Hirakawa Tomoe, Suzuki Shigeyuki, Kato Kumiko, Gotoh Momokazu, Yoshikawa Yoko
Program in Physical and Occupational Therapy, Nagoya University Graduate School of Medicine, 1-1-20, Daiko-minami, Higashi-ku, Nagoya, 461-8673, Japan.
Int Urogynecol J. 2013 Aug;24(8):1347-54. doi: 10.1007/s00192-012-2012-8. Epub 2013 Jan 11.
To compare the effects of pelvic floor muscle training (PFMT), with or without biofeedback (BF), for stress urinary incontinence (SUI), focusing on condition-specific quality of life (QOL) outcomes.
Women with SUI were randomized to PFMT with BF (BF group, n = 23) or without BF (PFMT group, n = 23) for 12 weeks. As primary outcome measures, subjective symptoms and QOL were assessed by the King's Health Questionnaire (KHQ) and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). A voiding diary, 1-h pad test, and measurement of PFM strength were secondary outcome measures. Changes in the primary and secondary outcomes were assessed before and after 12 weeks' exercise training.
Of the 9 domains of the KHQ, the scores of 5 significantly decreased in the PFMT group, and the scores of 7 significantly decreased in the BF group. All ICIQ-SF items and the total score significantly decreased in both groups after therapy. The number of incontinence episodes significantly decreased in the PFMT group, and tended to decrease in the BF group, but this was not significant (P = 0.054). The leakage volume in the 1-h pad test tended to decrease in both groups, but was not significant. Maximum vaginal squeeze pressure significantly increased in both groups. There were no significant inter-group differences in the changes in any of the parameters assessed.
The results indicate that PFMT is effective for treating SUI. There is no apparent add-on effect of BF training in short-term follow-up.
比较盆底肌训练(PFMT)联合或不联合生物反馈(BF)治疗压力性尿失禁(SUI)的效果,重点关注特定病情的生活质量(QOL)结果。
将患有SUI的女性随机分为接受BF的PFMT组(BF组,n = 23)或不接受BF的PFMT组(PFMT组,n = 23),为期12周。作为主要结局指标,通过国王健康问卷(KHQ)和国际尿失禁咨询问卷简表(ICIQ-SF)评估主观症状和生活质量。排尿日记、1小时护垫试验和盆底肌力量测量为次要结局指标。在12周运动训练前后评估主要和次要结局的变化。
在KHQ的9个领域中,PFMT组5个领域的得分显著降低,BF组7个领域的得分显著降低。治疗后两组所有ICIQ-SF项目和总分均显著降低。PFMT组尿失禁发作次数显著减少,BF组有减少趋势,但不显著(P = 0.054)。两组1小时护垫试验中的漏尿量均有减少趋势,但不显著。两组最大阴道挤压压力均显著增加。在评估的任何参数变化中,两组间均无显著差异。
结果表明PFMT对治疗SUI有效。在短期随访中,BF训练没有明显的附加效果。