全身振动训练治疗前列腺癌术后压力性尿失禁 4 周的效果：随机对照试验。

Effect of 4 weeks of whole-body vibration training in treating stress urinary incontinence after prostate cancer surgery: a randomised controlled trial.

机构信息

Department of Physiotherapy, Centre of Radiation, Oncology and Nuclear Medicine, Cairo University, Giza, Egypt; Department of Physiotherapy, College of Medical and Health Sciences, Ahlia University, Manama, Bahrain.

Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt.

出版信息

Physiotherapy. 2019 Sep;105(3):338-345. doi: 10.1016/j.physio.2018.07.013. Epub 2018 Sep 25.

DOI:10.1016/j.physio.2018.07.013

PMID:30630622

Abstract

BACKGROUND

Stress urinary incontinence is common in men after prostate cancer surgery. Rehabilitative interventions incorporate pelvic floor muscle training, biofeedback, electrical stimulation, lifestyle changes, or a combination of these strategies. However, little is known about the physiological impact of whole-body vibration for stress urinary incontinence after radical prostatectomy.

OBJECTIVE

To investigate the effect of whole-body vibration training on stress urinary incontinence after prostate cancer surgery.

DESIGN

Randomised controlled trial.

SETTING

Tertiary university hospitals.

PARTICIPANTS

Sixty-one patients with mild stress urinary incontinence after radical prostatectomy.

INTERVENTION

Group 1 included 30 patients who performed pelvic floor muscle training and whole-body vibration training with a frequency and amplitude of 20Hz/2mm for the first two sessions and 40Hz/4mm for the rest of the intervention. Group 2 included 31 patients who performed pelvic floor muscle training alone. The intervention in both groups was conducted three times per week for 4 weeks.

MAIN OUTCOMES

Incontinence Visual Analogue Scale (I-VAS) score, International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) score and 24-hour pad test result.

RESULTS

I-VAS score, ICIQ-UI-SF score and 24-hour pad test result showed significant within-group differences at each assessment with the exception of the baseline and post-intervention I-VAS score in Group 2. For example, Group 1 I-VAS score had a median difference of 3.9cm [95% confidence interval (CI) -4.0 to -3.8] from baseline to first follow-up, and a median difference of -2.0cm (95% CI -2.2 to -1.8) at 4-week follow-up. Comparisons between the groups demonstrated significant differences in favour of Group 1 after 4 weeks of intervention and at follow-up for all measured parameters.

CONCLUSION

Whole-body vibration training is an effective modality for treating patients with stress urinary incontinence after prostatectomy.

TRIAL REGISTRATION

Clinicaltrial.gov (NCT03325660).

摘要

背景

前列腺癌手术后，男性常出现压力性尿失禁。康复干预措施包括盆底肌训练、生物反馈、电刺激、生活方式改变或这些策略的组合。然而，对于根治性前列腺切除术后全身振动治疗压力性尿失禁的生理影响知之甚少。

目的

研究全身振动训练对前列腺癌手术后压力性尿失禁的影响。

设计

随机对照试验。

地点

三级大学医院。

参与者

61 例根治性前列腺切除术后轻度压力性尿失禁患者。

干预措施

第 1 组 30 例患者接受盆底肌训练和全身振动训练，前两次治疗频率和幅度为 20Hz/2mm，其余治疗频率和幅度为 40Hz/4mm。第 2 组 31 例患者仅接受盆底肌训练。两组患者每周进行 3 次干预，共 4 周。

主要结局

失禁视觉模拟量表（I-VAS）评分、国际尿失禁咨询问卷-尿失禁-短表（ICIQ-UI-SF）评分和 24 小时垫试验结果。

结果

I-VAS 评分、ICIQ-UI-SF 评分和 24 小时垫试验结果显示，除第 2 组基线和干预后 I-VAS 评分外，各评估时组内差异均具有统计学意义。例如，第 1 组 I-VAS 评分从基线到首次随访的中位数差值为 3.9cm[95%置信区间（CI）-4.0 至-3.8]，第 4 周随访时的中位数差值为-2.0cm（95%CI-2.2 至-1.8）。两组间比较显示，干预 4 周后和随访时，所有测量参数均以组 1 的差异具有统计学意义。