Howard Zara, Ross Lynda, Weir Kelly A, Baker Nadine, Smith Leanne, Nucifora Jennifer, Townsend Heidi, Roberts Shelley
Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD, 4215, Australia.
School of Exercise and Nutrition Services, Queensland University of Technology, Kelvin Grove Campus, Brisbane, QLD, 4059, Australia.
Int Urogynecol J. 2022 Apr;33(4):991-1000. doi: 10.1007/s00192-021-04743-9. Epub 2021 Mar 17.
Supervised pelvic floor muscle training (PFMT), weight loss and exercise are recommended for overweight/obese women with urinary incontinence (UI). This study aimed to implement and evaluate the feasibility, acceptability and effectiveness of a 12-week group exercise and healthy eating program (ATHENA) for overweight/obese women with UI.
This study, using an implementation-effectiveness hybrid type 3 design, was conducted within a Women's Health Physiotherapy outpatient service at an Australian tertiary public hospital. Intervention feasibility and acceptability were assessed through process evaluation of implementation, while clinical effectiveness was assessed via pre-/post-clinical and quality of life surveys. Process data were analyzed using descriptive statistics and effectiveness data were compared pre-/post-intervention using inferential statistics.
Of 156 eligible patients, 37 (24%) agreed to participate; 29 (78%) completed the ATHENA program. Median (IQR) age and body mass index were 53 (47-65) years and 30.8 (29.1-34.8) kg/m respectively. ATHENA was feasible to implement, with all components delivered as intended and high participant satisfaction. Ninety-seven percent of participants reported improved UI symptoms (global rating of change) and significant improvements in overall pelvic floor dysfunction and quality of life utility scores (p = 0.001). While weight did not change, significant improvements were found in body-food choice congruence (intuitive eating scale-2; p < 0.01).
The ATHENA intervention was feasible, acceptable and clinically effective for overweight and obese women with urinary incontinence at a tertiary public hospital in Australia. Further research into longer term outcomes and the cost effectiveness of this group intervention is recommended.
N/A. Ethics approval, HREC/2018/QGC/46582, date of registration 14/11/2018.
对于患有尿失禁（UI）的超重/肥胖女性，建议进行有监督的盆底肌肉训练（PFMT）、减肥和运动。本研究旨在实施并评估一项为期12周的针对患有UI的超重/肥胖女性的团体运动与健康饮食计划（ATHENA）的可行性、可接受性和有效性。
本研究采用实施-效果混合型3设计，在澳大利亚一家三级公立医院的女性健康物理治疗门诊服务中进行。通过对实施过程的评估来评估干预的可行性和可接受性，而临床有效性则通过临床前/后调查和生活质量调查进行评估。过程数据使用描述性统计进行分析，有效性数据在干预前/后使用推断性统计进行比较。
在156名符合条件的患者中，37名（24%）同意参与；29名（78%）完成了ATHENA计划。年龄中位数（四分位间距）和体重指数分别为53（47-65）岁和30.8（29.1-34.8）kg/m²。ATHENA计划实施可行，所有组成部分均按预期交付，参与者满意度高。97%的参与者报告尿失禁症状有所改善（总体变化评分），盆底功能障碍总体情况和生活质量效用评分有显著改善（p = 0.001）。虽然体重没有变化，但在身体-食物选择一致性方面有显著改善（直观饮食量表-2；p < 0.01）。
ATHENA干预对于澳大利亚一家三级公立医院中患有尿失禁的超重和肥胖女性是可行、可接受且临床有效的。建议对该团体干预的长期结果和成本效益进行进一步研究。
无。伦理批准，HREC/2018/QGC/46582，注册日期2018年11月14日。
