Khorasani Fahime, Ghaderi Fariba, Bastani Parvin, Sarbakhsh Parvin, Berghmans Bary
Department of Physiotherapy, Faculty of Rehabilitation, Tabriz University of Medical Sciences, Daneshgah Ave., Tabriz, Iran.
Iranian Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Int Urogynecol J. 2020 Nov;31(11):2301-2307. doi: 10.1007/s00192-020-04284-7. Epub 2020 Apr 10.
Stress urinary incontinence (SUI) and low back pain (LBP) are common postnatal problems. We aimed to compare the effects of stabilization exercises focusing on the pelvic floor on postnatal SUI and LBP.
This two-arm, single-blind, parallel, randomized controlled trial was done on 80 women (mean age: 30.5, range: 20-45 years), with postnatal SUI and LBP. They were randomized into two equal control and intervention groups. The control group received no treatment while the intervention group received home-based stabilization exercises focusing on pelvic floor muscles (PFM) 3 days a week for 12 weeks, three sets a day; each set included three different types of exercise each week. Outcome measures were UI severity, assessed by ICIQ-UI-SF, low back pain functional disability, assessed by the Oswestry Disability Index (ODI), LBP severity, assessed by visual analog scale (VAS), and PFM strength and endurance, assessed by vaginal examination. Transverse abdominis (TrA) muscle strength was assessed by manometric biofeedback. All outcomes were measured directly before and after treatment.
In the intervention group, PFM strength, TrA muscle strength, functional disability and pain severity were significantly improved (P < 0.05). Within-group results showed that all outcomes except pain severity (P = 0.06) had directly improved in the intervention group after treatment (P < 0.05), while in the control group only PFM strength and endurance and UI severity had improved (P < 0.05).
Home-based stabilization exercises focusing on the pelvic floor muscles could be effective for postnatal LBP and SUI.
Iranian Registry of Clinical Trials (Code: IRCT2017050618760N4).
压力性尿失禁(SUI)和腰痛(LBP)是常见的产后问题。我们旨在比较以盆底为重点的稳定化训练对产后SUI和LBP的影响。
这项双臂、单盲、平行、随机对照试验对80名患有产后SUI和LBP的女性(平均年龄:30.5岁,范围:20 - 45岁)进行。她们被随机分为两个相等的对照组和干预组。对照组不接受治疗,而干预组每周3天、持续12周、每天进行3组以盆底肌肉(PFM)为重点的家庭稳定化训练;每组每周包括三种不同类型的训练。结局指标包括通过ICIQ - UI - SF评估的尿失禁严重程度、通过Oswestry功能障碍指数(ODI)评估的腰痛功能障碍、通过视觉模拟量表(VAS)评估的LBP严重程度以及通过阴道检查评估的PFM力量和耐力。腹横肌(TrA)力量通过压力生物反馈进行评估。所有结局指标在治疗前后直接测量。
在干预组中,PFM力量、TrA肌肉力量、功能障碍和疼痛严重程度均有显著改善(P < 0.05)。组内结果显示,干预组治疗后除疼痛严重程度外(P = 0.06)所有结局指标均有直接改善(P < 0.05),而对照组仅PFM力量和耐力以及尿失禁严重程度有所改善(P < 0.05)。
以盆底肌肉为重点的家庭稳定化训练对产后LBP和SUI可能有效。
伊朗临床试验注册中心(代码:IRCT2017050618760N4)