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骨盆底肌肉训练方案增加首次妊娠和产后的肌肉收缩力:肌电图研究。

Pelvic floor muscle training program increases muscular contractility during first pregnancy and postpartum: electromyographic study.

机构信息

Faculty of Medical Sciences of the State University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.

出版信息

Neurourol Urodyn. 2013 Sep;32(7):998-1003. doi: 10.1002/nau.22346. Epub 2012 Nov 5.

Abstract

AIMS

The aim of this study was to evaluate the effect of a training program over both pelvic floor muscles contractility and urinary symptoms in primigravid pregnant and postpartum primiparous women.

PATIENTS AND METHODS

A clinical, prospective and blinded trial was conducted with 33 women divided into three groups: (G1) 13 primigravid pregnant women; (G2) 10 postpartum primiparous women (49.3 ± 5.84 days), after vaginal delivery with right mediolateral episiotomy; (G3) 10 postpartum primiparous women (46.3 ± 3.6 days), after cesarean section delivery. The evaluation was carried out using digital palpation (Modified Oxford Grading Scale), pelvic floor electromyography and, for the investigation of urinary symptoms, validated questionnaires (International Consultation on Incontinence Questionnaire-short form-ICIQ-UI SF and International Consultation on Incontinence Questionnaire Overactive Bladder-ICIQ-OAB). The protocol consisted of 10 individual sessions carried out by the physiotherapist through home visits, three times a week, with 60 min duration each. The statistical analysis was performed using ANOVA and Spearman's correlation coefficient.

RESULTS

The pelvic floor muscle contractility increased after the training program (P = 0.0001) for all groups. Decreases in the scores of both ICIQ-UI SF (P = 0.009) and ICIQ-OAB (P = 0.0003) were also observed after training.

CONCLUSION

Pelvic floor muscle training is an effective means for the increase in its own contractility in both primigravid pregnant and primiparous postpartum women, accompanied with a concomitant decrease in urinary symptoms.

摘要

目的

本研究旨在评估培训计划对初产妇妊娠和产后的盆底肌肉收缩力和尿症状的影响。

患者和方法

进行了一项临床、前瞻性和盲法试验,共有 33 名女性分为三组:(G1)13 名初产妇;(G2)10 名经阴道分娩伴右侧正中侧会阴切开术的产后初产妇(49.3±5.84 天);(G3)10 名经剖宫产分娩的产后初产妇(46.3±3.6 天)。评估采用数字触诊(改良牛津分级量表)、盆底肌肌电图进行,尿症状采用经过验证的问卷(国际尿失禁咨询问卷简表-ICIQ-UI SF 和国际尿失禁咨询问卷膀胱过度活动症-ICIQ-OAB)进行。方案包括由物理治疗师通过家访进行的 10 次个体疗程,每周 3 次,每次 60 分钟。统计分析采用方差分析和斯皮尔曼相关系数。

结果

所有组的盆底肌肉收缩力在训练计划后均增加(P=0.0001)。训练后 ICIQ-UI SF(P=0.009)和 ICIQ-OAB(P=0.0003)的评分也均下降。

结论

盆底肌肉训练是增加初产妇妊娠和产后初产妇盆底肌肉自身收缩力的有效手段,同时伴有尿症状的改善。

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