Cabral Alana Leandro, de Freitas Síssi Sisconeto, Pinto Rogério de Melo Costa, Resende Ana Paula Magalhães, Pereira-Baldon Vanessa Santos
Postgraduate Program in Health Sciences, Federal University of Uberlândia, Uberlândia, MG, Brazil.
Physical Therapy Postgraduate Program, Federal University of Triângulo Mineiro associated with Federal University of Uberlândia, Uberlândia, MG, Brazil.
Phys Ther. 2022 Mar 1;102(3). doi: 10.1093/ptj/pzab305.
The purpose of this study was to compare (1) the effects of the instrument-assisted perineal stretching technique with different application protocols in combination with perineal massage and (2) the effects of the isolated techniques on the extensibility and strength of the pelvic floor muscles (PFMs).
A randomized controlled clinical trial with parallel randomization, assessor blinding, and concealed allocation was conducted in the Campus Physical Education at the Federal University of Uberlândia in Brazil. Ninety-six pregnant women (18-40 years of age) were allocated into 4 groups: perineal massage (PnM) group (PnM protocol for 10 minutes); instrument-assisted perineal stretching with a long static protocol for 15 minutes [IStrLS group]); PnM + IStrLS group (both techniques applied in the 2 previous groups); and PnM + IStrSR group (the same techniques as used in the PnM + IStrLS group but with a short repeated protocol; 4 sets lasting 30 seconds each). Eight interventions were performed in all 4 groups twice weekly (beginning at the 34th gestational week). The primary outcome was PFM extensibility, assessed using vaginal dilator circumference, and the secondary outcome was PFM strength, assessed using vaginal manometry.
For the PFM extensibility variable, a significant main effect of time (F2,88 = 87.951) and group (F3,88 = 7.193) was found. Tukey post hoc test results showed that the PnM + IStrSR group presented greater extensibility than the PnM and IStrLS groups. The PnM group showed increased PFM strength after 8 sessions compared with the other groups.
Women who were pregnant and received the combination of perineal massage and instrument-assisted perineal stretching with short repeated application had a greater increase in PFM extensibility than perineal massage and instrument-assisted perineal stretching alone.
The combination of perineal massage and instrument-assisted perineal stretching techniques with a short, repeated protocol led to better PFM extensibility results than the application of the techniques alone in women who were pregnant.
Pregnant women can benefit from intervention using the combination of perineal massage and instrument-assisted perineal stretching techniques with a short, repeated protocol.
本研究旨在比较（1）不同应用方案的器械辅助会阴伸展技术与会阴按摩相结合的效果，以及（2）单独技术对盆底肌肉（PFMs）伸展性和力量的影响。
在巴西乌贝兰迪亚联邦大学的校园体育中心进行了一项平行随机、评估者盲法和隐蔽分配的随机对照临床试验。96名孕妇（年龄18 - 40岁）被分为4组：会阴按摩（PnM）组（进行10分钟的PnM方案）；采用长时静态方案进行15分钟器械辅助会阴伸展的组[IStrLS组]）；PnM + IStrLS组（应用前两组的两种技术）；以及PnM + IStrSR组（与PnM + IStrLS组使用相同技术，但采用短时重复方案；共4组，每组持续30秒）。所有4组每周进行两次，共8次干预（从妊娠第34周开始）。主要结局是使用阴道扩张器周长评估的PFMs伸展性，次要结局是使用阴道测压评估的PFMs力量。
对于PFMs伸展性变量，发现时间（F2,88 = 87.951）和组间（F3,88 = 7.193）有显著的主效应。Tukey事后检验结果显示，PnM + IStrSR组的伸展性高于PnM组和IStrLS组。与其他组相比，PnM组在8次疗程后PFMs力量增加。
怀孕且接受会阴按摩与短时重复应用的器械辅助会阴伸展相结合的女性，其PFMs伸展性的增加幅度大于单独进行会阴按摩和器械辅助会阴伸展。
会阴按摩与器械辅助会阴伸展技术相结合的短时重复方案，在怀孕女性中比单独应用这些技术能带来更好的PFMs伸展性结果。
孕妇可从采用短时重复方案的会阴按摩与器械辅助会阴伸展技术相结合的干预中获益。
