Serviço de Medicina Física e de Reabilitação, Centro Hospitalar Universitário de São João, Porto, Portugal.
Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
Int Urogynecol J. 2023 Mar;34(3):717-727. doi: 10.1007/s00192-022-05108-6. Epub 2022 May 21.
This study aimed to compare the effectiveness of a hybrid telerehabilitation program with a traditional face to face model in women with stress urinary incontinence (SUI) and mixed incontinence (MUI) with a predominance of SUI. The authors hypothesized that home pelvic floor muscle training (PFMT) would have a similar benefit to outpatient PFMT.
Parallel randomized controlled trial including 58 patients consecutively admitted to a tertiary academic hospital for pelvic floor rehabilitation consultation from 1 January to 30 April 2021 for conservative treatment of UI. Participants randomized to the intervention were submitted to a 12-week PFMT program: (1) a hybrid telerehabilitation program of two individual face-to-face sessions followed by 2-weekly sessions of video-telerehabilitation with a follow-up by a specialized physiotherapist, including one individual face-to-face session at 8 weeks; (2) a re-evaluation teleconsultation at 6 and 16 weeks; (3) a face-to-face consultation at 12 weeks. The control group had two initial individual sessions followed by twice-weekly group classes, and consultations were face to face. The primary outcome measure (at baseline and 12 weeks) was UI-related quality of life using the Portuguese Version of the King's Health Questionnaire.
At baseline the intervention (n = 18) and control (n = 17) groups were similar. UI-related quality of life significantly improved in both the intervention and control groups betweenbaseline (T0) and the end of the 12-week PFMT program (T12) (p = 0.002, p < 0.001, respectively), although the magnitude of the improvement was not significantly different between groups (-10.0 vs. -9.5 points, p = 0.918, respectively).
This hybrid telerehabilitation protocol showed effectiveness comparable to the traditional model in improving UI-related quality of life. Trial registration at www.
gov , no. NCT05114395.
本研究旨在比较混合远程康复方案与传统面对面模式对以压力性尿失禁（SUI）为主的女性压力性尿失禁（SUI）和混合性尿失禁（MUI）患者的有效性。作者假设家庭盆底肌训练（PFMT）与门诊 PFMT 具有相似的益处。
这是一项平行随机对照试验，纳入 2021 年 1 月 1 日至 4 月 30 日期间因 UI 保守治疗连续到三级学术医院进行盆底康复咨询的 58 名患者。随机分配到干预组的患者接受为期 12 周的 PFMT 方案：（1）由 2 次个体面对面会议和 2 周视频远程康复组成的混合远程康复方案，由专业物理治疗师随访，包括第 8 周的 1 次个体面对面会议；（2）6 周和 16 周时进行远程再评估咨询；（3）12 周时进行面对面咨询。对照组有 2 次初始个体会议，随后是每周 2 次的小组课程，咨询是面对面的。主要结局指标（基线和 12 周时）为使用葡萄牙版 King's 健康问卷评估的与 UI 相关的生活质量。
在基线时，干预组（n = 18）和对照组（n = 17）相似。在干预组和对照组中，与 UI 相关的生活质量在基线（T0）和 12 周 PFMT 方案结束时（T12）均显著改善（p = 0.002，p < 0.001），但两组之间的改善程度无显著差异（-10.0 与-9.5 分，p = 0.918）。
与传统模式相比，这种混合远程康复方案在改善与 UI 相关的生活质量方面显示出有效性。试验在 www.clinicaltrials.gov 注册，编号为 NCT05114395。
