SPECIFIC EDUCATION, EXERCISE, AND STRESS INCONTINENCE

约27%的65岁以上女性会患尿失禁 好几年了。超过75%的大小便失禁老年女性有压力尿 大小便失禁(SI)单独或作为混合性尿失禁的重要组成部分 大小便失禁。在这项研究中，我们寻求改善 中度SI的保守治疗。凯格尔运动(KE)是常见的 用于增强盆底肌肉的处方，特别是 重点是提肛肌(LA)。然而，有多少好处 这种治疗可以归因于LA的实际加强，以及 有多少可以归因于教育部分，哪些患者， 明知和不知不觉中也收到了，不清楚。教育性的 内容包括一般的膀胱训练，更具体地说， 了解LA在哪里、何时以及为什么可以使用它们来防止SI 而且，在最基本的层面上，如何感染他们的“诀窍” 是自愿的。在第一阶段，我们将使用随机的三组 (60+60+60)，首次量化疗效的对照试验 关于治疗SI的教育。我们将招募至少180名65-84岁的老年人 三年)有中度SI(1-3次尿液)的社区分娩妇女 剧集/天)用于本研究。特定教育组(ED组，n=60) 将在三个月内进行随访，以确定结果 措施，包括每日尿液次数和泄漏点 压力，与等待名单上的不治疗相比显示出显著的变化 (n=60)对照组。我们还将确定一个三个月的科科 干预(KE组，n=60)，包括锻炼以增强 除了ED计划外，LA的结果明显更好 3个月和6个月的随访结果，而不是单独使用ED。艾克集团LA 强度变化将使用仪表式望远镜进行量化。全 三个组别将根据普通教育和体力活动进行分层 以评估其对结果的影响。在第二阶段，我们将 进行发展研究，以提高第一阶段干预的有效性 通过确定(A)加权阴道锥体的使用-接受度 学习收缩左房和(B)加强左房肌肉。

Urinary incontinence affects approximately 27% of women over the age of 65 years. Over 75% of incontinent elderly women have stress urinary incontinence (SI) either alone or as a significant component of mixed incontinence. In this research we seek insights for improving the conservative treatment of moderate SI. Kegel exercises (KE) are commonly prescribed to strengthen the pelvic floor muscles, with particular emphasis on the levator ani (LA). However, how much any benefits derived from this treatment can be ascribed to actual strengthening of the LA, and how much can be ascribed to the educational component which patients, knowingly and unknowingly also receive, is unclear. The educational component includes general bladder training and, more specifically, learning where the LA are, when and why they can be of use to prevent SI and, at a very basic level, the "knack" of how to contract them volitionally. In Phase I we will use a randomized, three group (60+60+60), controlled trial to quantify, for the first time, the effect of education on treating SI. We will recruit at least 180 elderly 65-84 years) parous community-dwelling women with moderate SI (1-3 wetting episodes/day) for this study. A specific education group (ED group, n=60) will be followed over three months in order to determine whether outcome measures, including the number of daily wetting episodes and leak point pressures, show significant changes relative to a wait-listed no-treatment (NT, n=60) control group. We will also determine whether a three month KE intervention (KE group, n=60), which includes exercise to strengthen the LA in addition to the ED program, results in a significantly better outcome at three and six months follow-up than ED alone. ED & KE group LA strength changes will be quantified using an instrumented speculum. All three groups will be stratified by general education and physical activity levels in order to evaluate their effects on outcome. In Phase II we will conduct development studies to enhance Phase I intervention effectiveness by determining the use-acceptance of weighted vaginal cones for (a) learning to contract the LA and (b) strengthening the LA muscles.