Heřmánková Barbora, Špiritović Maja, Oreská Sabína, Štorkánová Hana, Mann Heřman, Pavelka Karel, Šenolt Ladislav, Vencovský Jiří, Bečvář Radim, Tomčík Michal
Institute of Rheumatology, Na Slupi 4, Prague 2, 128 50, Czech Republic.
Department of Physiotherapy, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic.
Rheumatol Ther. 2023 Aug;10(4):1089-1105. doi: 10.1007/s40744-023-00559-9. Epub 2023 May 23.
INTRODUCTION: Systemic sclerosis (SSc) and idiopathic inflammatory myopathies (IIM) are very rare rheumatic diseases burdened by a high prevalence of sexual dysfunctions. However, no specific treatment has been proposed to date. To our knowledge, this is the first (pilot) study aiming to investigate the effect of an 8-week tailored physiotherapy program on the sexual health of women with SSc and IIM. METHODS: In total, 12 women with SSc and 4 women with IIM were enrolled in the study. Based on the patients' capability to participate in the program, they were divided into an intervention group (IG) (mean ± SD age 46.8 ± 8.6 years) and a control group (CG) (mean ± SD age 46.3 ± 8.5 years). IG underwent the 8-week program (1 h of supervised physiotherapy twice weekly), whereas CG received no physiotherapy. At weeks 0 and 8, all patients filled in questionnaires assessing sexual function (Female Sexual Function Index [FSFI], Brief Index of Sexual Functioning for Women [BISF-W]), sexual quality of life (Sexual Quality of Life-Female [SQoL-F]), functional ability (Health Assessment Questionnaire [HAQ]), quality of life (Medical Outcomes Short Form-36 [SF-36]), and depression (Beck's Depression Inventory-II [BDI-II]). The changes were analyzed with two-way ANOVA and Friedmann's test. RESULTS: Compared to the statistically significant deterioration in CG over weeks 0-8, we found statistically significant improvements in the total scores of FSFI and BISF-W, and some of their domains, functional status, and the physical component of quality of life. CONCLUSION: Our 8-week physiotherapy program not only prevented the natural course of progressive deterioration of functional ability but also led to a significant improvement in sexual function and quality of life in women with SSc and IIM. However, due to the lack of randomization and a relatively small sample size resulting from the strict inclusion criteria, further validation of our results is needed. TRIAL REGISTRATION NUMBER: ISRCTN91200867 (prospectively registered).
引言:系统性硬化症(SSc)和特发性炎性肌病(IIM)是非常罕见的风湿性疾病,性功能障碍的患病率很高。然而,迄今为止尚未提出具体的治疗方法。据我们所知,这是第一项(试点)研究,旨在调查为期8周的量身定制的物理治疗方案对患有系统性硬化症和特发性炎性肌病的女性性健康的影响。 方法:共有12名系统性硬化症女性患者和4名特发性炎性肌病女性患者参与了该研究。根据患者参与该方案的能力,将她们分为干预组(IG)(平均±标准差年龄46.8±8.6岁)和对照组(CG)(平均±标准差年龄46.3±8.5岁)。干预组接受为期8周的方案(每周两次,每次1小时的监督下的物理治疗),而对照组不接受物理治疗。在第0周和第8周,所有患者填写问卷,评估性功能(女性性功能指数[FSFI]、女性性功能简要指数[BISF-W])、性生活质量(女性性生活质量[SQoL-F])、功能能力(健康评估问卷[HAQ])、生活质量(医学结果简表-36[SF-36])和抑郁(贝克抑郁量表-II[BDI-II])。采用双向方差分析和弗里德曼检验分析变化情况。 结果:与对照组在0至8周期间统计学上显著的恶化相比,我们发现FSFI和BISF-W的总分及其一些领域、功能状态和生活质量的身体成分有统计学上的显著改善。 结论:我们为期8周的物理治疗方案不仅阻止了功能能力逐渐恶化的自然进程,而且还使患有系统性硬化症和特发性炎性肌病的女性的性功能和生活质量得到了显著改善。然而由于缺乏随机分组且严格的纳入标准导致样本量相对较小,我们的结果需要进一步验证。 试验注册号:ISRCTN91200867(前瞻性注册)
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