Rouen University Hospital, Department of Urology, Rouen, France; La Musse Clinical Research Department and Physiotherapy Training Institute (Fondation La Renaissance Sanitaire), Saint-Sébastien-de-Morsent, France.
La Musse Clinical Research Department and Physiotherapy Training Institute (Fondation La Renaissance Sanitaire), Saint-Sébastien-de-Morsent, France.
Prog Urol. 2023 Dec;33(17):1083-1091. doi: 10.1016/j.purol.2023.09.002. Epub 2023 Sep 26.
Current literature highlights the difficulty in identifying an optimal educational technique for maintaining continence during cough.
To characterize the effects of an educational intervention focusing on neutral posture during cough in women with cough-induced urinary incontinence (UI).
This interventional study design included women with cough-induced UI. We recorded PFMs surface electromyographic (sEMG) peak activity, and assessed symptoms and quality of life (QoL) 6 weeks after the intervention. The effect of the experimental situation was estimated using a linear mixed model, sEMG measurements during coughing were indexed to each situation and adjusted to the resting value at, and a moderation analysis was used.
RESULTS/FINDINGS: Eighteen participants were included. The measurement situations (control versus experimental) did not have a statistically significant impact on sEMG peak activity during coughing: mean effect [95% CI] 3.42 [-1.28; 7.66]. Six weeks post-intervention, participants reported statistically significant decrease in urinary symptoms (P=0.0246) and significant improvement in QoL (P=0.00776). This was also particularly marked on the dimension related to effort activities (P=0.00162).
This study suggests that a brief educational intervention focusing on neutral posture during cough, without voluntary pre-contraction of the PFMs, has no clinically significant influence on sEMG peak activity of the PFMs in women with cough-induced UI. However, this intervention can lead to a significant improvement in urinary symptoms and QoL at 6 weeks. These improvements seem to be independent of electromyographic PFMs peak activity recorded during cough. As such, our preliminary results pave the way for future research.
NP4.
目前的文献强调了在咳嗽时保持尿失禁（UI）的过程中，难以确定最佳教育技术。
描述在咳嗽诱发的 UI 女性中，针对咳嗽时中立姿势的教育干预对其的影响。
该干预性研究设计纳入了咳嗽诱发 UI 的女性。我们记录了 PFMs 表面肌电图（sEMG）的峰值活动，并在干预后 6 周评估了症状和生活质量（QoL）。使用线性混合模型估计了实验情况的影响，将咳嗽时的 sEMG 测量值与每种情况进行索引，并对休息值进行了调整，然后使用了 moderation 分析。
结果/发现：纳入了 18 名参与者。测量情况（对照与实验）对咳嗽时 sEMG 峰值活动没有统计学上的显著影响：平均效应[95%CI]为 3.42[-1.28;7.66]。干预后 6 周，参与者报告的尿症状有统计学显著改善（P=0.0246），QoL 有显著提高（P=0.00776）。与努力活动相关的维度尤其显著（P=0.00162）。
本研究表明，针对咳嗽时中立姿势的简短教育干预，无需 PFMs 主动预收缩，对咳嗽诱发 UI 女性的 PFMs sEMG 峰值活动没有临床显著影响。然而，该干预可在 6 周时导致尿症状和 QoL 的显著改善。这些改善似乎与咳嗽期间记录的 PFMs 肌电图峰值活动无关。因此，我们的初步结果为未来的研究铺平了道路。
NP4。
