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在压力性尿失禁女性中,经过8周的表面电刺激后,哪些盆底肌肉功能与主观和客观症状的改善相关?

Which pelvic floor muscle functions are associated with improved subjective and objective symptoms after 8 weeks of surface electrical stimulation in women with stress urinary incontinence?

作者信息

Hwang Ui-Jae, Lee Min-Seok, Jung Sung-Hoon, Ahn Sun-Hee, Kwon Oh-Yun

机构信息

234 Maeji-ri, Heungeop-Myeon, Kangwon-Do 220-710, Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea.

Sophie-Marceau Women's Clinic, Daegu, South Korea.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2020 Apr;247:16-21. doi: 10.1016/j.ejogrb.2020.02.008. Epub 2020 Feb 5.

Abstract

OBJECTIVE

Stress urinary incontinence (SUI) is defined as involuntary urine loss during effort, sneezing, or coughing. We investigated which pelvic floor muscle (PFM) functions (muscle strength, power, and endurance) are associated with improvement in subjective and objective symptoms after 8 weeks of surface electrical stimulation (SES) training. This study was performed to determine the effects of SES in the seated position on PFM functions and subjective and objective symptoms, and to identify predictors of improved subjective and objective symptoms after 8 weeks of SES training via secondary analysis of females with SUI.

STUDY DESIGN

The study was performed between August 2018 and December 2018. Patients with SUI were randomized into an SES group (n = 17) and a control group (n = 17). Both groups were assessed pre-intervention and after 8 weeks of intervention. The outcome measures were PFM functions (strength, power, and endurance) as measured via perineometry, the score on the urogenital distress inventory-6 (UDI-6), and the ultra-short perineal pad test result.

RESULTS

Significant differences in all PFM functions, the UDI-6 score, and the pad weight were evident both between the groups (SES vs. control group) and within the groups (pre-SES vs. post-SES). On regression of factors predicting relative changes in subjective and objective symptoms, the relative change in PFM power accounted for 15 and 13 % of the variance in the UDI-6 score (P < 0.05) and pad weight (P < 0.05), respectively.

CONCLUSIONS

SES in a seated position improved both subjective and objective symptoms in females with SUI. PFM power, the UDI-6 score, and the pad weight test result should be considered when developing intervention guidelines to improve the subjective and objective symptoms of females with SUI.

摘要

目的

压力性尿失禁(SUI)被定义为在用力、打喷嚏或咳嗽时出现的不自主尿液流失。我们调查了经过8周表面电刺激(SES)训练后,哪些盆底肌(PFM)功能(肌肉力量、功率和耐力)与主观和客观症状的改善相关。本研究旨在确定坐位时SES对PFM功能以及主观和客观症状的影响,并通过对患有SUI的女性进行二次分析,确定8周SES训练后主观和客观症状改善的预测因素。

研究设计

该研究于2018年8月至2018年12月进行。将SUI患者随机分为SES组(n = 17)和对照组(n = 17)。两组在干预前和干预8周后均进行评估。结局指标包括通过会阴测量法测量的PFM功能(力量、功率和耐力)、泌尿生殖系统困扰量表-6(UDI-6)得分以及超短会阴护垫试验结果。

结果

两组(SES组与对照组)之间以及组内(SES训练前与训练后),所有PFM功能、UDI-6得分和护垫重量均存在显著差异。在对预测主观和客观症状相对变化的因素进行回归分析时,PFM功率的相对变化分别占UDI-6得分(P < 0.05)和护垫重量(P < 0.05)方差的15%和13%。

结论

坐位时的SES改善了患有SUI女性的主观和客观症状。在制定改善患有SUI女性主观和客观症状的干预指南时,应考虑PFM功率、UDI-6得分和护垫重量测试结果。

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