Hort Julia Picinini, Mendoza Arbieto Eliane Regina, Fukuda Fernanda, Brandão Sofia, Da Roza Thuane
UDESC-CEFID, Department of Physical Therapy, Faculty of Health and Sport Sciences Center. Pascoal Simone, 358 - Coqueiros, 88080-350, Florianópolis, SC, Brazil.
Centro Hospitalar de São João, Department of Radiology, Alameda Prof. Hernâni Monteiro, 4202-451, Porto, Portugal; CESPU - Advanced Polytechnic and University Cooperative, CRL | Vale do Ave Higher School of Health of the Polytechnic Health Institute of North, Portugal.
J Bodyw Mov Ther. 2025 Jun;42:1057-1062. doi: 10.1016/j.jbmt.2025.03.006. Epub 2025 Mar 4.
Studies have suggested abdominal hypopressive technique (AHT) as a therapeutic approach to treat urinary incontinence (UI) and improve pelvic floor muscle (PFM) strength. This controlled pilot study, using a pre-post-test design in three different groups, investigated the maximal voluntary contraction (MVC) and the vaginal resting pressure (VRP) of PFM before and immediately after three therapeutic training sessions: of a) PFM training (PFMT), b) AHT, or c) AHT associated with MVC of the PFM (AHT + MVC), in upright and lying positions among women with UI. Additionally, the study investigated if there was a difference in VRP or MVC values when measured at lying or upright positions.
The ICIQ-UI-SF questionnaire was used to assess UI symptoms. Seventeen incontinent women (13 with mixed UI, 3 with stress UI, and 1 with urgency UI) were randomized to one of the 3 therapeutic training groups. Peritron® manometer was used to assess the VRP and MVC measurements. All participants were evaluated both in the lying and upright position, before and after a 40-min training session.
Immediately after the training session, the values of MVC decreased significantly in all groups in the lying position (mean difference of 34.2, 30.5, and 28.4 for PFMT, AHT and AHT + MVC, respectively). In the upright position, the values of MVC decreased significantly for PFMT and AHT + MVC groups (mean difference of 34.7 and 41.8, respectively), indicating PFM fatigue. In the upright position, the AHT group had the lowest VRP values after the training, suggesting no change in muscle tone.
The significant reduction in the MVC, especially in upright position, in the groups who performed PFM contraction, provides data for a specific PFM strengthening. The AHT group was also the one who had the lowers VRP values after the training, suggesting no change in muscle tone. These findings suggest that isolated work on the AHT may not be effective to training the PFM.
BLINDED.
研究表明，腹部减压技术（AHT）可作为治疗尿失禁（UI）和增强盆底肌肉（PFM）力量的一种治疗方法。这项对照试验研究采用前后测试设计，将受试者分为三组，对患有UI的女性在三种治疗训练课程（即a）PFM训练（PFMT）、b）AHT或c）AHT联合PFM的最大自主收缩（MVC）训练（AHT + MVC））前后的PFM最大自主收缩（MVC）和阴道静息压力（VRP）进行了研究，测试分别在直立位和卧位进行。此外，该研究还调查了在卧位或直立位测量时VRP或MVC值是否存在差异。
采用ICIQ-UI-SF问卷评估UI症状。17名尿失禁女性（13名混合性UI、3名压力性UI和1名急迫性UI）被随机分配到3个治疗训练组之一。使用Peritron®压力计评估VRP和MVC测量值。所有参与者在40分钟训练课程前后均在卧位和直立位进行评估。
训练课程结束后即刻，所有组卧位的MVC值均显著下降（PFMT、AHT和AHT + MVC组的平均差值分别为34.2、30.5和28.4）。在直立位，PFMT组和AHT + MVC组的MVC值显著下降（平均差值分别为34.7和41.8），表明PFM疲劳。在直立位，训练后AHT组的VRP值最低，表明肌张力无变化。
进行PFM收缩的组中MVC显著降低，尤其是在直立位，这为特定的PFM强化提供了数据。AHT组也是训练后VRP值最低的组，表明肌张力无变化。这些发现表明，单独进行AHT对训练PFM可能无效。
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