Interactive computer games for treatment of pelvic floor dysfunction
Interactive computer games for treatment of pelvic floor dysfunction
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DOI：
10.1016/s0022-5347(05)65714-x
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发表时间：
2001-11-01
影响因子：
6.6
通讯作者：
McKenna, PH
中科院分区：
文献类型：
--
作者：
Herndon, CDA;Decambre, M;McKenna, PH
目的：我们回顾了我们在排尿功能障碍患者中使用保守医疗程序和计算机游戏辅助骨盆底肌肉再训练的经验，以证实我们先前的研究结果，即大多数患者的改善和/或治愈，并确定可能与治疗失败相关的因素。材料和方法：所有患者表现为排尿功能障碍的症状参加我们的盆底肌肉再训练进行了检查。主观评价夜间遗尿、白天遗尿、便秘、大便失禁的改善情况和突破性尿路感染的发生率。我们最初的保守治疗（包括我们的生物反馈计划）失败的患者进一步接受药物治疗，并对结果进行了审查。Fisher精确检验用于统计分析，以确定可能预测失败的因素与我们的program.Results：在过去的2年中，134名女孩和34名男孩参加了盆底肌肉再训练计划。其中160名患者（95%）符合该计划。患者平均年龄为7.6岁（范围4 - 18岁）。平均每小时治疗次数为4.9次（范围2 - 13次）。尿流率和肌电图显示，32%的患者表现为平坦型尿流伴残余尿量增加，47%的患者表现为平坦型尿流伴残余尿量正常，11%的患者表现为间断型尿流伴残余尿量增加，10%的患者表现为间断型尿流伴残余尿量正常。87%（146）的患者主观改善，而13%（22）的患者无改善。统计学上显著的失败预测因素包括膀胱容量小于预测容量的60%（p
Purpose: We reviewed our experience with a conservative medical program and computer game assisted pelvic floor muscle retraining in patients with voiding dysfunction to substantiate our previous findings that demonstrated improvement and/or cure in a majority of patients, and identify factors that may be associated with unsuccessful treatment.Materials and Methods: All patients presenting with symptoms of dysfunctional voiding enrolled in our pelvic floor muscle retraining were examined. Cases were subjectively evaluated for improvement of nocturnal enuresis, diurnal enuresis, constipation, encopresis and incidence of break through urinary tract infection. Patients in whom our initial conservative approach that included our biofeedback program failed were further treated with medication, and outcomes were reviewed as well. Fisher's exact test was used for statistical analysis to identify factors that may predict failure with our program.Results: During the last 2 years 134 girls and 34 boys were enrolled in the pelvic floor muscle retraining program. Of the patients 160 (95%) were compliant with the program. Mean patient age was 7.6 years (range 4 to 18). The average number of hourly treatment sessions was 4.9 (range 2 to 13). Uroflowmetry and electromyography demonstrated a flattened flow pattern with increased post-void residual volume in 32% of patients, flattened flow pattern with normal post-void residual 47%, staccato flow pattern with increased post-void residual 11% and staccato flow pattern with normal post-void residual 10%. Subjective improvement was demonstrated in 87% (146) of patients, while 13% (22) had no improvement. Statistically significant predictors of failure included bladder capacity less than 60% of predicted volume (p