Pelvic floor disorders affect one in four American women. Few modifiable risk factors have been identified that might reduce the incidence or progression of pelvic floor disorders. Popular wisdom and scant clinical data suggest that strenuous activity causes or promotes pelvic floor disorders. Given the health benefits of activity, women should be encouraged to be maximally active unless there is scientific evidence to the contrary. Existing physical activity instruments are largely designed to assess cardiovascular exertion and are validated using activity diaries, accelerometers, and step counters. Such measures may not accurately measure activities that increase loading on the pelvic floor (such as lifting). After researching available technologies, we concluded that a tool to understand how physical activities impact abdominal pressure in the real world does not exist. Over the past 18 months, our interdisciplinary team of bioengineers, urogynecologists, electrical engineers, and exercise scientists developed and validated the performance of a prototype for an intravaginal abdominal pressure sensor that accurately measures pressure in the upper vagina, an easily accessible space that records pressures similar to the true intraabdominal pressure. In this proposal, we plan first to further develop an integrated system (the "WRAPS", Wireless Remote Abdominal Pressure System) to monitor intraabdominal pressure outside of the clinical setting. This system will consist of three key elements: an intravaginal pressure sensor with wireless data transmission capability, a small portable data monitoring and storage unit, and computer based data translation software for downloading and managing the pressure data. In a controlled exercise laboratory setting, we will then use intraabdominal pressure data generated by the WRAPS to determine the reproducibility of intraabdominal pressures measured during specific types of physical activity and will finalize development of a valid questionnaire that categorizes the magnitude of intraabdominal pressures during activities. Finally, in a real-world setting in which participants wear the intravaginal sensor during waking hours for four 1-week periods over the course of a year, we will characterize intraabdominal pressures experienced by women of varying degrees of habitual physical activity and, using WRAPS data as the gold standard, determine whether activity can be appropriately categorized in terms of pelvic loading by means of self-administered questionnaires, the current standard. Obtaining future evidence about the impact of physical stressors on pelvic floor disorders relies on our ability to measure the risk factor in question. This innovative translational collaboration will remove a critical barrier to progress in understanding the etiology of pelvic floor disorders in women.
The effect of strenuous physical activity on new or recurrent pelvic floor disorders is unknown. We developed an intravaginal pressure sensor to measure intraabdominal pressure. We will perfect the wireless technology needed to use the sensor remotely so that we can understand how different activities done during real world settings affect intraabdominal pressures and pelvic floor disorders.
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