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女性中风患者尿失禁的盆底肌训练:一项随机、对照、双盲试验

Pelvic floor muscle training for urinary incontinence in female stroke patients: a randomized, controlled and blinded trial.

作者信息

Shin Doo Chul, Shin Seung Ho, Lee Myung Mo, Lee Kyoung Jin, Song Chang Ho

机构信息

Department of Physical Therapy, College of Health Science, Sahmyook University, Seoul, Republic of Korea.

Department of Physical Therapy, College of Health Science, Sahmyook University, Seoul, Republic of Korea

出版信息

Clin Rehabil. 2016 Mar;30(3):259-67. doi: 10.1177/0269215515578695. Epub 2015 Apr 10.

Abstract

OBJECTIVE

To examine the effects of pelvic floor muscle training (PFMT) on the contractility of pelvic floor muscle and lower urinary tract symptoms in female stroke patients.

DESIGN

Randomized, single-blind controlled study.

SETTING

Outpatient rehabilitation hospital.

SUBJECTS

Thirty one female patients who were more than three months post-stroke and stress urinary incontinence.

INTERVENTIONS

The subjects were randomized to either a PFMT group (n = 16), or a control group (n = 15). Both groups received general rehabilitation exercise for 6 weeks, but the PFMT group additionally received PFMT for 6 weeks.

MAIN MEASURES

Vaginal function test using a perineometer (maximal vaginal squeeze pressure) and intra-vaginal electromyography (activity of pelvic floor muscle), and urinary symptoms and quality of life using a Bristol Female Lower Urinary Tract Symptom questionnaire.

RESULTS

After intervention, the maximal vaginal squeeze pressures for the PFMT and control groups were 18.35 (5.24) and 8.46 (3.50) mmHg, respectively. And the activities of pelvic floor muscle of the PFMT and control groups was 12.09 (2.24) ㎶ and 9.33 (3.40) ㎶, respectively. After intervention, the changes of scores for inconvenience in the activity of daily living of the PFMT and control groups were -15.00 (6.25) and -0.17 (1.59), respectively. In addition, the changes of score for lower urinary tract symptom was improved more in the PFMT group (-4.17 (4.00)) than in the control group (-0.25 (1.29)) (P < 0.05).

CONCLUSIONS

These findings suggest that PFMT is beneficial for the management of urinary incontinence in female stroke patients.

摘要

目的

探讨盆底肌训练(PFMT)对女性脑卒中患者盆底肌收缩力及下尿路症状的影响。

设计

随机、单盲对照研究。

地点

门诊康复医院。

对象

31例脑卒中后3个月以上且有压力性尿失禁的女性患者。

干预措施

将受试者随机分为PFMT组(n = 16)和对照组(n = 15)。两组均接受6周的一般康复锻炼,但PFMT组额外接受6周的PFMT。

主要测量指标

使用会阴压力计进行阴道功能测试(最大阴道挤压压力)和阴道内肌电图(盆底肌活动),以及使用布里斯托尔女性下尿路症状问卷评估尿路症状和生活质量。

结果

干预后,PFMT组和对照组的最大阴道挤压压力分别为18.35(5.24)mmHg和8.46(3.50)mmHg。PFMT组和对照组的盆底肌活动分别为12.09(2.24)μV和9.33(3.40)μV。干预后,PFMT组和对照组日常生活活动不便评分的变化分别为-15.00(6.25)和-0.17(1.59)。此外,PFMT组下尿路症状评分的改善程度(-4.17(4.00))高于对照组(-0.25(1.29))(P < 0.05)。

结论

这些发现表明,PFMT对女性脑卒中患者尿失禁的管理有益。

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