problems. Arch Bone Jt Surg 9(3):345–349. https://doi.org/10.22038/abjs.2020.50995.2531CrossRefPubMedPubMedCentral

Alanee S, Heiner J, Liu N, Monga M (2009) Horseback riding: Impact on sexual dysfunction and lower urinary tract symptoms in men and women. Urology 73(1):109–114. https://doi.org/10.1016/j.urology.2008.07.058CrossRefPubMed

Almousa S, Bandin Van Loon A (2019) The prevalence of urinary incontinence in nulliparous female sportswomen: A systematic review. J Sports Sci 37(14):1663–1672. https://doi.org/10.1080/02640414.2019.1585312CrossRefPubMed

Almousa S, Lamprianidou E, Kitsoulis, G (2018) The effectiveness of stabilising exercises in pelvic girdle pain during pregnancy and after delivery: A systematic review. Physiother Res Int 23:e1699. https://doi.org/10.1002/pri.1699

Araújo MP, Oliveira Ed, Zucchi EV, Trevisani VF, Girão MJ, Sartori MG (2008) The relationship between urinary incontinence and eating disorders in female long-distance runners. Rev Assoc Med Bras 54(2):146–149

Ashworth DC, Maule SP, Stewart F, Nathan HL, Shennan AH, Chappell LC (2020) Setting and techniques for monitoring blood pressure during pregnancy. Cochrane Database Syst Rev 8:Art. No.: CD012739. https://doi.org/10.1002/14651858.CD012739.pub2

Aukee P, Immonen P, Penttinen J, Laippala P, Airaksinen O (2002) Increase in pelvic floor muscle activity after 12 weeks’ training: A randomized prospective pilot study. Urol 60(6):1020–1023; discussion 1023–1024

Baessler K, O‘Neill S, Maher C, Battistutta D (2004) Neurourol Urodynam 23(5–6):398–399

Basu M, Mukerji S, Doumouchtsis SK (2014) Perineal trauma in women undergoing vaginal delivery following intra-uterine fetal demise: A case-control analysis. Int Urogynecol J 25(1):61–64. https://doi.org/10.1007/s00192-013-2148-1CrossRefPubMed

Bernstein I, Juhl L, Grøncall S, Bonde B, Klarkov P (1991) Pelvic floor muscle thickness measured by perinea ultrasonography. Scand J Urol Nephrol Suppl 137:131–133PubMed

Bey ME, Marzilger R, Hinkson L, Arampatzis A, Legerlotz K (2019) Patellar tendon stiffness is not reduced during pregnancy. Front Physiol 10:334. https://doi.org/10.3389/fphys.2019.00334CrossRefPubMedPubMedCentral

Bø K (1992) Stress urinary incontinence physical activity and pelvic floor muscle strength training. Scand J Med Sci Sports 2:197–206CrossRef

Bø K (2004a) Pelvic floor muscle training is effective in treatment of female stress urinary incontinence but how does it work? Int Urogynecol J Pelvic Floor Dysfunct 15(2):76–84PubMedCrossRef

Bø K (2004b) Urinary incontinence pelvic floor dysfunction exercise and sport. Sports Med 34(7):451–464PubMedCrossRef

Bø K (2006) Can pelvic floor muscle training prevent and treat pelvic organ prolapse? Acta Obstet Gynecol Scand 85(3):263–268PubMedCrossRef

Bø K, Borgen JS (2001) Prevalence of stress and urge urinary incontinence in elite athletes and controls. Med Sci Sports Exerc 33(11):1797–1802PubMedCrossRef

Bø K, Herbert RD (2013) There is not yet strong evidence that exercise regimens other than pelvic floor muscle training can reduce stress urinary incontinence in women: A systematic review. J Physiother 59:159–168PubMedCrossRef

Bø K, Nygaard IE (2020) Is physical activity good or bad for the female pelvic floor? A Narrative Review. Sports Med 50(3):471–484. https://doi.org/10.1007/s40279-019-01243-1CrossRefPubMed

Bø K, Sundgot-Borgen J (2008) Are former female elite athletes more likely to experience urinary incontinence later in life than non-athletes? 20(1):100–104. https://doi.org/10.1111/j.1600-0838.2008.00871

Bø K, Stien R (1994) 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 Urodyn 13(1):35–41PubMedCrossRef

Bringezu G, Schreiner O (2020) Lehrbuch der Entstauungstherapie, 5. Aufl. Springer, München-HeidelbergCrossRef

Bullinger M, Kirchberger I, Ware J (1995) Der deutsche SF-36 Health Survey Übersetzung und psychometrische Testung eines krankheitsübergreifenden Instruments zur Erfassung der gesundheitsbezogenen Lebensqualität. Z Gesundheitswiss 3(1):21–36CrossRef

Bump RC, Hurt WG, Fantl JA, Wyman JF (1991) Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. Am J of Obstet Gynecol 165:322–329CrossRef

Cardozo L, Cutner A (1997) Lower urinary tract symptoms in pregnancy. Br J Urol 80(Suppl 1):14–23PubMed

Carls C (2007) The prevalence of stress urinary incontinence in high school and college-age female athletes in the midwest: Implications for education and prevention. Urol Nurs 27(1):21–24, 39

Cavalli M, Aiolfi A,·Bruni PG, Manfredini L, Lombardo F, Bonfanti MT, Bona D, Campanelli G (2021) Prevalence and risk factors for diastasis recti abdominis: A review and proposal of a new anatomical variation. Hernia 25:883–890. https://doi.org/10.1007/s10029-021-02468-8

Caylet N, Fabbro-Peray P, Marès P, Dauzat M, Prat-Pradal D, Corcos J (2006) Prevalence and occurrence of stress urinary incontinence in elite women athletes. Can J Urol 13(4):3174–3179PubMed

Cerruto MA, D’Elia C, Aloisi A, Fabrello M, Artibani W (2013) Prevalence, incidence and obstetric factors’ impact on female urinary incontinence in Europe: A systematic review. Urol Int 90:1–9. https://doi.org/10.1159/000339929CrossRefPubMed

Chen L, Ferreira ML, Beckenkamp PR, Caputo EL, Feng S, Ferreira PH (2021) Comparative efficacy and safety of conservative care for pregnancy-related low back pain: A systematic review and network. Phys Ther 101:1–13CrossRef

Chen Y, GengX ZH, Wang W, Liang Y, Zhang C, Wang L (2022) Systematic review and meta-analysis of evaluation of selective cesarean section in postpartum pelvic floor function recovery under perineal ultrasound. Ann Palliat Med. 11(2):730–742. https://doi.org/10.21037/apm-22-46CrossRefPubMed

Clemens LS (2021) Der Einfluss von Schwangerschaft und Geburt auf Veränderungen des Beckenbodens: Eine prospektive longitudinale Beobachtungsstudie.https://doi.org/10.22028/D291-35353

Cooray SD, Wijeyaratne LA, Soldatos G, Allotey J, Boyle JA, Teede HJ (2020) The unrealised potential for predicting pregnancy complications in women with gestational diabetes: A systematic review and critical appraisal. Int J Environ Res Public Health 17(9):3048. https://doi.org/10.3390/ijerph17093048CrossRefPubMedPubMedCentral

Criner JA (2001) Urinary incontinence in vulnerable populations: Female soldiers. Urol Nurs 21(2):120–123PubMed

Culleton-Quinn E, Bø K, Fleming N, Mockler D, Cusack C, Daly D (2022) Elite female athletes’ experiences of symptoms of pelvic floor dysfunction: A systematic review. Int Urogynecol J 33(10):2681–2711. https://doi.org/10.1007/s00192-022-05302-6CrossRefPubMedPubMedCentral

Dall’alba V, Callegari-Jacques SM, Krahe C, Bruch JP, Alves BC, Barros SG (2015) Health-related quality of life of pregnant women with heartburn and regurgitation. Arq Gastroenterol 52(2):100–104.https://doi.org/10.1590/S0004-28032015000200005

Daneau C, Abboud J, Marchand A-A, Houle M, Pasquier M, Ruchat S-M, Descarreaux M (2021) Mechanisms underlying lumbopelvic pain during pregnancy: A proposed model. Front. Pain Res 2:773988. https://doi.org/10.3389/fpain.2021.773988CrossRef

Da Roza T, Brandão S, Mascarenhas T, Jorge RN, Duarte JA (2014) Volume of training and the ranking level are associated with the leakage of urine in young female trampolinists. Clin J Sport Med 25(3):270–275 [Epub ahead of print]

Davenport MH, Marchand A-A, Mottola MF, Poitras VJ, Gray CE, Garcioa AJ, Barrowman N, Sobierajski F, James N, Meah VL, Skow RJ, Riske L, Nuspl M, Nagpal TS, Courbalay A, Slater LG, Adamo KB, Davies GA, Barakat R, Ruchat S-M (2018) Exercise for the prevention and treatment of low back, pelvic girdle and lumbopelvic pain during pregnancy: A systematic review and meta-analysis. Br J Sports Med 53:90–98. https://doi.org/10.1136/bjsports-2018-099400CrossRefPubMed

de Mattos Lourenco TR, Matsuoka PK, Baracat EC, Haddad JM (2018) Urinary incontinence in female athletes: a systematic review. Int Urogynecol J 29(12):1757–1763. https://doi.org/10.1007/s00192-018-3629-zCrossRefPubMed

Dimpfl T, Hesse U, Schüssler B (1992) Incidence and cause of postpartum urinary stress incontinence. Eur J Obstet Gynecol Reprod Biol 43(1):29–33

Diz-Teixeira P, Alonso-Calvete A, Justo-Cousiño LA, González-González Y, Cuña-Carrera ID (2023) Update on physiotherapy in postpartum urinary incontinence: A systematic review. Arch Esp Urol 76(1):29–39. https://doi.org/10.56434/j.arch.esp.urol.20237601.2CrossRefPubMed

Driusso P, Beleza ACS, Mira DM, de Oliveira Sato T, de Carvalho Cavalli R, Ferreira CHJ, de Fátima Carreira Moreira R (2020) Are there differences in short-term pelvic floor muscle function after cesarean section or vaginal delivery in primiparous women? A systematic review with meta-analysis. Int Urogynecol J 31:1497–1506.https://doi.org/10.1007/s00192-020-04231-6

Ehrlich GE (2003) Low back pain. Bull WHO 81:671–676PubMedPubMedCentral

Eliasson K, Larsson T, Mattsson E (2002) Prevalence of stress incontinence in nulliparous elite Trampolinists. Scand J Med Sci Sports 12:106–110PubMedCrossRef

Eliasson K, Edner A, Mattsson E (2008) 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 19(5):687–696. https://doi.org/10.1007/s00192-007-0508-4CrossRefPubMed

Falah-Hassani K, Reeves J, Shiri R, Hickling D, McLean L (2021) The pathophysiology of stress urinary incontinence: A systematic review and meta-analysis. Int Urogynecol J 32:501–552. https://doi.org/10.1007/s00192-020-04622-9CrossRefPubMedPubMedCentral

Fernandes A, Fitz F, Silva A, Filoni E, Filho JM (2014) Prevalence of urinary incontinence symptoms in adolescent female soccer players and their impact on quality of life. Occup Environ Med 71(Suppl 1):A59-60. https://doi.org/10.1136/oemed-2014-102362.184CrossRef

Fiani B, Sekhon M, Doan T, Bowers B, Covarrubias C, Barthelmass M, De Stefano F, Kondilis A (2021) Sacroiliac Joint and Pelvic Dysfunction Due to Symphysiolysis in Postpartum Women. Cureus 13(10):e18619. https://doi.org/10.7759/cureus.18619CrossRefPubMedPubMedCentral

Franke H, Franke JD, Belz S, Fryer G (2017) Osteopathic manipulative treatment for low back and pelvic girdle pain during and after pregnancy: A systematic review and meta-analysis. J Bodyw Mov Ther 21(4):752–762. https://doi.org/10.1016/j.jbmt.2017.05.014CrossRefPubMed

García-Sánchez E, Ávila-Gandía V, López-Román J, Martínez-Rodríguez A, Rubio-Arias JÁ (2019) What pelvic floor muscle training load is optimal in minimizing urine loss in women with stress urinary incontinence? A systematic review and meta-analysis. Int J Environ Res Public Health 16(22):4358. https://doi.org/10.3390/ijerph16224358CrossRefPubMedPubMedCentral

Garrison SR, Allan GM, Sekhon RK, Musini VM, Khan KM (2012) Magnesium for skeletal muscle cramps. Cochrane Database Syst Rev (12)9:CD009402. https://doi.org/10.1002/14651858.CD009402.pub2

Giagio S, Salvioli S, Pillastrini P, Innocenti T (2021) Sport and pelvic floor dysfunction in male and female athletes: A scoping review. Neurourol Urodyn 40(1):55–64. https://doi.org/10.1002/nau.24564CrossRefPubMed

Gilleard WL, Crosbie J, Smith R (2002) Static trunk posture in sitting and standing during pregnancy and early postpartum. Arch Phys Med Rehabil 83(12):1739–1744PubMedCrossRef

Goldstick O, Constantini N (2014) Urinary incontinence in physically active women and female athletes. Br J Sports Med 48(4):296–298. https://doi.org/10.1136/bjsports-2012-091880CrossRefPubMed

Goldsmith LT, Weiss G (2009) Relaxin in human Pregnancy. Ann NY Acad Sci 1160:130–135. https://doi.org/10.1111/j.1749-6632.2008.03800.xCrossRefPubMed

Goeschen K, Petros PP (2009) Urogynäkologie aus Sicht der Integraltheorie: funktionelle Anatomie, Diagnostik und Therapie nach der Integraltheorie. Springer Medizin Verlag, Heidelberg

Granath AB, Hellgren MS, Gunnarsson RKJ (2006) Water aerobics reduces sick leave due to low back pain during pregnancy. Obstet Gynecol Neonatal Nurs 35(4):465–471CrossRef

Gunnarsson M, Teleman P, Mattiasson A, Lidfeldt J, Nerbrand C, Samsioe G (2002) Effects of pelvic floor exercises in middle aged women with a history of naïve urinary incontinence: A population based study. Eur Urol 41(5):556–561PubMedCrossRef

Gunnemann A, Liedl B, Goeschen K (2017) 25 Jahre Integraltheorie nach Petros. Urologe 56:1548–1558. https://doi.org/10.1007/s00120-017-0521-2

Heidler H (1991) Stress- und Dranginkontinenz. Neue Sicherheit durch Beckenbodentraining. Therapiewoche 41(49):3210–3217

Henscher U (2022) Physiotherapie in der Gynäkologie. Georg Thieme Verlag, Stuttgart

Hextall A, Cardozo L (2001) The role of estrogen supplementation in lower urinary tract dysfunction. Int Urogynecol J Pelvic Floor Dysfunct 12(4):258–261PubMedCrossRef

Hodges PW, Kaigle Holm Elkstrom L, Cresswell A, Hansson T, Thorstensson A (2003) Intervertebral stiffness of the spine is increased by evoked contraction of transversus abdominis and the diaphragm: In vivo porcine studies. Spine 28(23):2594–2601PubMedCrossRef

Inanir A, Cakmak B, Hisim Y, Demirturk F (2014) Evaluation of postural equilibrium and fall risk during pregnancy. Gait Posture 39(4):1122–1125. https://doi.org/10.1016/j.gaitpost.2014.01.013CrossRefPubMed

Jiang K, Novi JM, Darnell S, Arya LA (2004) Exercise and urinary incontinence in women. Obstet Gynecol Surv 59(10):717–721; quiz 745–746

Juhl M, Andersen PK, Olsen J, Madsen M, Jørgensen T, Nøhr EA, Andersen A-MN (2007) physical exercise during pregnancy and the risk of preterm birth: A study within the Danish National Birth Cohort. Am J of Epidem 167:7. https://doi.org/10.1093/aje/kwm364CrossRef

Juhl M, Olsen J, Andersen PK, Nøhr EA, Andersen AM (2010) Physical exercise during pregnancy and fetal growth measures: A study within the Danish National Birth Cohort. Am J Obstet Gynecol 202(63):e1-8. https://doi.org/10.1016/j.ajog.2009.07.033CrossRef

Kamisan Atan I, Zhang W, Shek KL, Dietz HP (2021) Does pregnancy affect pelvic floor functional anatomy? A retrospective study. Eur J Obstet Gynecol Reprod Biol 259:26–31. https://doi.org/10.1016/j.ejogrb.2021.01.047CrossRefPubMed

Kanakaris NK, Roberts CS, Giannoudis PV (2011) Pregnancy-related pelvic girdle pain: An update. BMC Med 15(9):15. https://doi.org/10.1186/1741-7015-9-15CrossRef

Kelleher CJ, Cardozo LD, Khullar V, Salvatore S (1997) A new questionnaire to assess the the quality of life of urinary incontinent women. Br J Obstet Gynaecol 104:1374–1379PubMedCrossRef

Kesikburun S, Güzelküçük Ü, Fidan U, Demir Y, Ergün A, Tan AK (2018) Musculoskeletal pain and symptoms in pregnancy: A descriptive study. Ther Adv Musculoskel Dis 10(12):229–234. https://doi.org/10.1177/1759720X18812449CrossRef

Knoepp LR, McDermott KC, Muñoz A, Blomquist JL, Handa VL (2013) Joint hypermobility obstetrical outcomes and pelvic floor disorders. Int Urogynecol J 24(5):735–740. https://doi.org/10.1007/s00192-012-1913-xCrossRefPubMed

Kölbl H (2003) Make a cesarean sectio safer – Have a vaginal delivery: Wie ist es jetzt wirklich mit dem Beckenboden und dem Geburtsmodus? J Urol Urogynäkol (Österreich) 10(3):17–21

Koyasu K, Kinkawa M, Ueyama N, Tanikawa Y, Adachi K, Matsuo H (2015) The prevalence of primary neck and shoulder pain and its related factors in Japanese postpartum women. Clin Exp Obstet Gynecol 42(1):5–10PubMedCrossRef

Krejci J, Poloczkova H, Nemec P (2015) Current therapeutic concepts in peripartum cardiomyopathy. Curr Pharm Des 21(4):507–514PubMedCrossRef

Lapitan MC, Chye PL (2001) The epidemiology of overactive bladder among females in Asia: A questionnaire survey. Int Urogynecol J 12(4):226–2311CrossRef

Laycock J, Jerwood D (2001) Pelvic floor muscle assessment: The PERFECT scheme. Physiotherapy 87:12CrossRef

Leet T, Flick L (2003) Effect of exercise on birthweight. Clin Obstet Gynecol 46:423–431PubMedCrossRef

Legerlotz K, Hansen M (2020) Editorial: Female Hormones: Effect on Musculoskeletal Adaptation and Injury Risk. Front Physiol 11:628. https://doi.org/10.3389/fphys.2020.00628CrossRefPubMedPubMedCentral

Liang CC, Chang SD, Lin SJ, Lin YJ (2012) Lower urinary tract symptoms in primiparous women before and during pregnancy. Arch Gynecol Obstet 285(5):1205–1210. https://doi.org/10.1007/s00404-011-2124-2CrossRefPubMed

Mack S (2010) Hormone bei der Geburt- aktueller Wissensstand. Die Hebamme 23(4):243–247. https://doi.org/10.1055/s-0030-1267807CrossRef

Martínez Franco E, Parés D, Lorente Colomé N, Méndez Paredes JR, Amat Tardiu L (2014) Urinary incontinence during pregnancy. Is there a difference between first and third trimester? Eur J Obstet Gynecol Reprod Biol 182:86–90. https://doi.org/10.1016/j.ejogrb.2014.08.035CrossRefPubMed

May L (2015) Cardiac physiology of pregnancy. Compr Physiol 5(3):1325–1344. https://doi.org/10.1002/cphy.c140043

Meczekalski B, Katulski K, Czyzyk A, Podfigurna Stopa A (2014) Health in older women athletes. Maturitas 79(4):357–361. https://doi.org/10.1016/j.maturitas.2014.08.004CrossRefPubMed

Meems M, Truijens S, Spek V, Visser LH, Pop V (2015) Prevalence course and determinants of carpal tunnel syndrome symptoms during pregnancy: A prospective study. BJOG 122(8):1112–1118. https://doi.org/10.1111/1471-0528.13360CrossRefPubMed

Mens JM, Pool-Goudzwaard A, Stam HJ (2009) Mobility of the pelvic joints in pregnancy-related lumbopelvic pain: A systematic review. Obstet Gynecol Surv 64(3):200–208. https://doi.org/10.1097/OGX.0b013e3181950f1bCrossRefPubMed

Milsom I, Abrams P, Cardozo L, Roberts RG, Thüroff J, Wein AJ (2001) How widespread are symptoms of an overactive bladder and how are they managed? A population based prevalence study. Br J Urol Int 87:760–766CrossRef

Mitschang C, Görge T (2021) In welchen Situationen beeinflusst die Schwangerschaft unsere Therapieentscheidungen in der Phlebologie? Phlebologie 50:154–157. https://doi.org/10.1055/a-1353-2870CrossRef

Molinet Coll C, Martinez-Franco E, Altimira Queral L, Cuadras D, Amat Tardiu L, Parés D (2022) Hormonal influence in stress urinary incontinence during pregnancy and postpartum. Reprod Sci 29(8):2190–2199. https://doi.org/10.1007/s43032-022-00946-7CrossRefPubMed

Mørkved S, Bø K (2014) Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: A systematic review. Br J Sports Med 48(4):299–310. https://doi.org/10.1136/bjsports-2012-091758CrossRefPubMed

Mukkannavar P, Desai BR, Mohanty U, Parvatikar V, Karwa D, Daiwajna S (2013) Pelvic girdle pain after childbirth: The impact of mode of delivery. J Back Musculoskelet Rehabil 26(3):281–290. https://doi.org/10.3233/BMR-130378CrossRefPubMed

Neumann P, Gill V (2002) Pelvic floor and abdominal muscle interaction: EMG activity and intra-abdominal pressure. Int Urogynecol J 13:125–132CrossRef

Nygaard IE (1997) Does prolonged high-impact activity contribute to later urinary incontinence? A retrospective cohort study of female Olympians. Obstet Gynecol 90(5):718–722PubMedCrossRef

Nygaard I, DeLancey JO, Arnsdorf L, Murphy E (1990) Exercise and incontinence. Obstet Gynecol 75(5):848–851PubMed

Nygaard IE, Thompson FL, Svengalis SL, Albright JP (1994) Urinary incontinence in elite nulliparous athletes. Obstet Gynecol 84(2):183–187PubMed

Nygaard I, Girts T, Fultz NH, Kinchen K, Pohl G, Sternfeld B (2005) Is urinary incontinence a barrier to exercise in women? Obstet Gynecol 106(2):307–314PubMedCrossRef

Nygaard IE, Shaw JM, Bardsley T, Egger MJ (2015) Lifetime physical activity and female stress urinary incontinence. Am J Obstet Gynecol 213(1):40.e1–10. https://doi.org/10.1016/j.ajog.2015.01.044CrossRefPubMed

Onida S, Lane TR, Davies AH (2013) Improving the management of varicose veins. Practitioner 257(1766):21–24

Oxlund BS, Ørtoft G, Brüel A, Danielsen CC, Oxlund H, Uldbjerg N (2010) Cervical collagen and biomechanical strength in non-pregnant women with a history of cervical insufficiency. Reprod Biol Endocrinol 8:92. https://doi.org/10.1186/1477-7827-8-92CrossRefPubMedPubMedCentral

Peters C, Schulz T, Michna H (2003) Sport und gesunde Lebensführung in Vorsorge und Therapie des Prostatakarzinoms. Dtsch Z Onkol 35:24–29CrossRef

Petros PE, Ulmsten U (1990) An integral theory of female urinary incontinence. Acta Obst Gynecol Scand 69(153):1–79

Pires T, Pires P, Moreira H, Viana R (2020) Prevalence of urinary incontinence in high-impact sport athletes: A systematic review and meta-analysis. J Hum Kinet 73:279–288. https://doi.org/10.2478/hukin-2020-0008

Ponnapula P, Boberg JS (2010) Lower extremity changes experienced during pregnancy. J Foot Ankle Surg 49(5):452–458. https://doi.org/10.1053/j.jfas.2010.06.018CrossRefPubMed

Poświata A, Socha T, Opara J (2014) Prevalence of stress urinary incontinence in elite female endurance athletes. J Hum Kinet 44: 91–96. https://doi.org/10.2478/hukin-2014–0114

Poyatos-León R, García-Hermoso A, Sanabria-Martínez G, Álvarez-Bueno C, Sánchez-López M, Martínez-Vizcaíno V (2015) Effects of exercise during pregnancy on mode of delivery: A meta-analysis. Acta Obstet Gynecol Scand 10:1039–1047. https://doi.org/10.1111/aogs.12675CrossRef

Ramsayer B (2012) Physiologische Geburt. Elwin Staude Verlag, Hannover

Razak A, Florendo-Chin A, Banfield L, Abdul Wahab MG, McDonald S, Shah PS, Mukerji A (2017). Pregnancy-induced hypertension and neonatal outcomes: A systematic review and meta-analysis. J Perinatol:1–8. https://doi.org/10.1038/jp.2017.162

Rebullido TR, Gómez-Tomás C, Faigenbaum AD, Chulvi-Medrano I (2021) The prevalence of urinary incontinence among adolescent female athletes: A systematic review. J Funct Morphol Kinesiol 6(1):12. https://doi.org/10.3390/jfmk6010012

Rebullido TR, Stracciolini A (2019) Pelvic floor dysfunction in female athletes: Is relative energy deficiency in sport a risk factor? Curr Sports Med Rep 18(7):255–257. https://doi.org/10.1249/JSR.0000000000000615CrossRefPubMed

Reimers C, Staer-Jensen J, Siafarikas F, Saltyte-Benth J, Bø K, Ellström Engh M (2016) Change in pelvic organ support during pregnancy and the first year postpartum: A longitudinal study. BJOG 123(5):821–829. https://doi.org/10.1111/1471-0528.13432CrossRefPubMed

Roberts JM, Pearson GD, Cutler JA, Lindheimer MD (2015) Summary of the NHLBI working group on research on hypertension during pregnancy. Hypertens Pregn 22(2):109–127. https://doi.org/10.1081/PRG-120016792CrossRef

Robinson JE, Short RV (1977) Changes in breast sensitivity at puberty during the menstrual cycle and at parturition. Br Med J 1:1188–1191PubMedPubMedCentralCrossRef

Robinson HS, Mengshoel AM, Bjelland EK, Vøllestad NK (2010) Pelvic girdle pain clinical tests and disability in late pregnancy. Man Ther 15(3):280–285. https://doi.org/10.1016/j.math.2010.01.006CrossRefPubMed

Rock C-M (2003) Funktionelle Störungen und reflektorische Inkontinenz. In: Carrière B (Hrsg) Beckenboden. Thieme, Stuttgart, S 83–101

Sachsenmaier B (1991) Inkontinenz. Hilfen Versorgung und Pflege. Schlütersche Verlagsbuchhandlung, Hannover

Salvatore S, Serati M, Laterza R, Uccella S, Torella M, Bolis P-F (2009) The impact of urinary stress incontinence in young and middle-age women practising recreational sports activity: An epidemiological study. Br J Sports Med 43(14):1115–1118. https://doi.org/10.1136/bjsm.2008.049072CrossRefPubMed

Sangsawang B, Sangsawang N (2013) Stress urinary incontinence in pregnant women: A review of prevalence, pathophysiology, and treatment. Int Urogynecol J 24:901–912. https://doi.org/10.1007/s00192-013-2061-7CrossRefPubMedPubMedCentral

Sapsford R (2004) Rehabilitation of pelvic floor muscles utilizing trunk stabilization. Man Ther 9:3–12PubMedCrossRef

Sapsford RR, Hodges PW (2001) Contraction of the pelvic floor muscles during abdominal maneuvers. Arch Phys Med Rehabil 82:1081–1088PubMedCrossRef

Schaeffer MR, Guenette JA, Jensen D (2021) Impact of ageing and pregnancy on the minute ventilation/carbon dioxide production response to exercise. Eur Respir Rev 30:200–225. https://doi.org/10.1183/16000617.0225-2020CrossRef

Schettino MT, Mainini G, Ercolano S, Vascone C, Scalzone G, D’Assisi D, Tormettino B, Gimigliano F, Esposito E, Di Donna MC, Colacurci N, Torella M (2014) Risk of pelvic floor dysfunctions in young athletes. Clin Exp Obstet Gynecol 41(6):671–676

Schlagintweit A (2017) Subjektive und klinische Langzeitergebnisse nach uteruserhaltender sakrospinaler Fixation (ussF, modifiziert nach Amreich-Richter) am eigenen Patientinnenkollektiv. https://edoc.ub.uni-muenchen.de/21533/7/Schlagintweit_Amelie.pdf

Schüle K, Huber G (2004) Grundlagen der Sporttherapie – Prävention ambulante und stationäre Rehabilitation. Urban, Fischer, München

Schulte-Frei B (2007) Sport- und Bewegungstherapie für den weiblichen Beckenboden. Alltagsrelevanz Analyse und Therapie unter Berücksichtigung der neuromuskulären Ansteuerung. Dissertation zur Erlangung des akademischen Grades. Deutsche Sporthochschule Köln. Institut für Rehabilitation und Behindertensport https://fis.dshs-koeln.de/portal/files/719417/Dissertation_Schulte_Frei_Birgit_2007.pdf

Schulte-Frei B (2013) Beckenboden und Sport. Inkontinenzprävention im Alltag. Uro-News 17(2):18–24CrossRef

Sklempe Kokic I, Ivanisevic M, Uremovic M, Kokic T, Pisot R, Simunic B (2017) Effect of therapeutic exercises on pregnancy-related low back pain and pelvic girdle pain: Secondary analysis of a randomized controlled trial. J Rehabil Med 49(3):251–257. https://doi.org/10.2340/16501977-2196CrossRefPubMed

Sorrigueta-Hernández A, Padilla-Fernandez BY, Marquez-Sanchez MT, Flores-Fraile MC, Flores-Fraile J, Moreno-Pascual C, Lorenzo-Gomez A, Garcia-Cenador MB, Lorenzo-Gomez MF (2020) Benefits of physiotherapy on urinary incontinence in high-performance female athletes. Meta-Analysis. J Clin Med 9(10):3240. https://doi.org/10.3390/jcm9103240CrossRefPubMedPubMedCentral

Tamussino K, Lippitt G (2005) Inkontinenz und Sport. J Urol Urogynäkol (Sonderheft 4) (Ausg Österreich) 12:24

Tanzberger R (1991) Krankengymnastische Therapie bei Inkontinenz. Krankengymnastik 43(12):1364–1371

Tara F, Vakilian F, Moosavi-Baigy F, Salehi M, Moghiman T (2015) Prenatal and cardiovascular outcome in pregnant patients with dyspnea. Res Cardiovasc Med 4(2):e20950. https://doi.org/10.5812/cardiovascmed.20950CrossRefPubMedPubMedCentral

Teixeira RV, Colla C, Sbruzzi G, Mallmann A, Paiva LL (2028) Prevalence of urinary incontinence in female athletes: A systematic review with meta-analysis. Int Urogynecol J 29(12):1717–1725. https://doi.org/10.1007/s00192-018-3651-1CrossRef

Thyssen HH, Clevin L, Olesen S, Lose G (2002) Urinary incontinence in elite female atheletes and dancers. Int Urogynecol J Pelvic Floor Dysfunct 13(1):15–17PubMedCrossRef

Vitton V, Baumstarck-Barrau K, Brardjanian S, Caballe I, Bouvier M, Grimaud JC (2011) Impact of high-level sport practice on anal incontinence in a healthy young female population. J Womens Health (Larchmt) 20(5):757–763. https://doi.org/10.1089/jwh.2010.2454CrossRefPubMed

Vesentini G, Prior J, Ferreira PH, Hodges PW, Rudge M, Ferreira ML (2020) Pelvic floor muscle training for women with lumbopelvic pain: A systematic review and meta-analysis. Eur J Pain. 2020 Nov; 24(10):1865–1879. https://doi.org/10.1002/ejp.1636

Vleeming A, de Vries HJ, Mens JM, van Wingerden JP (2002) Possible role of the long dorsal sacroiliac ligament in women with peripartum pelvic pain. Acta Obstet Gynecol Scand 81(5):430–436PubMedCrossRef

Wang SM (2003) Backaches related to pregnancy: the risk factors etiologies treatments and controversial issues. Curr Opin Anaesthesiol 16(3):269–273PubMedCrossRef

Wiezer M, Hage-Fransen MAH, Otto A, Wieffer-Platvoet MS, Slotman MH, Nijhuis-van der Sanden MWG, Pool-Goudzwaard AL (2020) Risk factors for pelvic girdle pain postpartum and pregnancy related low back pain postpartum: A systematic review and meta-analysis. Musculoskeletal Science and Practice.https://doi.org/10.1016/j.msksp.2020.102154

Wijma J, Potters AE, de Wolf BT, Tinga DJ, Aarnoudse JG (2003) Anatomical and functional changes in the lower urinary tract following spontaneous vaginal delivery. BJOG 110(7):658–663PubMedCrossRef

Wiskemann, J, Baumann F. (2022) Update: S3-Leitline Bewegungstherapie bei onkologischen Erkrankungen. Forum. Springer Medizin, Heidelberg

Woll A, Bös K (2004) Wirkungen von Gesundheitssport. Bewegungstherapie Gesundheitssport 20:97–106CrossRef

Woodley SJ, Lawrenson P, Boyle R, Cody JD, Mørkved S, Kernohan A, Hay-Smith EJC (2020) Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev 5:Art. No.: CD007471. https://doi.org/10.1002/14651858.CD007471.pub4

Xue X, Chen Y, Mao X, Tu H, Yang X, Deng Z, Li N (2021) Efect of kinesio taping on low back pain during pregnancy: A systematic review and meta-analysis. BMC Pregnancy Childbirth 21:712. https://doi.org/10.1186/s12884-021-04197-3CrossRefPubMedPubMedCentral

Yagi T, Kodama M, Bun M, Shimura H, Sawada K, Endo M, Kimura T (2021) Magnetic resonance imaging evaluation of pelvic floor structure during pregnancy. Eur J Obstet Gynecol Reprod Biol 264:289–293. https://doi.org/10.1016/j.ejogrb.2021.07.045CrossRefPubMed

Ye W, Luo C, Huang J, Li C, Liu Z, Liu F (2022) Gestational diabetes mellitus and adverse pregnancy outcomes: Systematic review and meta-analysis. BMJ 377:e067946. https://doi.org/10.1136/bmj-2021-067946CrossRefPubMedPubMedCentral

Yu WD, Panossian V, Hatch JD, Liu SH, Finerman GA (2001) Combined effects of estrogen and progesterone on the anterior cruciate ligament. Clin Orthop Relat Res 383:268–281. https://doi.org/10.1097/00003086-200102000-00031CrossRef

Zelle BA, Gruen GS, Brown S, George S (2005) Sacroiliac joint dysfunction evaluation and management. Clin J Pain 21:446–455PubMedCrossRef

Titel: Beckenboden
verfasst von: Birgit Schulte-Frei
Rebecca Böwe
Lars Jäger
Astrid Landmesser
Verlag: Springer Berlin Heidelberg
Buch: Sport in der Schwangerschaft
Print ISBN: 978-3-662-67951-7

Electronic ISBN: 978-3-662-67952-4

Copyright-Jahr: 2023
DOI: https://doi.org/10.1007/978-3-662-67952-4_9

Neu im Fachgebiet Gynäkologie und Geburtshilfe

Nodal-negativ nach neoadjuvanter Chemo: Axilladissektion verzichtbar?

03.05.2024 Mammakarzinom Nachrichten

Wenn bei Mammakarzinomen durch eine neoadjuvante Chemotherapie ein Downstaging von nodal-positiv zu nodal-negativ gelingt, scheint es auch ohne Axilladissektion nur selten zu axillären Rezidiven zu kommen.

Rezidivierender Peritonsillarabszess nach Oralsex

02.05.2024 Peritonsillarabszess Kasuistik

Die erotischen Dimensionen von Peritonsillarabszessen scheinen eng begrenzt zu sein. Das heißt aber nicht, solche Abszesse und Erotik hätten nichts miteinander gemein, wie ein Fallbericht verdeutlicht.

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärzte und Psychotherapeuten.

Ambulantisierung: Erste Erfahrungen mit dem Hybrid-DRG

02.05.2024 DCK 2024 Kongressbericht

Die Hybrid-DRG-Verordnung soll dazu führen, dass mehr chirurgische Eingriffe ambulant durchgeführt werden, wie es in anderen Ländern schon länger üblich ist. Die gleiche Vergütung im ambulanten und stationären Sektor hatten Niedergelassene schon lange gefordert. Aber die Umsetzung bereitet ihnen doch Kopfzerbrechen.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen