Luginbuehl Helena, Baeyens Jean-Pierre, Taeymans Jan, Maeder Ida-Maria, Kuhn Annette, Radlinger Lorenz
Bern University of Applied Sciences, Health, Bern, Switzerland.
Vrije Universiteit Brussel, Faculty of Physical Education and Physiotherapy, Brussel, Belgium.
Neurourol Urodyn. 2015 Aug;34(6):498-506. doi: 10.1002/nau.22612. Epub 2014 Apr 9.
A better understanding of pelvic floor muscle (PFM) activation and strength components is a prerequisite to get better insight in PFM contraction mechanisms and develop more specific PFM-training regimens for female stress urinary incontinence (SUI) patients. The aim of this systematic review (2012:CRD42012002547) was to evaluate and summarize existing studies investigating PFM activation and strength components influencing female continence and SUI.
PubMed, EMBASE, and Cochrane databases were systematically searched for literature from January 1980 to November 2013 for cross-sectional studies comparing female SUI patients with healthy controls and intervention studies with SUI patients reporting on the association between PFM activation and strength components and urine loss. Trial characteristics, evaluated PFM components, their definitions, measurement methods, study outcomes, as well as quality measures, based on the Cochrane risk of bias tool, were independently extracted. The high heterogeneity of the retrieved data made pooling of results impossible and therefore restricted the analysis to a systematic review.
Cross-sectional studies showed group differences in favor of the continent women compared to SUI patients for PFM activation or PFM maximal strength, mean strength or sustained contraction. All intervention studies showed an improvement of PFM strength and decrease in urine loss in SUI patients after physical therapy.
Higher PFM activation and strength components influence female continence positively. This systematic review underscored the need for a standardized PFM components' terminology (similar to rehabilitation and training science), standardized test procedures and well matched diagnostic instruments.
更好地理解盆底肌（PFM）激活和力量组成部分是深入了解PFM收缩机制并为女性压力性尿失禁（SUI）患者制定更具针对性的PFM训练方案的先决条件。本系统评价（2012：CRD42012002547）的目的是评估和总结现有研究，这些研究探讨了影响女性控尿和SUI的PFM激活和力量组成部分。
系统检索PubMed、EMBASE和Cochrane数据库，以获取1980年1月至2013年11月的文献，包括比较女性SUI患者与健康对照的横断面研究，以及报告PFM激活和力量组成部分与尿失禁之间关联的SUI患者干预研究。基于Cochrane偏倚风险工具，独立提取试验特征、评估的PFM组成部分、其定义、测量方法、研究结果以及质量指标。检索数据的高度异质性使得结果合并不可能，因此将分析限制为系统评价。
横断面研究表明，与SUI患者相比，在PFM激活、PFM最大力量、平均力量或持续收缩方面，控尿女性组存在差异。所有干预研究均显示，物理治疗后SUI患者的PFM力量有所改善，尿失禁减少。
较高的PFM激活和力量组成部分对女性控尿有积极影响。本系统评价强调了标准化PFM组成部分术语（类似于康复和训练科学）、标准化测试程序以及匹配良好的诊断仪器的必要性。
