School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, QC, Canada.
Arch Phys Med Rehabil. 2010 Jul;91(7):1059-63. doi: 10.1016/j.apmr.2010.03.006.
To identify predictors of success for physiotherapy treatment in women with persistent postpartum stress urinary incontinence (SUI).
Secondary analysis of data from a single-blind randomized controlled trial comparing 2 physiotherapy intervention programs for persistent SUI in postpartum women.
Obstetric clinic of a mother and children's university hospital.
Women, ages 23 to 39 (N=57), were randomized to 1 of 2 pelvic floor muscle (PFM) training programs, 1 with and 1 without abdominal muscle training.
Over 8 weeks, participants in each group followed a specific home exercise program once a day, 5 days a week. In addition, participants attended individual weekly physiotherapy sessions throughout the 8-week program.
Treatment success was defined as a pad weight gain of less than 2 g on a 20-minute pad test with standardized bladder volume after 8 weeks' treatment. The relationship between potential predictive PFM function variables as measured by a PFM dynamometer and success of physiotherapy was studied using forward stepwise multivariate logistic regression analyses.
Forty-two women (74%) were classified as treatment successes, and 15 (26%) were not. Treatment success was associated with lower pretreatment PFM passive force and greater PFM endurance pretreatment, but the latter association was barely statistically significant. This model explained between 23% (Cox and Snell R(2)) and 34% (Nagelkerke R(2)) of the outcome variability.
The results contribute new information on predictors of success for physiotherapy treatment in women with persistent postpartum SUI.
确定持续性产后压力性尿失禁（SUI）女性物理治疗成功的预测因素。
对一项比较两种物理治疗方案治疗持续性产后 SUI 的单盲随机对照试验数据进行二次分析。
一所母婴大学附属医院的产科诊所。
年龄在 23 至 39 岁之间的女性（N=57），随机分为两组：一组接受盆底肌肉（PFM）训练，一组接受 PFM 训练加腹肌训练。
两组参与者在 8 周内每天在家中进行特定的锻炼方案，每周 5 天。此外，两组参与者每周参加一次个体物理治疗课程，贯穿整个 8 周的治疗计划。
治疗成功定义为 20 分钟垫上测试时垫上增重小于 2g，且标准化膀胱容量后 8 周治疗。使用正向逐步多元逻辑回归分析研究了潜在的预测性 PFM 功能变量（如 PFM 测力计测量）与物理治疗成功之间的关系。
42 名女性（74%）被归类为治疗成功，15 名女性（26%）为治疗失败。治疗成功与治疗前 PFM 被动力较低和治疗前 PFM 耐力较大相关，但后者的相关性仅略具有统计学意义。该模型解释了结局变异性的 23%（Cox 和 Snell R²）到 34%（Nagelkerke R²）。
这些结果为持续性产后 SUI 女性的物理治疗成功预测因素提供了新的信息。
