Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Physical Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Mult Scler Relat Disord. 2022 Mar;59:103559. doi: 10.1016/j.msard.2022.103559. Epub 2022 Jan 29.
Pelvic floor muscle training (PFMT) is a conservative treatment program for the management of lower urinary tract dysfunction (LUTD). This systematic review aimed to investigate the overall effectiveness of PFMT on LUTD in people with multiple sclerosis (MS).
Seven databases (PubMed/Medline, Scopus, PEDro, WOS, CINAHL, Cochrane, and Embase) were searched between 1990 and July 2019. We investigated urine leakage as our primary outcome. The secondary outcomes were neurogenic bladder symptoms measured by the overactive bladder questionnaire (OAB-V8 questionnaire) and the power/endurance of pelvic floor muscles.
Fifteen studies were identified as eligible. Both urine leakage (standardized mean difference (SMD) = 0.50, 95% CI [-0.78, -0.23], and neurogenic bladder symptoms, SMD = -2.24, 95% CI [-4.44, -0.03] significantly decreased by PFMT in people with MS. PFMT increased the overall endurance and power of pelvic floor muscles moderately and significantly, SMD = 1.25, 95% CI [0.69, 1.81], and SMD = 0.64, 95% CI [0.24, 1.05], respectively.
Moderate to high-quality studies showed the overall efficacy of PFMT in decreasing urine leakage and neurogenic bladder symptoms and increasing endurance and power of pelvic floor muscles. MS patients with lower urinary tract symptoms could benefit from PFMT in the short term.
盆底肌训练（PFMT）是一种保守治疗方案，用于管理下尿路功能障碍（LUTD）。本系统评价旨在调查 PFMT 对多发性硬化症（MS）患者 LUTD 的总体疗效。
1990 年至 2019 年 7 月，我们在 7 个数据库（PubMed/Medline、Scopus、PEDro、WOS、CINAHL、Cochrane 和 Embase）中进行了检索。我们将尿失禁作为主要结局进行研究。次要结局为使用膀胱过度活动症问卷（OAB-V8 问卷）评估的神经源性膀胱症状和盆底肌的力量/耐力。
共确定了 15 项符合条件的研究。PFMT 可显著降低 MS 患者的尿失禁（标准化均数差（SMD）=0.50，95%CI [-0.78，-0.23]）和神经源性膀胱症状（SMD=-2.24，95%CI [-4.44，-0.03]）。PFMT 还可适度且显著地增加盆底肌的整体耐力和力量，SMD 分别为 1.25（95%CI [0.69，1.81]）和 0.64（95%CI [0.24，1.05]）。
多项高质量研究表明，PFMT 总体上可减少尿失禁和神经源性膀胱症状，增加盆底肌的耐力和力量。短期来看，PFMT 可能有益于 MS 合并下尿路症状的患者。
