Effects of pelvic floor muscle training on strength and predictors of response in the treatment of urinary incontinence
Effects of pelvic floor muscle training on strength and predictors of response in the treatment of urinary incontinence
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DOI：
10.1002/nau.10021
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发表时间：
2002-01-01
影响因子：
2
通讯作者：
Fantl, JA
中科院分区：
文献类型：
--
作者：
Theofrastous, JP;Wyman, JF;Fantl, JA
目的：本研究的目的是（1）确定训练对盆底肌力量的影响;（2）确定盆底肌力量的变化是否与疾病的变化相关;（3）确定人口统计学特征、临床尿失禁严重程度指数或尿动力学指标是否可预测对盆底肌训练的反应。研究方法：134例尿失禁女性（95例为真性压力性尿失禁[GSI]; 19例为逼尿肌不稳定[DI]; 20例为混合性尿失禁[GSI + DI]）被随机分配至骨盆底肌肉训练组（n = 67）或膀胱训练组（n = 67）。在基线和治疗12周后进行尿日记、尿动力学评价和使用气囊测压法测量阴道压力。主要结果测量包括每周失禁发作和阴道压力测量。结果：两个治疗组的失禁发作减少（P小于或等于0.004）。阴道压力增加更多的盆底肌肉训练比膀胱训练（P = 0.0003）。除了GSI患者每周失禁发作次数减少与最大持续阴道压增加之间存在弱相关性（r = 0.32，P = 0.04）外，盆底肌肉力量增加与排尿状态改善之间无显著相关性。基线人口统计学特征、临床尿失禁严重程度或尿动力学指标与盆底肌肉训练后阴道压力增加或临床严重程度改善之间无显著相关性。结论：骨盆底肌肉训练可以改善阴道压力，增加阴道压力测量值，但这些变化之间的直接相关性很弱。女性对行为治疗的反应并不取决于她的人口统计学特征、临床尿失禁严重程度、尿动力学测量或初始骨盆底肌肉力量。(C)2002 Wiley-Liss，Inc.
Aims: The objectives of this study were (1) to determine the effect of training on pelvic floor muscle strength; (2) to determine whether changes in pelvic floor muscle strength correlate with changes ill continence; and (3) to determine whether demographic characteristics, clinical incontinence severity indices, or urodynamic measures predict response to pelvic floor muscle training. Methods: One hundred thirty-four women with urinary incontinence (95 = genuine stress incontinence [GSI]; 19 detrusor instability [DI]; 20 = mixed incontinence [GSI + DI]) were randomized to pelvic floor muscle training (n = 67) or bladder training (n = 67). Urinary diaries, urodynamic evaluation, and vaginal pressure measurements by using balloon manometry were performed at baseline and after 12 weeks of therapy. Primary outcome measures consisted of incontinent episodes per week and vaginal pressure measurements. Results: Both treatment groups had a reduction in incontinent episodes (P less than or equal to 0.004). Vaginal pressures increased more with pelvic floor muscle training than with bladder training (P = 0.0003). Other than a weak correlation between a reduction in incontinent episodes/week and an increase in maximum sustained vaginal pressure in women with GSI (r = 0.32, P = 0.04), there were no significant correlations between increases in pelvic floor muscle strength and improvement in continence status. There were no significant correlations between baseline demographic characteristics, clinical incontinence severity, or urodynamic measures and increases in vaginal pressure or improvement in clinical severity after pelvic floor muscle training. Conclusions: Pelvic floor muscle training improves continence and increases vaginal pressure measurements, but the direct correlations between these alterations are weak. A woman's response to behavioral treatment does not depend on her demographic characteristics, clinical incontinence severity, urodynamic measures, or initial pelvic floor muscle strength. (C) 2002 Wiley-Liss, Inc.