Laboratory of Sensory-Motor Rehabilitation Engineering, Institute of Research and Development, University of Vale do Paraíba-UNIVAP, São José Dos Campos, SP, Brazil.
Post Graduate Program in Human Movement and Rehabilitation (PPGMHR), University Center of Anápolis (UniEVANGÉLICA), Anápolis, GO, Brazil.
Lasers Med Sci. 2023 Nov 29;38(1):278. doi: 10.1007/s10103-023-03919-7.
The dysfunctions of the female pelvic floor have a great influence on the quality of life of women, in all areas, social, psychological, and sexual. Stress urinary incontinence is the clinical condition in which the woman involuntarily loses urine to efforts, such as coughing and sneezing, causing great embarrassment and affecting her quality of life. The physiotherapeutic treatments include muscle strengthening; however, muscle fatigue is present when performing the exercises. Here we investigate the effects of photobiomodulation to prevent muscle fatigue in the pelvic floor in the treatment of stress urinary incontinence, associated with a muscle strengthening exercise protocol. We used an infrared laser (808 nm, 100 mW) and 3 J/point and fluence of 107.1 J/cm. The application was performed at 3 points on the vaginal introits and at another 3 points inside the vaginal canal cavity for the treatment of stress urinary incontinence associated with strengthening exercises with vaginal cones. Twenty-two volunteers participated in the study, divided into two groups: group 1 (laser therapy + strengthening) and group 2 (placebo laser + strengthening). In the group 1 quality of life score, the assessment (11.63 ± 4.33) was the highest score at 17 and in the reevaluation (7.81 ± 5.14) the lowest was 0 (p < 0.05). The muscular strength increased considerably (p < 0.05) for group 1, where the vast majority of patients gained more than twice the strength in the pelvic apparatus (8.36 ± 6.65 before X 13.81 ± 8.92 after). The volunteers acquired an increase in the contraction of the muscles of the pelvic apparatus (p < 0.05) (3.45 ± 1.07); after laser application, this number increased considerably (4.27 ± 0.61). Endurance had an increase of almost 50% compared to placebo, demonstrating the resistance gain in the perineal muscles (3.90 ± 2.35 X 5 ± 1.90). We concluded that photobiomodulation treatment showed significant efficacy in relation to muscle fatigue in the pelvic apparatus right after a strengthening program in women with stress urinary incontinence.
女性盆底功能障碍对女性的生活质量有很大影响，包括社交、心理和性生活方面。压力性尿失禁是指女性在咳嗽、打喷嚏等活动时不由自主地漏尿的临床症状，会给患者带来极大的尴尬并影响其生活质量。物理治疗方法包括肌肉强化训练，但在进行这些锻炼时会出现肌肉疲劳。在这里，我们研究了光生物调节疗法在治疗压力性尿失禁中的应用，这种疗法与一种肌肉强化锻炼方案相结合，可以预防盆底肌肉疲劳。我们使用了一种 808nm 的红外激光，剂量为 3J/点，光密度为 107.1J/cm。应用于阴道入口的 3 个点和阴道腔内的另外 3 个点，用于治疗与阴道锥状物强化锻炼相关的压力性尿失禁。22 名志愿者参与了这项研究，分为两组：第 1 组（激光治疗+强化锻炼）和第 2 组（假激光+强化锻炼）。在第 1 组中，生活质量评分在 17 岁时达到最高（11.63±4.33），在重新评估时（7.81±5.14）达到最低（0）（p<0.05）。第 1 组的肌肉力量显著增加（p<0.05），其中绝大多数患者的盆底器官力量增加了两倍以上（8.36±6.65 在前 X 13.81±8.92 在后）。志愿者的盆底肌肉收缩能力也有所增加（p<0.05）（3.45±1.07）；经过激光治疗后，这个数字显著增加（4.27±0.61）。与安慰剂相比，耐力增加了近 50%，表明会阴部肌肉的阻力增加（3.90±2.35 X 5±1.90）。我们得出结论，光生物调节疗法在治疗女性压力性尿失禁患者的盆底肌肉疲劳方面具有显著疗效，特别是在强化锻炼方案之后。
