Tim Sabina, Mazur-Bialy Agnieszka
Department of Biomechanics and Kinesiology, Faculty of Health Science, Jagiellonian University Medical College, Skawińska 8, 31-066 Krakow, Poland.
J Clin Med. 2024 Dec 18;13(24):7730. doi: 10.3390/jcm13247730.
: The postpartum period is marked by numerous physical changes, often leading to pelvic floor disorders (PFD) such as urinary incontinence (UI) and diastasis recti abdominis (DRA). This study aimed to assess the occurrence of UI and DRA in postpartum women and evaluate the effectiveness of physiotherapy in managing UI and DRA. : A total of 396 women, between the 3rd and 5th postpartum day, were randomized into three groups: control (GrCon), online exercise group (GrOnl), and supervised group (GrSup). GrCon received only education, whereas GrOnl and GrSup had three sessions with exercises with physiotherapist-online or supervised. Data were collected through questionnaires, ICIQ FLUTS, body posture assessments, and DRA measurements. : The results showed a significant reduction in UI and DRA symptoms across all groups, with the GrSup group showing the greatest improvement. UI symptoms decreased from 49% during pregnancy to 36.9% postpartum, with GrSup women reporting fewer urological complaints compared to the GrOnl and GrCon groups ( < 0.001). DRA incidence dropped from 76.2% in the early postpartum days to 23.4% at six weeks, with GrSup showing the lowest rates (9.8%). Notably, supervised physiotherapy resulted in a higher frequency (94.7%) and correct performance of PFME (72.2%) compared to the online and control groups. : The study concludes that supervised physiotherapy is more effective than online sessions in managing postpartum UI and DRA, emphasizing the importance of guided exercise for better outcomes.
产后时期有许多身体变化，常常导致盆底功能障碍（PFD），如尿失禁（UI）和腹直肌分离（DRA）。本研究旨在评估产后女性中尿失禁和腹直肌分离的发生率，并评估物理治疗在管理尿失禁和腹直肌分离方面的有效性。
共有396名产后第3至5天的女性被随机分为三组：对照组（GrCon）、在线运动组（GrOnl）和监督组（GrSup）。GrCon仅接受教育，而GrOnl和GrSup与物理治疗师进行了三次在线或监督下的运动课程。通过问卷调查、ICIQ FLUTS、身体姿势评估和腹直肌分离测量收集数据。
结果显示，所有组的尿失禁和腹直肌分离症状均有显著减轻，其中GrSup组改善最大。尿失禁症状从孕期的49%降至产后的36.9%，与GrOnl组和GrCon组相比，GrSup组女性报告的泌尿系统问题更少（<0.001）。腹直肌分离发生率从产后早期的76.2%降至六周时的23.4%，GrSup组发生率最低（9.8%）。值得注意的是，与在线组和对照组相比，监督下的物理治疗导致盆底肌肉运动锻炼（PFME）的频率更高（94.7%）且执行正确（72.2%）。
该研究得出结论，在管理产后尿失禁和腹直肌分离方面，监督下的物理治疗比在线课程更有效，强调了有指导的运动对于获得更好效果的重要性。
