Vahtera T, Haaranen M, Viramo-Koskela A L, Ruutiainen J
Masku Neurological Rehabilitation Centre, Finland.
Clin Rehabil. 1997 Aug;11(3):211-9. doi: 10.1177/026921559701100304.
To determine the effect of pelvic floor muscle exercises combined with electrical stimulation of pelvic floor on lower urinary tract dysfunction in multiple sclerosis (MS) patients with near normal (< 100 ml) postvoid residual volumes.
Open, controlled, randomized study in two parallel groups.
Rehabilitation centre for MS patients.
Fifty women and 30 men with definite MS and current symptoms of lower urinary tract dysfunction.
The muscle activity of the pelvic floor muscles was tested using surface EMG. Subjective urinary symptoms were assessed using a questionnaire.
Pelvic floor muscles were stimulated using electrical stimulation at six sessions. During and after the final session the patients were taught to exercise their pelvic floor muscles and advised to continue these exercises regularly for at least six months. The control group was not treated.
The maximal contraction power and endurance of the pelvic floor muscles increased after six sessions of electrical stimulation with interferential currents. Symptoms of urinary urgency, frequency and incontinence were significantly less frequent in the treated group than in the untreated subjects. Male patients appeared to respond better to the treatment than female patients. Compliance with the pelvic floor exercises was over 60% at the end of a follow-up for six months. Most drop-outs were due to the disappearance of urinary tract symptoms or to severe relapses in MS.
The present study indicates that pelvic floor muscle exercises combined with electrical stimulation of the pelvic floor constitute an effective treatment for lower urinary tract dysfunction at least in male patients with MS.
确定盆底肌肉锻炼联合盆底电刺激对残余尿量接近正常(<100 ml)的多发性硬化症(MS)患者下尿路功能障碍的影响。
开放、对照、随机研究,分为两个平行组。
MS患者康复中心。
50名女性和30名男性,确诊为MS且目前存在下尿路功能障碍症状。
使用表面肌电图测试盆底肌肉的肌肉活动。使用问卷评估主观尿路症状。
通过电刺激对盆底肌肉进行6次刺激。在最后一次刺激期间及之后,教导患者锻炼盆底肌肉,并建议他们定期持续进行这些锻炼至少6个月。对照组未接受治疗。
采用干扰电流进行6次电刺激后,盆底肌肉的最大收缩力和耐力增加。治疗组尿急、尿频和尿失禁症状的发生频率明显低于未治疗组。男性患者似乎比女性患者对治疗反应更好。在6个月的随访结束时,盆底锻炼的依从率超过60%。大多数退出者是由于尿路症状消失或MS严重复发。
本研究表明,盆底肌肉锻炼联合盆底电刺激至少对患有MS的男性患者的下尿路功能障碍构成有效治疗。