Navarro-Brazález Beatriz, Prieto-Gómez Virginia, Prieto-Merino David, Sánchez-Sánchez Beatriz, McLean Linda, Torres-Lacomba María
Physiotherapy in Women's Health (FPSM) Research Group. Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28805 Madrid, Spain.
Applied statistical methods in Medical Research Group, Catholic University of Murcia (UCAM), 30107 Murcia, Spain.
J Clin Med. 2020 Apr 17;9(4):1149. doi: 10.3390/jcm9041149.
Hypopressive exercises have emerged as a conservative treatment option for pelvic floor dysfunction (PFD). The aim of this study was to compare the effects of an eight-week hypopressive exercise program to those of an individualized pelvic floor muscle (PFM) training (PFMT) program, and to a combination of both immediately after treatment and at follow-up assessments at 3, 6 and 12 months later. The study was a prospective, single-centre, assessor-blinded, randomised controlled trial. Ninety-four women with PFD were assigned to PFMT ( = 32), hypopressive exercises ( = 31) or both ( = 31). All programs included the same educational component, and instruction about lifestyle interventions and the knack manoeuvre. Primary outcomes were the Pelvic Floor Distress Inventory Short Form (PFDI-20); the Pelvic Floor Impact Questionnaire Short Form (PFIQ-7); PFM strength (manometry and dynamometry) and pelvic floor basal tone (dynamometry). There were no statistically significant differences between groups at baseline, nor after the intervention. Overall, women reduced their symptoms (24.41-30.5 on the PFDI-20); improved their quality of life (14.78-21.49 on the PFIQ-7), improved their PFM strength (8.61-9.32 cmHO on manometry; 106.2-247.7 g on dynamometry), and increased their pelvic floor basal tone (1.8-22.9 g on dynamometry). These data suggest that individual PFMT, hypopressive exercises and a combination of both interventions significantly reduce PFD symptoms, enhance quality of life, and improve PFM strength and basal tone in women with PFD, both in the short and longer term.
低压力运动已成为盆底功能障碍（PFD）的一种保守治疗选择。本研究的目的是比较为期八周的低压力运动计划与个性化盆底肌肉（PFM）训练（PFMT）计划的效果，并比较这两种计划单独使用以及在治疗后立即联合使用和在3、6和12个月后的随访评估中的效果。该研究是一项前瞻性、单中心、评估者盲法、随机对照试验。94名患有PFD的女性被分配到PFMT组（n = 32）、低压力运动组（n = 31）或两组联合组（n = 31）。所有计划都包括相同的教育内容，以及关于生活方式干预和诀窍动作的指导。主要结局指标包括盆底困扰量表简表（PFDI-20）；盆底影响问卷简表（PFIQ-7）；PFM强度（压力测定和肌力测定）和盆底基础张力（肌力测定）。在基线时以及干预后，各组之间均无统计学显著差异。总体而言，女性减轻了症状（PFDI-20评分从24.41降至30.5）；改善了生活质量（PFIQ-7评分从14.78提高到21.49），增强了PFM强度（压力测定时从8.61 cmH₂O提高到9.32 cmH₂O；肌力测定时从106.2 g提高到247.7 g），并提高了盆底基础张力（肌力测定时从1.8 g提高到22.9 g）。这些数据表明，单独的PFMT、低压力运动以及这两种干预措施的联合使用，在短期和长期内均能显著减轻PFD女性的症状，提高生活质量，并改善PFM强度和基础张力。
