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综合康复方法结合手动和机械-声振动疗法治疗尿失禁。

Integrated Rehabilitation Approach with Manual and Mechanic-Acoustic Vibration Therapies for Urinary Incontinence.

机构信息

Department of Medical and Oral Sciences and Biotechnologies, "Gabriele D'Annunzio" University, Chieti, Italy.

Department of Biomolecular Sciences, "Carlo Bo" University, Urbino, Italy.

出版信息

Adv Exp Med Biol. 2019;1211:41-50. doi: 10.1007/5584_2019_436.

Abstract

This study aims to verify whether an integrated rehabilitation protocol comprising neuromuscular manual therapy and focused mechanical-acoustic vibrations can significantly reduce pelvic floor dysfunctions in women affected by stress, urge, or mixed urinary incontinence. Sixty-two women were treated with a combination of neuromuscular manual therapy and mechanical-acoustic vibrations at the level of superficial pelvic floor muscle groups. The results were analyzed before the beginning and after the end of the study protocol with the myometric measuring device MyotonPRO, the Pelvic Floor Disability Index (PFDI-20), and the Pelvic Floor Impact Questionnaire (PFIQ-7). Two patients withdrew from the study after the first visit. The 60 remaining patients showed significant improvements of myometric parameters, with the percentage variations ranging from +8.5% to +20.7% for the muscle logarithmic decrement, from -11.2 to -13.9% for muscle frequency, and from -4.8% to -12.3% for muscle stiffness. There has been a reduction of 56% in the perceived disability induced by urinary incontinence, measured with the PFDI-20, and 43% reduction in the impact of the problem on daily living, measured with the PFIQ-7. We conclude that a combination of neuromuscular manual therapy and mechanical-acoustic vibrations effectively reduces pelvic symptoms in patients affected by urinary incontinence, with minimal invasiveness.

摘要

本研究旨在验证一种综合康复方案,包括神经肌肉手动疗法和聚焦机械声振动,是否能显著减轻患有压力性、急迫性或混合性尿失禁的女性的盆底功能障碍。62 名女性接受了神经肌肉手动疗法和机械声振动联合治疗,作用于浅层盆底肌群。研究开始前和研究方案结束后,使用肌动描记仪 MyotonPRO、盆底功能障碍指数(PFDI-20)和盆底影响问卷(PFIQ-7)对结果进行分析。两名患者在首次就诊后退出研究。其余 60 名患者的肌动学参数均有显著改善,肌肉对数衰减的百分比变化范围为+8.5%至+20.7%,肌肉频率为-11.2%至-13.9%,肌肉僵硬为-4.8%至-12.3%。通过 PFDI-20 测量,尿失禁引起的感知障碍减少了 56%,通过 PFIQ-7 测量,日常生活中问题的影响减少了 43%。我们得出结论,神经肌肉手动疗法和机械声振动的联合应用可有效减轻尿失禁患者的盆底症状,且具有微创性。

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