Gynecology Department of Federal University of São Paulo, Brazil.
Neurourol Urodyn. 2012 Jan;31(1):121-5. doi: 10.1002/nau.21149. Epub 2011 Oct 28.
The aim of the study was to compare the effect of hypopressive exercises including pelvic floor muscle contraction, pelvic floor muscle training (PFMT) alone and control on pelvic floor muscle function in women with pelvic organ prolapse (POP).
Fifty-eight women with a mean age of 55.4 (± 9.8) years old with stage II POP were randomly assigned to participate in the PFMT group, the hypopressive exercises associated with PFMT (HE + PFMT) group or the control group. Each treatment group underwent a 3-month course of treatment. The three groups received lifestyle advice regarding weight loss, constipation, coughing, and the avoidance of heavy lifting. Participants were evaluated before and after the treatment. Maximal voluntary contraction (MVC) and endurance were assessed using the Modified Oxford grading system. To evaluate muscle activation, surface electromyography (SEMG) was used.
The two treatment group significantly increase pelvic floor muscle function as measured by MVC (P < 0.001) using the Modified Oxford grading system, as well as muscle activation (P < 0.001), measured by SEMG. The PFMT group was superior regarding endurance (P = 0.007). Both groups were superior to the control group regarding MVC, endurance and muscle activation.
Adding hypopressive exercises to PFMT does not improve PFM function. Both treatment groups performed better than the control group.
本研究旨在比较包括盆底肌收缩在内的减压运动、单独盆底肌训练（PFMT）和对照组对盆腔器官脱垂（POP）女性盆底肌功能的影响。
将 58 名年龄平均为 55.4（±9.8）岁、POP Ⅱ期的女性随机分配至 PFMT 组、减压运动联合 PFMT（HE+PFMT）组或对照组。每组治疗 3 个月。三组均接受有关减肥、便秘、咳嗽和避免重物提举的生活方式建议。治疗前后对参与者进行评估。使用改良牛津分级系统评估最大自主收缩（MVC）和耐力。使用表面肌电图（SEMG）评估肌肉激活情况。
使用改良牛津分级系统评估，MVC（P＜0.001）和 SEMG 评估的肌肉激活（P＜0.001），两组治疗组的盆底肌功能均显著改善。PFMT 组在耐力方面更具优势（P=0.007）。两组在 MVC、耐力和肌肉激活方面均优于对照组。
将减压运动加入 PFMT 并不能改善 PFM 功能。两组治疗组的表现均优于对照组。
