Determining the Optimal Pelvic Floor Muscle Training Regimen for Women with Stress Urinary Incontinence
Determining the Optimal Pelvic Floor Muscle Training Regimen for Women with Stress Urinary Incontinence
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DOI：
10.1002/nau.21104
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发表时间：
2011-01-01
影响因子：
2
通讯作者：
Jenkinson, David
中科院分区：
文献类型：
--
作者：
Dumoulin, Chantale;Glazener, Cathryn;Jenkinson, David
骨盆底肌肉（PFM）训练在女性压力性尿失禁（SUI）的治疗中获得了A级证据评级，这是基于大量随机对照试验（RCT）的荟萃分析，并在许多已发表的指南中得到推荐。然而，在这些随机对照试验中，实际使用的PFM训练方案差异很大。因此，到目前为止，最佳的PFM训练方案，以实现可持续发展仍然是未知的，以下问题仍然存在：多久应该妇女参加PFM训练课程和多少收缩，他们应该执行最大的效果？强化锻炼的养生法比运动控制策略或功能再训练更好吗？它是更好地管理一个PFM训练方案，以个人或小组会议同样有效，或更好？哪一个更好，PFM训练本身或结合生物反馈，神经肌肉电刺激，和/或阴道锥？我们应该用改善还是治愈作为最终结果来确定哪种方案是最好的？问题是无止境的。作为我们努力确定最佳PFM训练方案的起点，本研究的目的是（a）审查目前关于不同PFM训练方案对SUI妇女有效性的证据，（B）讨论SUI妇女PFM功能障碍的现有文献，包括骨骼肌训练理论的最新证据和其他已知影响妇女参与和坚持PFM训练的因素。Neurorol。Urodynam。30：746-753，2011. (C)2011 Wiley-Liss，Inc.
Pelvic floor muscle (PFM) training has received Level-A evidence rating in the treatment of stress urinary incontinence (SUI) in women, based on meta-analysis of numerous randomized control trials (RCTs) and is recommended in many published guidelines. However, the actual regimen of PFM training used varies widely in these RCTs. Hence, to date, the optimal PFM training regimen for achieving continence remains unknown and the following questions persist: how often should women attend PFM training sessions and how many contractions should they perform for maximal effect? Is a regimen of strengthening exercises better than a motor control strategy or functional retraining? Is it better to administer a PFM training regimen to an individual or are group sessions equally effective, or better? Which is better, PFM training by itself or in combination with biofeedback, neuromuscular electrical stimulation, and/or vaginal cones? Should we use improvement or cure as the ultimate outcome to determine which regimen is the best? The questions are endless. As a starting point in our endeavour to identify optimal PFM training regimens, the aim of this study is (a) to review the present evidence in terms of the effectiveness of different PFM training regimens in women with SUI and (b) to discuss the current literature on PFM dysfunction in SUI women, including the up-to-date evidence on skeletal muscle training theory and other factors known to impact on women's participation in and adherence to PFM training. Neurourol. Urodynam. 30:746-753, 2011. (C) 2011 Wiley-Liss, Inc.