Bertotto Adriane, Schvartzman Renata, Uchôa Silvana, Wender Maria Celeste Osório
Graduate Program in Medical Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
Departament of Physical Therapy, Centro Universitário La Salle, Canoas, RS, Brazil.
Neurourol Urodyn. 2017 Nov;36(8):2142-2147. doi: 10.1002/nau.23258. Epub 2017 May 16.
To compare the efficacy of pelvic floor muscle exercises (PFME) with and without electromyographic biofeedback (BF) in increasing muscle strength, improving myoelectric activity, and improving pre-contraction and quality of life in postmenopausal women with stress urinary incontinence.
Randomized controlled trial of 49 postmenopausal women with stress urinary incontinence. Participants were allocated across three groups: control, PFME alone, and PFME + BF. Forty-five women completed the study (14 control, 15 PFME, 16 PFME + BF; mean age 58.26 years). Outcome assessment was carried out using digital palpation (modified Oxford grading scale), electromyography, and the International Consultation Incontinence Questionnaire-Short Form (ICIQ-SF) quality of life instrument. The treatment protocol consisted of eight twice-weekly, 20-min one-on-one sessions. Controls were assessed only at baseline and after 1 month.
The PFME and PFME + BF groups exhibited significant increases in muscle strength (Oxford scale) (P < 0.0001), precontraction while coughing (P < 0.0001), maximum voluntary contraction, duration of endurance contraction, and ICIQ-SF scores (P < 0.0001). PFME + BF was associated with significantly superior improvement of muscle strength, precontraction while coughing, maximum voluntary contraction, and duration of endurance contraction as compared to PFME alone (P < 0.05).
This preliminary study suggests that pelvic floor muscle training, with and without biofeedback, is associated with increased muscle strength, myoelectric activity, precontraction of pelvic floor muscles, and improved quality of life in postmenopausal women with stress urinary incontinence.
比较盆底肌锻炼（PFME）联合与不联合肌电图生物反馈（BF）在增加绝经后压力性尿失禁女性肌肉力量、改善肌电活动、改善收缩前状态及生活质量方面的疗效。
对49例绝经后压力性尿失禁女性进行随机对照试验。参与者被分为三组：对照组、单纯盆底肌锻炼组和盆底肌锻炼+生物反馈组。45名女性完成了研究（14名对照组、15名盆底肌锻炼组、16名盆底肌锻炼+生物反馈组；平均年龄58.26岁）。使用数字触诊（改良牛津分级量表）、肌电图和国际尿失禁咨询问卷简表（ICIQ-SF）生活质量工具进行结果评估。治疗方案包括每周两次、每次20分钟的一对一训练，共八次。对照组仅在基线和1个月后进行评估。
盆底肌锻炼组和盆底肌锻炼+生物反馈组在肌肉力量（牛津量表）（P<0.0001）、咳嗽时的收缩前状态（P<0.0001）、最大自主收缩、耐力收缩持续时间和ICIQ-SF评分（P<0.0001）方面均有显著提高。与单纯盆底肌锻炼相比，盆底肌锻炼+生物反馈在肌肉力量、咳嗽时的收缩前状态、最大自主收缩和耐力收缩持续时间方面的改善明显更优（P<0.05）。
这项初步研究表明，无论有无生物反馈，盆底肌训练都与绝经后压力性尿失禁女性的肌肉力量增加、肌电活动增强、盆底肌收缩前状态改善以及生活质量提高有关。
