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宫颈癌放疗前盆底的预康复:一项初步研究。

Pre-rehabilitation of the pelvic floor before radiation therapy for cervical cancer: a pilot study.

机构信息

Universidad Bernardo O'Higgins, School of Kinesiology, Santiago, Chile.

Universidad del Desarrollo, Escuela de Kinesiología, Santiago, Chile.

出版信息

Int Urogynecol J. 2020 Nov;31(11):2411-2418. doi: 10.1007/s00192-020-04391-5. Epub 2020 Jun 29.

DOI:10.1007/s00192-020-04391-5
PMID:32601784
Abstract

INTRODUCTION AND HYPOTHESIS

The objective was to evaluate pelvic floor muscle (PFM) function regarding strength, activation and incontinence, approximately 1 month before and after radiation therapy in women with cervical cancer.

METHODS

This was a pilot study of 49 women with cervical cancer at stages I to III. These women attended an educational session with a physical therapist who taught them to perform preventive pelvic floor muscle exercises (PFMEs; slow and fast contractions and the "knack") at home before, during and after radiation therapy. The women received instructions for performing PFME prior to radiation therapy. The modified Oxford scale, electromyography (EMG), the International Consultation on Incontinence Questionnaire Short Form to assess urinary incontinence and two questions for faecal and gas incontinence were used.

RESULTS

Twenty-eight women (57%; mean age = 44 years, range 27-66) completed the study, 21 (43%) were lost to follow-up. There was no significant change from baseline to post-radiation therapy in muscle strength, EMG records and incontinence (p > 0.05). The median of PFM strength was equal at baseline and after intervention (median = 2; IQR = 1).

CONCLUSIONS

The results of this study suggest that pre-rehabilitation teaching PFMEs might be a protective factor for preserving PFM strength and preventing incontinence 1 month after radiation therapy. It is a feasible intervention.

摘要

引言与假设

目的是评估宫颈癌女性在放疗前约 1 个月和放疗后大约 1 个月时的盆底肌(PFM)功能,包括力量、激活和尿失禁。

方法

这是一项针对 49 名宫颈癌 I 期至 III 期患者的试点研究。这些女性参加了一个由物理治疗师主持的教育课程,学习在家中进行预防盆底肌锻炼(PFME;缓慢和快速收缩以及“窍门”),在放疗前、放疗中和放疗后进行。在放疗前,女性会收到关于进行 PFME 的指导。使用改良牛津量表、肌电图(EMG)、国际尿失禁咨询问卷短表评估尿失禁以及用于评估粪便和气体失禁的两个问题。

结果

28 名女性(57%;平均年龄 44 岁,范围 27-66 岁)完成了研究,21 名女性(43%)失访。与基线相比,放疗后肌肉力量、EMG 记录和失禁没有显著变化(p>0.05)。基线和干预后的 PFM 力量中位数相等(中位数=2;IQR=1)。

结论

这项研究的结果表明,放疗前进行康复教育,教授 PFME 可能是保护 PFM 力量和预防放疗后 1 个月尿失禁的一个因素。这是一种可行的干预措施。

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Strategies to enhance self-efficacy and adherence to home-based pelvic floor muscle exercises did not improve adherence in women with urinary incontinence: a randomised trial.
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The Normal, the Radiosensitive, and the Ataxic in the Era of Precision Radiotherapy: A Narrative Review.精准放疗时代的正常组织、放射敏感组织和共济失调:一项叙述性综述
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Barriers to and facilitators of adherence to pelvic floor muscle exercises and vaginal dilator use among gynecologic cancer patients: a qualitative study.妇科癌症患者坚持进行盆底肌锻炼和阴道扩张器使用的障碍和促进因素:一项定性研究。
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