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产后腹直肌分离的肌电图生物反馈辅助盆底肌肉训练康复方案:一项随机对照试验。

Rehabilitation programme including EMG-biofeedback- assisted pelvic floor muscle training for rectus diastasis after childbirth: a randomised controlled trial.

机构信息

Department of Gynaecology and Obstetrics, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.

Department of Rehabilitation, General Practice Centre, Nanhai Hospital, Southern Medical University, Foshan, China.

出版信息

Physiotherapy. 2022 Dec;117:16-21. doi: 10.1016/j.physio.2022.05.001. Epub 2022 May 17.

Abstract

OBJECTIVE

To evaluate the effect of a comprehensive rehabilitation programme on closure of the rectus diastasis (RD) and quality of life in women after delivery.

DESIGN

A randomised controlled trial with blinded assessment.

SETTING

A tertiary hospital and participants' homes in Foshan, China.

SUBJECTS

Sixty-six women with RD 2-6 months after delivery were recruited into this study (study group n = 33, control group n = 33). The mean age of participants was 29.9 [standard deviation (SD) 4.3] years.

INTERVENTIONS

Each participant performed abdominal exercises. Patients in the study group received electromyographic-biofeedback-assisted pelvic floor muscle training (BAPFMT) in combination with neuromuscular electrical stimulation (NMES) of the rectus abdominis, and patients in the control group underwent NMES of the rectus abdominis alone.

MAIN OUTCOMES

The main study outcomes were inter-recti distance (IRD) and change in Short-Form Health Survey-36 (SF-36) scores 6 weeks after the intervention.

RESULTS

A significant decrease in IRD was observed in the study group at 6 weeks [study group 1.6 (SD 0.3) cm vs control group 2.0 (SD 0.3); mean difference - 0.4, 95% confidence interval (CI) - 0.59 to - 0.26]. Similarly, the physical component summary, an integral component of SF-36, showed a significant improvement in the study group compared with the control group at 6 weeks [study group 45.5 (SD 1.2) vs control group 41.2 (SD 2.6); mean difference 4.3, 95% CI 3.72-4.50].

CONCLUSION

A postpartum programme including BAPFMT for women with RD is feasible and improves the physical domain of quality of life.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.fimmu, No: RCT 02561078. CONTRIBUTION OF THE PAPER.

摘要

目的

评估综合康复方案对产后女性腹直肌分离(RD)闭合和生活质量的影响。

设计

随机对照试验,盲法评估。

地点

中国佛山的一家三级医院和参与者的家中。

受试者

本研究共纳入 66 例产后 2-6 个月 RD 的女性(研究组 n=33,对照组 n=33)。参与者的平均年龄为 29.9 [标准差(SD)4.3]岁。

干预措施

每位参与者都进行了腹部运动。研究组患者接受肌电生物反馈辅助盆底肌训练(BAPFMT)联合腹直肌神经肌肉电刺激(NMES),对照组患者仅接受腹直肌 NMES。

主要结局

主要研究结局为干预 6 周后腹直肌间距离(IRD)和简明健康调查问卷-36(SF-36)评分的变化。

结果

研究组在 6 周时 IRD 显著下降[研究组 1.6(SD 0.3)cm 与对照组 2.0(SD 0.3)cm;平均差异-0.4,95%置信区间(CI)-0.59 至-0.26]。同样,SF-36 的组成部分——生理成分综合评分在研究组也较对照组在 6 周时显著改善[研究组 45.5(SD 1.2)vs 对照组 41.2(SD 2.6);平均差异 4.3,95%CI 3.72-4.50]。

结论

产后 RD 女性采用 BAPFMT 的康复方案是可行的,可以改善生活质量的生理领域。

临床试验注册

ClinicalTrials.fimmu,编号:RCT 02561078。

论文的贡献。

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