PELVIC FLOOR DYSFUNCTION IN CARDIOPULMONARY DISEASES: MECHANISMS, EVIDENCE, AND CLINICAL APPROACHES

Abstract

Cardiopulmonary diseases are chronic conditions affecting heart and lung function and are associated with high morbidity and mortality worldwide. Common symptoms, such as chronic cough, dyspnea, and respiratory muscle dysfunction, not only compromise respiratory capacity but also impact the thoracic, abdominal, and pelvic musculo-fascial chain, leading to functional impairments and movement limitations. Pelvic floor dysfunction may develop through multidimensional mechanisms, including increased intra-abdominal pressure, diaphragmatic dysfunction, abdomino-pelvic dyssynergy, and impaired core stability. Additionally, disruptions in the gut-lung axis can affect gastrointestinal motility and excretory function, increasing the load on the pelvic floor. While cardiopulmonary diseases alone negatively affect quality of life, coexisting pelvic floor dysfunction can impose an additional burden. This review aims to systematically examine the relationships between cardiopulmonary diseases and pelvic floor dysfunction, elucidate potential pathophysiological mechanisms, and highlight the importance of clinical assessment and comprehensive rehabilitation strategies. Early diagnosis and appropriate interventions may therefore help preserve both pelvic floor and respiratory functions and improve patients’ quality of life.

Keywords

• Pelvic floor
• Cardiac diseases
• Pulmonary diseases
• Quality of life
• Physiotherapy and rehabilitation

KARDİYOPULMONER HASTALIKLARDA PELVİK TABAN DİSFONKSİYONU: MEKANİZMALAR, KANITLAR VE KLİNİK YAKLAŞIMLAR

Abstract

Kardiyopulmoner hastalıklar, kalp ve akciğer fonksiyonlarını etkileyen ve dünya genelinde yüksek morbidite ile mortaliteye yol açan kronik sağlık sorunlarıdır. Bu hastalıklarda sık görülen kronik öksürük, dispne ve solunum kas disfonksiyonu gibi semptomlar yalnızca solunum kapasitesini etkilemekle kalmaz; torakal, abdominal ve pelvik kas‑fasya zincirinin bütününü de etkileyerek fonksiyonel bozulmalara ve hareket kısıtlılıklarına yol açabilir. Pelvik taban disfonksiyonları; artmış intraabdominal basınç, diyafram disfonksiyonu, abdomino‑pelvik dissinerji ve kor stabilitedeki bozulmalar gibi çok boyutlu mekanizmalar aracılığıyla ortaya çıkabilir. Ayrıca bağırsak‑akciğer aksındaki işlev bozuklukları, gastrointestinal motiliteyi ve boşaltım fonksiyonlarını etkileyerek pelvik taban üzerindeki yükü artırabilir. Kardiyopulmoner hastalıklar bireylerin yaşam kalitesini tek başına olumsuz etkilerken, bu hastalığa eşlik edebilen pelvik taban disfonksiyonları yaşam kalitesi üzerinde ek bir yük oluşturabilir. Bu derlemenin amacı, kardiyopulmoner hastalıklar ile pelvik taban disfonksiyonu arasındaki ilişkileri mevcut literatür ışığında sistematik biçimde incelemek, olası patofizyolojik mekanizmaları açıklamak ve klinik değerlendirme ile bütüncül rehabilitasyon stratejilerinin önemini vurgulamaktır. Böylece, erken tanı ve uygun müdahalelerin, hem pelvik taban hem de solunum fonksiyonlarının korunmasına ve hastaların yaşam kalitesinin artırılmasına katkı sağlayabileceği ortaya koymaktadır.

Keywords

• Pelvik taban
• Kardiyak hastalıklar
• Pulmoner hastalıklar
• Yaşam kalitesi
• Fizyoterapi ve rehabilitasyon

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