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绝经后女性压力性尿失禁患者行盆底肌训练与普拉提训练的对比分析:一项随机对照试验。

Comparative analysis of pelvic floor muscle training and Pilates in managing urinary incontinence among postmenopausal women: a randomized controlled trial.

机构信息

Health Science Center, Universidade Estadual do Norte do Paraná (UENP), Alameda Padre Magno, Jacarezinho, Paraná, 86400-000, Brazil.

出版信息

Int Urogynecol J. 2024 Mar;35(3):561-569. doi: 10.1007/s00192-023-05712-0. Epub 2024 Jan 11.

DOI:10.1007/s00192-023-05712-0
PMID:38206341
Abstract

INTRODUCTION AND HYPOTHESIS

This study is aimed at comparing the effectiveness of pelvic floor muscle training (PFMT) and Pilates on the improvement of urinary incontinence (UI), strength, and endurance of the pelvic floor muscles (PFMs), and the impact of UI on the quality of life in postmenopausal women.

METHODS

Forty postmenopausal women were randomly divided in to two groups: PFMT (n = 20) and Pilates (n = 20). The participants were followed for 12 weeks, three times a week on nonconsecutive days. UI was assessed using the pad test and the voiding diary, PFM strength and resistance using bidigital assessment and manometry, and the impact of UI on quality of life using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), before and after the 3-month treatment.

RESULTS

There was a significant intra-group improvement in both groups for the pad test, mean daily urinary loss, and ICIQ-SF. The strength was significantly improved only in the PFMT group, and the endurance in both groups. Peak strength manometry was significantly improved only in the Pilates group, and the mean strength manometry in both groups. There was also an improvement in both groups for peak endurance manometry and mean endurance manometry. In the inter-group comparison, there was a significant improvement only in muscle strength, which was positive for group.

CONCLUSIONS

There was no difference between Pilates and PFMT for the management of women in post-menopause with stress urinary incontinence, provided that voluntary contraction of the PFMs is performed. However, further randomized clinical trials need to be carried out.

摘要

引言与假设

本研究旨在比较盆底肌训练(PFMT)和 Pilates 对改善绝经后女性尿失禁(UI)、盆底肌(PFMs)力量和耐力的有效性,以及 UI 对生活质量的影响。

方法

将 40 名绝经后妇女随机分为两组:PFMT 组(n=20)和 Pilates 组(n=20)。参与者每周非连续 3 次,共 12 周。采用垫试验和排尿日记评估 UI,双指评估和测压法评估 PFM 力量和阻力,国际尿失禁咨询问卷-短表(ICIQ-SF)评估 UI 对生活质量的影响,治疗前和治疗后 3 个月进行评估。

结果

两组垫试验、平均每日尿失重量和 ICIQ-SF 均有显著的组内改善。PFMT 组 PFM 力量显著改善,两组耐力均显著改善。仅 Pilates 组的峰值压力测压法显著改善,两组的平均压力测压法均显著改善。两组的峰值耐力测压法和平均耐力测压法也均有改善。组间比较,仅肌肉力量有显著改善,PFMT 组为正性。

结论

对于绝经后压力性尿失禁的女性,Pilates 和 PFMT 的管理效果没有差异,前提是要进行 PFMs 的自愿收缩。然而,还需要开展进一步的随机临床试验。

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