Department of Health Care Services, Köyceğiz Vocational School of Health Services, Muğla Sıtkı Koçman University, Muğla, Turkey.
Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Ege University, İzmir, Turkey.
Ir J Med Sci. 2023 Jun;192(3):1481-1495. doi: 10.1007/s11845-022-03083-x. Epub 2022 Jul 1.
No other systematic review presented the effectiveness of pelvic floor muscle training (PFMT) in individual with stroke.
The purpose of this systematic review and meta-analysis was to demonstrate the effectiveness of PFMT for urinary incontinence in patients with stroke.
"Web of Science (WoS), Cochrane Library, PubMed and Scopus" databases were searched. "Revised Cochrane risk-of-bias tool randomized trials (RoB 2)" and "PEDro" were used to assess the risk of bias and methodological quality of the studies. Narrative synthesis and meta-analysis were conducted to present the results.
A total of 8 articles were included in the review. Seven articles were classified as "good" level evidence. Four articles were considered to have "high risk" of bias for the overall score. Regarding two homogenous studies, PFMT-based rehabilitation was not superior standard urinary incontinence therapy on SF-36-Social Function score at 12-week follow-up (ES 0.47, 95% CI - 0.16-0.96). Data pooling of two studies did not provide an additional advantage of pelvic muscle training on 3 days voiding diary (night, total day) score at 12-week follow-up (ES 28, 95% CI - 0.61-0.48; ES 0.30, 95% CI - 0.23-0.95). On the other hand, low-quality evidence demonstrated that pelvic muscle training yielded better results on daytime voiding (ES 0.28, 95% CI 0.04-1.16).
The results demonstrated that PFMT had positive effects in terms of daytime urination frequency and incontinence. Although some studies have reported positive effects on symptoms, function, strength, and endurance, the generalizability of these results is controversial. Further studies should assess the quality-of-life and function with urinary incontinence and stroke-specific tools.
没有其他系统评价报告过盆底肌训练（PFMT）对脑卒中患者的有效性。
本系统评价和荟萃分析的目的是展示 PFMT 对脑卒中患者尿失禁的有效性。
检索了“Web of Science (WoS)、Cochrane 图书馆、PubMed 和 Scopus”数据库。使用“修订后的 Cochrane 随机试验偏倚风险工具（RoB 2）”和“PEDro”评估研究的偏倚风险和方法学质量。采用叙述性综合和荟萃分析呈现结果。
共纳入 8 篇文章进行综述。7 篇文章被归类为“良好”水平的证据。4 篇文章在总体评分方面被认为存在“高风险”偏倚。关于两项同质研究，PFMT 为基础的康复治疗在 12 周随访时在 SF-36 社交功能评分上并不优于标准尿失禁治疗（ES 0.47，95%CI -0.16-0.96）。对两项研究的数据进行汇总，在 12 周随访时，骨盆肌肉训练对 3 天排尿日记（夜间、全天）评分没有提供额外的优势（ES 28，95%CI -0.61-0.48；ES 0.30，95%CI -0.23-0.95）。另一方面，低质量证据表明，骨盆肌肉训练在白天排尿方面效果更好（ES 0.28，95%CI 0.04-1.16）。
结果表明，PFMT 在白天排尿频率和失禁方面有积极的效果。尽管一些研究报告了对症状、功能、力量和耐力的积极影响，但这些结果的普遍性存在争议。进一步的研究应该使用尿失禁和中风特定工具评估生活质量和功能。
