Yoshida Mikako, Murayama Ryoko, Hotta Kumi, Higuchi Yoshihide, Sanada Hiromi
Department of Life Support Technology (Molten), Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
Department of Advanced Nursing Technology, Division of Health Sciences and Nursing, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
Neurourol Urodyn. 2017 Jan;36(1):98-103. doi: 10.1002/nau.22867. Epub 2015 Sep 9.
To evaluate differences in motor learning of pelvic floor muscle (PFM) contraction between women with and without stress urinary incontinence (SUI) under transabdominal ultrasonography (TAUS)-guided PFM training.
Postpartum women received an intensive 3-month PFM training program from 3 to 6 months postpartum. The program consisted of home exercises and weekly group sessions with individual TAUS-guided training. Motor learning progress of PFM contraction was evaluated with TAUS at each weekly session. We regarded a woman who contracted her PFM correctly more than 9 times out of the 10 repetitions as having achieved the associative stage of motor learning. Women were evaluated before and after a 12-week intervention for PFM and SUI by using transperineal ultrasonography and questionnaire, respectively.
Seventy-three women were included: 44 primiparous women (60.3%) and 64 vaginal deliveries (87.7%). Of 73 women, 22 (30.1%) were classified as the SUI group. By the fifth session, the proportion of women who could correctly contract their PFM > 9 out of the 10 repetitions had increased significantly more in the non-SUI group than in the SUI group (90.0% vs. 58.8%, P = 0.011). The proportion of women achieving the associative stage of correct PFM contraction was not different between the two groups after the sixth session. PF morphology and SUI were improved after intervention (P < 0.05).
The proportion of women achieving the associative stage in women with SUI was less than that in women without SUI in the early phase of the combination of group and home PFM training with TAUS-guided training. Neurourol. Urodynam. 36:98-103, 2017. © 2015 Wiley Periodicals, Inc.
评估在经腹超声(TAUS)引导下进行盆底肌(PFM)训练时,有压力性尿失禁(SUI)和无压力性尿失禁的女性之间盆底肌收缩运动学习的差异。
产后女性在产后3至6个月接受为期3个月的强化盆底肌训练计划。该计划包括家庭锻炼以及每周一次的小组课程,并伴有个体化的TAUS引导训练。在每周的课程中,通过TAUS评估盆底肌收缩的运动学习进展。我们将在10次重复动作中有超过9次正确收缩盆底肌的女性视为达到了运动学习的联合阶段。分别使用经会阴超声和问卷调查对女性进行为期12周的盆底肌和压力性尿失禁干预前后的评估。
纳入73名女性:44名初产妇(60.3%),64例阴道分娩(87.7%)。73名女性中,22名(30.1%)被归类为压力性尿失禁组。到第五次课程时,在10次重复动作中能够正确收缩盆底肌超过9次的女性比例,非压力性尿失禁组显著高于压力性尿失禁组(90.0%对58.8%,P = 0.011)。第六次课程后,两组中达到正确盆底肌收缩联合阶段的女性比例没有差异。干预后盆底肌形态和压力性尿失禁情况有所改善(P < 0.05)。
在小组和家庭盆底肌训练与TAUS引导训练相结合的早期阶段,压力性尿失禁女性达到联合阶段的比例低于无压力性尿失禁的女性。《神经泌尿学与尿动力学》36:98 - 103,2017年。© 2015威利期刊公司。