Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
Dokuz Eylül University, Institute of Health Sciences, Izmir, Turkey.
Int Urogynecol J. 2023 Sep;34(9):2067-2080. doi: 10.1007/s00192-023-05499-0. Epub 2023 Mar 23.
A multiple-component intensive pelvic floor muscle training (MCI-PFMT) protocol was developed as a neurophysiological-based rehabilitation model to improve neuroplasticity. This study aimed to investigate the effects of the MCI-PFMT protocol on muscle fatigue and symptoms in women with urinary incontinence.
This randomized controlled trial included 49 female patients with mixed urinary incontinence. Participants were divided into the MCI-PFMT group and the control group. The MCI-PFMT group performed supervised intensive pelvic floor muscle training, while the control group received bladder training and standard pelvic floor muscle training as a home program. Both training sessions were conducted 5 days a week for a single week. Participants' symptoms were evaluated with questionnaires, bladder diary, and pad tests. Superficial electromyography, ultrasonography, and the PERFECT scale were used to evaluate pelvic floor and abdominal muscle functions.
In the post-treatment evaluation, symptoms were decreased in both groups, with a significant decrease in the MCI-PFMT group (p < 0.05). While average and peak work values of pelvic floor muscles, transversus abdominus, and internal oblique muscles increased in both groups, maximum voluntary contraction values of these muscles decreased (p < 0.05). A 12.7% decrease was observed in the maximum voluntary contraction values of pelvic floor muscles in the control group, while a 9.6% decrease was observed in the MCI-PFMT group.
The MCI-PFMT protocol can lead to pelvic floor and abdominal muscle fatigue. However, it may be effective at decreasing symptoms in women with urinary incontinence. Additional studies on this issue are needed.
一种多成分强化盆底肌肉训练（MCI-PFMT）方案被开发为一种基于神经生理学的康复模型，以改善神经可塑性。本研究旨在探讨 MCI-PFMT 方案对尿失禁女性肌肉疲劳和症状的影响。
这是一项随机对照试验，纳入了 49 例混合性尿失禁女性患者。参与者被分为 MCI-PFMT 组和对照组。MCI-PFMT 组进行监督强化盆底肌肉训练，而对照组则接受膀胱训练和标准盆底肌肉训练作为家庭方案。两组均每周训练 5 天，持续 1 周。通过问卷、膀胱日记和垫试验评估参与者的症状。使用表面肌电图、超声和 PERFECT 量表评估盆底和腹肌功能。
在治疗后评估中，两组的症状均有所减轻，MCI-PFMT 组的症状减轻更为显著（p<0.05）。虽然两组的盆底肌肉、腹横肌和内斜肌的平均和峰值工作值均有所增加，但这些肌肉的最大自主收缩值却有所下降（p<0.05）。对照组的盆底肌肉最大自主收缩值下降了 12.7%，而 MCI-PFMT 组下降了 9.6%。
MCI-PFMT 方案可导致盆底和腹肌疲劳。然而，它可能对减轻尿失禁女性的症状有效。需要对此问题进行更多的研究。
