Oliveira Marlene, Ferreira Margarida, Azevedo Maria João, Firmino-Machado João, Santos Paula Clara
Physiotherapist, Camélia Hotel Sénior & Homes, Guimarães, Portugal.
Visiting Professor, Physiotherapy Department, CESPU - Instituto Politécnico de Saúde do Norte, Vale do Sousa e Vale do Ave, Portugal.
Rev Assoc Med Bras (1992). 2017 Jul;63(7):642-650. doi: 10.1590/1806-9282.63.07.642.
Strengthening exercises for pelvic floor muscles (SEPFM) are considered the first approach in the treatment of stress urinary incontinence (SUI). Nevertheless, there is no evidence about training parameters.
To identify the protocol and/or most effective training parameters in the treatment of female SUI.
A literature research was conducted in the PubMed, Cochrane Library, PEDro, Web of Science and Lilacs databases, with publishing dates ranging from January 1992 to March 2014. The articles included consisted of English-speaking experimental studies in which SEPFM were compared with placebo treatment (usual or untreated). The sample had a diagnosis of SUI and their age ranged between 18 and 65 years. The assessment of methodological quality was performed based on the PEDro scale.
Seven high methodological quality articles were included in this review. The sample consisted of 331 women, mean age 44.4±5.51 years, average duration of urinary loss of 64±5.66 months and severity of SUI ranging from mild to severe. SEPFM programs included different training parameters concerning the PFM. Some studies have applied abdominal training and adjuvant techniques. Urine leakage cure rates varied from 28.6 to 80%, while the strength increase of PFM varied from 15.6 to 161.7%.
The most effective training protocol consists of SEPFM by digital palpation combined with biofeedback monitoring and vaginal cones, including 12 week training parameters, and ten repetitions per series in different positions compared with SEPFM alone or a lack of treatment.
盆底肌肉强化训练（SEPFM）被认为是治疗压力性尿失禁（SUI）的首选方法。然而，目前尚无关于训练参数的证据。
确定治疗女性SUI的方案和/或最有效的训练参数。
在PubMed、Cochrane图书馆、PEDro、科学网和Lilacs数据库中进行文献研究，发表日期从1992年1月至2014年3月。纳入的文章包括英语实验研究，其中将SEPFM与安慰剂治疗（常规或未治疗）进行比较。样本诊断为SUI，年龄在18至65岁之间。基于PEDro量表进行方法学质量评估。
本综述纳入了7篇方法学质量较高的文章。样本包括331名女性，平均年龄44.4±5.51岁，平均尿失禁持续时间64±5.66个月，SUI严重程度从轻度到重度不等。SEPFM方案包括关于盆底肌肉的不同训练参数。一些研究应用了腹部训练和辅助技术。漏尿治愈率从28.6%到80%不等，而盆底肌肉力量增加从15.6%到161.7%不等。
最有效的训练方案包括通过数字触诊结合生物反馈监测和阴道球囊进行SEPFM，包括12周的训练参数，与单独的SEPFM或不治疗相比，在不同体位下每个系列进行十次重复。
