Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Żołnierska 54 str.,71-210, Szczecin, Poland.
Department of Gynaecology, Endocrinology and Gynaecologic Oncology, Pomeranian Medical University, Unii Lubelskiej 1 str., 71-252, Szczecin, Poland.
Biomed Res Int. 2019 Jan 6;2019:5321864. doi: 10.1155/2019/5321864. eCollection 2019.
Urinary incontinence (UI) is a health problem affecting the quality of women's lives (QOL) at various life stages. Stress urinary incontinence (SUI) can be caused by previous vaginal deliveries and is especially likely to occur in the perimenopausal period. The most commonly recommended first-choice treatment methods involve exercises for the pelvic floor muscles (PFM). The aim of this study was to assess the impact of isolated PFM exercises and combined training of the PFM and the m.transversus abdominis (TrA) muscle on the QoL of patients with SUI with regard to the number of vaginal deliveries.
137 women with SUI were qualified for analysis (mean age 53,1 ± 5,5). To assess the effectiveness of PFM training QOL questionnaire was used (ICIQ-LUTS qol). PFM training for groups A (PFM+TrA) and B (PFM) was intended for 12 weeks. Statistica v. 12.0 PL, StatSoft, USA, was used for statistical calculations.
The analysis demonstrated that conservative treatment based on the A training program (PFM + TrA) yielded statistically significantly better results than the B program (PFM), with the improvement observed in such QoL domains as the performance of household duties, physical activity and travelling, social limitations, emotions, sleep problems and fatigue, the frequency of changing panty liners, fluid intake control, and embarrassment.
Both the combined training of the PFM and the synergistic (TrA) muscle and the isolated PFM exercises improve the QoL of women with SUI. Nonetheless, the combined PFM and TrA muscle physiotherapy is more effective. The exercises for the PFM and the synergistic muscle give better results in women who have given birth fewer than three times than isolated PFM exercises.
尿失禁（UI）是影响女性在各个生命阶段生活质量（QOL）的健康问题。压力性尿失禁（SUI）可由先前的阴道分娩引起，尤其容易发生在围绝经期。最常推荐的一线治疗方法包括骨盆底肌肉（PFM）锻炼。本研究旨在评估孤立的 PFM 锻炼和 PFM 与横腹肌（TrA）肌肉联合训练对 SUI 患者生活质量的影响，重点关注阴道分娩次数。
137 名 SUI 患者符合分析条件（平均年龄 53.1 ± 5.5 岁）。为了评估 PFM 训练的效果，使用了生活质量问卷（ICIQ-LUTS qol）。A 组（PFM+TrA）和 B 组（PFM）的 PFM 训练计划旨在进行 12 周。统计计算使用了 Statistica v. 12.0 PL，StatSoft，USA。
分析表明，基于 A 训练计划（PFM + TrA）的保守治疗比 B 计划（PFM）产生了统计学上显著更好的结果，在做家务、体力活动和旅行、社会限制、情绪、睡眠问题和疲劳、更换护垫的频率、液体摄入控制和尴尬等生活质量领域得到了改善。
PFM 和协同（TrA）肌肉的联合训练以及孤立的 PFM 锻炼都能提高 SUI 女性的生活质量。然而，联合 PFM 和 TrA 肌肉物理治疗更有效。对于分娩次数少于三次的女性，PFM 和协同肌肉锻炼的效果优于孤立的 PFM 锻炼。
