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1.
Kincade JE Dougherty MC Busby-Whitehead J Carlson JR Nix WB Kelsey DT Smith FC Hunter GS Rix AD 《Urologic nursing》2005,25(5):353-363
Urinary incontinence (UI) is a common chronic condition among women. Treatment of UI can involve behavioral techniques, pharmacological strategies, or surgical intervention. Clinically, treatment strategies should start with the simplest and least invasive measures. To overcome the deficiencies in previous research and provide definitive information for clinical practice, a randomized clinical trial is currently underway. This clinical trial uses a pretest-posttest design to first determine the effectiveness of self-monitoring techniques before subjects are randomized into one of two treatment groups or an attentional control group with a 1-year followup. The study design, sampling plan, and interventions used in an ongoing clinical trial to assess the effectiveness of self-monitoring and efficacy of biofeedback to treat UI in women are described. Innovative techniques to assess adherence to the pelvic muscle exercise protocol are addressed. 相似文献
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目的 探讨盆底肌肉训练在产后压力性尿失禁产妇中的临床作用。 方法 对60例产妇入院资料进行分析,将其随机分为2组。2组均进行常规护理,实验组在常规护理的基础上进行盆底肌肉训练。在产妇产后1年,通过问卷调查、尿垫试验和盆底肌力评价2组盆底肌肉训练的效果。 结果 实验组产后12个月排尿状况评分为(1.86±0.33)分,低于对照组(2.60±0.47)分,差异有统计学意义(t=19.71,P<0.05);产后12个月盆底肌力评分为(4.46±0.42)分,高于对照组(3.13±0.39)分,差异亦有统计学意义(t=18.82,P<0.01);实验组产后12个月尿垫试验阳性率为10.00%,低于对照组36.67%(χ2=4.56,P<0.05)。 结论 产后压力性尿失禁采用盆底肌肉训练治疗效果理想。 相似文献
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刘振华 《医药高职教育与现代护理》2020,3(2):119-122
目的 探讨King互动达标理论对老年压力性尿失禁患者盆底肌训练依从性的影响。方法 按照随机数字表法将2018年1月至2019年2月河池市妇幼保健院收治的100例老年压力性尿失禁盆底肌训练患者分为对照组和观察组各50例,对照组给予压力性尿失禁常规护理,观察组将King互动达标理论应用于护理干预中,观察比较两组患者干预后盆底肌训练依从情况,以及干预前和干预后两组患者最大尿道压(MUP)、最大尿道关闭压(MUCP)。结果 观察组患者干预后盆底肌训练依从率高于对照组(96% vs. 70%)(P<0.01)。干预前两组患者MUP和MUCP差异无统计学意义(P>0.05);干预6个月后,两组患者MUP和MUCP均较干预前提高,且干预组高于对照组(P<0.01)。结论 King互动达标理论用于老年压力性尿失禁护理干预中能提高患者盆底肌训练依从性,促进患者膀胱和尿道功能的康复,值得临床推广应用。 相似文献
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Swati Jha Stephen J. Walters Oscar Bortolami Simon Dixon Abualbishr Alshreef 《Physiotherapy》2018,104(1):91-97
Aims
To evaluate the clinical and cost-effectiveness of electric stimulation plus standard pelvic floor muscle training compared to standard pelvic floor muscle training alone in women with urinary incontinence and sexual dysfunction.Methods
Single centre two arm parallel group randomised controlled trial conducted in a Teaching hospital in England. Participants were women presenting with urinary incontinence and sexual dysfunction. The interventions compared were electric stimulation versus standard pelvic floor muscle training.Outcome measures
included Prolapse and Incontinence Sexual function Questionnaire (PISQ) physical function dimension at post-treatment (primary); other dimensions of PISQ, SF-36; EQ-5D, EPAQ, resource use, adverse events and cost-effectiveness (secondary outcomes).Results
114 women were randomised (Intervention n = 57; Control group n = 57). 64/114 (56%).Participants
had valid primary outcome data at follow-up (Intervention 30; Control 34). The mean PISQ-PF dimension scores at follow-up were 33.1 (SD 5.5) and 32.3 (SD 5.2) for the Intervention and Control groups respectively; with the Control group having a higher (better) score. After adjusting for baseline score, BMI, menopausal status, time from randomisation and baseline oxford scale score the mean difference was ?1.0 (95% CI: ?4.0 to 1.9; P = 0.474).There was no differences between the groups in any of the secondary outcomes at follow-up. Within this study, the use of electrical stimulation was cost-effective with very small incremental costs and quality adjusted life years (QALYs).Conclusions
In women presenting with urinary incontinence in conjunction with sexual dysfunction, physiotherapy is beneficial to improve overall sexual function. However no specific form of physiotherapy is beneficial over another.Trial registration ISRCTN09586238. 相似文献6.
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Camila Teixeira Vaz Rosana Ferreira Sampaio Fernanda Saltiel Elyonara Mello Figueiredo 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2019,23(2):116-124
Background
Although the efficacy of pelvic floor muscle training (PFMT) and bladder training are well established, there is a paucity of patient centered models using these interventions to treat women with UI at primary level of health assistance in Brazil.Objective
To investigate the effectiveness of a physical therapy intervention to treat women with UI in primary health centers.Methods
Pragmatic non-randomized controlled trial in which women with UI from the community participated in a supervised physical therapy program consisting of bladder training plus 12 weeks of PFMT, performed either at home or in the health center. Outcome measures were amount and frequency of urine loss measured by the 24-h pad-test and the 24-h voiding diary; secondary outcome was the impact of UI on quality of life measured by the ICIQ-SF. Outcomes were measured at baseline, at the 6th and 12th weeks of the intervention and 1 month after discharge.Results
Interventions reduced the amount (pad-test, p = 0.004; d = 0.13, 95% CI = ?0.23 to 0.49) and frequency of urine loss (voiding diary, p = 0.003; d = 0.51, 95%CI = 0.14 to 0.87), and the impact of UI on quality of life (ICIQ-SF, p < 0.001; d = 1.26, 95%CI = 0.87 to 1.66) over time, with positive effects from the 6th week up to 1 month for both intervention setting (home and health center), and no differences between them.Conclusion
Interventions were effective, can be implemented in primary health centers favoring the treatment of a greater number of women who do not have access to specialized physical therapy.Trial registration: RBR-8tww4y. 相似文献8.
Erica Feio Carneiro Nunes Luciana Maria Malosá Sampaio Daniela Aparecida Biasotto-Gonzalez Reny Costa dos Reis Nagano Paulo Roberto Garcia Lucareli Fabiano Politti 《Physiotherapy》2019,105(1):10-23
Background
Several clinical effects have been attributed to the use of biofeedback (BF) as an adjuvant in the treatment of women with stress urinary incontinence (SUI).Objectives
To determine whether BF is more effective than other interventions for women with SUI in terms of quantification of urine leakage, episodes of urinary loss, quality of life and muscle strength.Data sources
Science Direct, Embase, MEDLINE, Pedro, SciELO, CINAHL and LILACS from January 2000 to February 2017.Study selection
Randomised controlled trials (RCTs) addressing the effects of pelvic muscle floor training (PFMT) with BF for the conservative treatment of women with SUI.Data extraction and data synthesis
Two independent assessors extracted data from articles. The risk of bias for individual studies was assessed using the Jadad scale and Physiotherapy Evidence Database (PEDro) scale. Mean differences (MD) and 95% confidence intervals were calculated and combined in meta-analyses.Results
In total, 1194 studies were retrieved and 11 were included in this review. Only two RCTs demonstrated a low risk of bias according to the PEDro scale. The results demonstrated that PFMT with BF was no better than alternative interventions in terms of muscle strength measured using a perineometer.Limitations
Low methodological quality of studies, heterogeneity of outcomes, and differences in implementation of intervention protocols and BF modalities.Conclusions
PFMT with BF does not offer therapeutic benefits over alternative interventions (no training, PFMT alone and vaginal electrical stimulation) for the treatment of female SUI.Systematic review registration number PROSPERO
CRD42017060780. 相似文献9.
盆底肌肉功能锻炼治疗女性轻中度压力性尿失禁的临床研究 总被引:1,自引:0,他引:1
目的观察盆底肌肉功能锻炼治疗女性轻、中度压力性尿失禁(SUI)的临床疗效,为寻找合适的治疗方法提供理论参考。方法将107例轻、中度SUI患者随机分为治疗组和对照组。对照组采用常规药物治疗,治疗组采用盆底肌肉功能锻炼治疗。连续治疗12周后评价临床疗效,观察治疗前后两组患者尿动力学指标的变化。结果 (1)两组患者的最大尿流率、平均尿流率与治疗前比较显著下降(P0.05)。两组患者的排尿时间、功能性尿道长、最大尿道关闭压与治疗前比较显著上升(P0.05),且治疗组与对照组比较均有显著性差异(P0.05);(2)治疗组临床疗效总有效率为92.2%,显著高于对照组(P0.05)。结论盆底肌肉功能锻炼是轻、中度女性SUI患者的首选治疗方法 ,值得临床推广应用。 相似文献
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女性张力性尿失禁的主要高危因素有妊娠、阴道分娩尤其是阴道助产或分娩巨大儿史、多产及肥胖,严重影响患者的生活质量。其治疗方法有非手术治疗和手术治疗,前者主要有盆底肌锻炼、盆底电刺激疗法及药物治疗等,盆底肌锻炼是研究热点之一。对张力性尿失禁做盆底肌锻炼治疗具有重要意义。 相似文献
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目的比较观察盆底肌肉功能锻炼与手术治疗女性中度压力性尿失禁(SUI)的临床疗效,为寻找合适的治疗方法提供理论参考。方法将114例中度SUI患者随机分为治疗组58例和对照组56例。对照组采用经闭孔阴道无张力吊带术(TVT-O)治疗,治疗组采用盆底肌肉功能锻炼治疗。连续治疗12周后评价临床疗效和生活质量,进行成本/效益分析。结果治疗组临床疗效总有效率为86.2%,高于对照组的83.9%。治疗后2组患者的生活质量得分与治疗前比较显著上升,尿失禁问卷得分与治疗前比较显著下降,且治疗组与对照组之间有差异。成本/效益分析表明,治疗组患者的医疗总成本、临床总有效率每增长一个百分点需要花费的成本和生活质量增长1分需要花费的成本均显著低于对照组。结论盆底肌肉功能锻炼是中度女性SUI患者的首选治疗方法,应当推广和应用。 相似文献
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背景:女性盆底肌生物反馈治疗仪已广泛应用于压力性尿失禁的治疗,其原理是利用从患者身上测量的肌电信号,并结合生物反馈技术和电疗技术来治疗女性尿失禁。目的:探讨盆底生物刺激反馈治疗对女性压力性尿失禁的治疗效果。方法:采用盆底生物刺激反馈治疗仪治疗30例轻、中度压力性尿失禁女性患者,治疗时间4-8周,设置刺激参数60 Hz、20-60 mA,反馈12 s指导患者收缩盆底肌肉,分析治疗前后患者盆底肌肉2 s快速收缩表面肌电最大值、盆底肌肉持续10 s收缩表面肌电平均值、盆底肌肉60 s耐受收缩表面肌电平均值变化,并观察每天漏尿次数。结果与结论:患者治疗后盆底肌肉2 s快速收缩表面肌电最大值、盆底肌肉持续10 s收缩表面肌电平均值、盆底肌肉60 s耐受收缩表面肌电平均值等较治疗前有明显增高(P 〈0.05)、平均每日漏尿次数较治疗前明显减少(P〈0.05)。结果证实,盆底生物刺激反馈治疗可明显增加女性轻、中度压力性尿失禁患者盆底肌肉收缩表面肌电值,疗效较好。 相似文献
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目的 比较观察盆底肌肉功能锻炼与手术治疗女性中度压力性尿失禁(SUI)的临床疗效,为寻找合适的治疗方法提供理论参考.方法 将114例中度SUI患者随机分为治疗组58例和对照组56例.对照组采用经闭孔阴道无张力吊带术(TVT-O)治疗,治疗组采用盆底肌肉功能锻炼治疗.连续治疗12周后评价临床疗效和生活质量,进行成本/效益分析.结果 治疗组临床疗效总有效率为86.2%,高于对照组的83.9%.治疗后2组患者的生活质量得分与治疗前比较显著上升,尿失禁问卷得分与治疗前比较显著下降,且治疗组与对照组之间有差异.成本/效益分析表明,治疗组患者的医疗总成本、临床总有效率每增长一个百分点需要花费的成本和生活质量增长1分需要花费的成本均显著低于对照组.结论 盆底肌肉功能锻炼是中度女性SUI患者的首选治疗方法,应当推广和应用. 相似文献
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Experience of pelvic floor muscle exercises among women in Taiwan: a qualitative study of improvement in urinary incontinence and sexuality
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Hsia‐Tzu Kao MSN RN Mark Hayter PhD RN MMed. Sci Sharron Hinchliff PhD BSc PGCertHE Chuan‐Hsiu Tsai PhD RN Min‐Tao Hsu PhD RN 《Journal of clinical nursing》2015,24(13-14):1985-1994
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Markus Huebner Katja Riegel Heidemarie Hinninghofen Diethelm Wallwiener Ralf Tunn Christl Reisenauer 《Physiotherapy research international》2011,16(3):133-140
Background and Purpose. Pelvic floor muscle training (PFMT) is an effective therapy for stress urinary incontinence (SUI). There is little and inconsistent data about different strategies of PFMT. Finding the right, patient‐oriented treatment decision seems to be essential in order to achieve good results in conservative management of SUI. It was the aim of this prospective randomized controlled trial (RCT) to compare three different strategies using electromyography (EMG) biofeedback‐assisted PFMT with and without electrical stimulation (ES) for treatment of SUI in women capable of voluntarily contracting the pelvic floor when a home‐training device with vaginal electrode was used. Method. Three‐arm RCT comparing 1) EMG biofeedback‐assisted PFMT and conventional ES; 2) EMG biofeedback‐assisted PFMT and dynamic ES; and 3) EMG biofeedback‐assisted PFMT. Primary outcome measures were quality of life (King's Health Questionnaire) and degree of suffering (rated on a visual analogue scale from 1 to 10). Secondary outcome measures were number of pads used, pad weight test, contractility of the pelvic floor measured by digital palpation and intra‐vaginal EMG. Results. The quality of life significantly increased over the 12‐week training. The number of pads used was reduced, the pad weight test and the contractility of the pelvic floor significantly improved. There were no significant differences between the three groups. Conclusion. This RCT shows significant improvement in patients' quality of life for conservative therapy of SUI. Differences between the three therapeutic options analyzed could not be found. Additional ES showed no benefit for patients with SUI, capable of voluntary pelvic floor contraction. Copyright © 2010 John Wiley & Sons, Ltd. 相似文献
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<正>我国成年女性中,压力性尿失禁(stressurinary incontinence,SUI)患病率高达18.9%[1]。临床多通过病史、症状及体征诊断SUI,但对判断SUI病因及识别合并症存在一定困难[2-3]。妊娠及分娩是导致神经、周围结缔组织和盆底肌肉损伤重要因素[4]。盆底超声可从形态及功能两方面综合评估膀胱、尿道及周围病变,实时、动态显示膀胱颈、尿道运动轨迹,早期发现尿道高活动度型SUI; 相似文献
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盆底肌功能训练预防产后尿失禁的临床效果观察 总被引:14,自引:1,他引:14
目的 探讨Kegel盆底肌功能训练法对于预防产后尿失禁的效果.方法 将162例足月初产头住分娩的产妇,随机分为观察组(90例)和对照组(72例).观察组进行10周以上的Kegel盆底肌功能训练,对照组进行一般的产后健康教育.两组均于产后6个月随访,评价Kegel训练的效果.结果 观察组有76例产妇(84.4%)可坚持进行盆底肌功能训练,其尿失禁发生率明显低于对照组,差异有显著性意义(P<0.05).结论 产后Kegel盆底肌功能训练方法简单,产妇的依从性好,可以有效预防并治疗产后尿失禁. 相似文献
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目的调查产后压力性尿失禁(SUI)患者盆底肌训练知信行情况。方法便利选取2018年1月—2019年1月北京某妇产医院产后12周在盆底门诊就诊患者213例,采用产褥期妇女盆底肌功能锻炼知信行及需求问卷进行调查,分析患者盆底肌功能锻炼知信行的影响因素。结果213例SUI患者盆底肌训练知信行总体标准分为(75.70±10.23)分。单因素分析显示,不同年龄、家庭人均月收入、最高受教育程度、职业状况、分娩方式、孕期体重增长、当前是否有尿失禁患者盆底功能锻炼知信行水平比较,差异均有统计学意义(P<0.2)。多重回归分析显示,家庭人均月收入、孕期体重增长及当前是否存在尿失禁是盆底功能锻炼知信行水平的影响因素(P<0.05)。结论产后压力性尿失禁患者盆底肌功能锻炼的态度积极,但认知水平仍有待提高,医护人员应加强相关知识的宣教,增强患者对于盆底功能锻炼重要性的认识。 相似文献
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目的 基于术前盆底超声参数构建列线图模型,探讨其预测盆底脏器脱垂(POP)患者盆底重建术后发生进展性压力性尿失禁(SUI)的价值。方法 选取2019年5月至2022年4月我院因国际泌尿科学会POP-Q分度≥Ⅱ度行盆底重建术女性患者495例建立预测模型作为模型组,其中术前POP合并SUI 295例;根据术前、术后SUI发生情况分为术后进展组76例(包括新发46例,加重30例)与SUI改善组219例;对模型组样本采取Bootstrap法重复抽样1000次作为内部验证组。应用单因素分析、多因素Logistic回归分析POP患者盆底重建术后发生进展性SUI的独立危险因素,并构建列线图模型。绘制受试者工作特征曲线、校准曲线、临床决策曲线、临床影响曲线对该模型区分度、校准度及临床适用性进行验证。结果 (1)单因素分析显示,SUI改善组与术后进展组孕次、产次、Ba点及指压诱发试验阳性、高血压史、糖尿病史、术前混合性尿失禁史、联合尿道中段无张力悬吊术(TVT-O)占比,以及盆底超声所测残余尿量(PVR)、尿道旋转角(Uret.rot)、尿道内口呈漏斗样改变、肛提肌损伤比较差异均有统计学意义(均P<... 相似文献