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An effective and easy to insist on self-made pelvic floor muscle rehabilitation for the elderly women with stress urinary incontinence

2019-01-15 06:47:46
TMR Non-Drug Therapy 2019年3期

An effective and easy to insist on self-made pelvic floor muscle rehabilitation for the elderly women with stress urinary incontinence

Stress urinary incontinence (SUI) refers to involuntary urine overflow in patients with sudden increases in abdominal pressure such as exercise, sneezing or coughing [1]. Pepsi floor muscle training (PFMT), also known as Kegel exercise, enhances the strength, control and coordination of the pelvic floor muscles and detrusor pressure, allowing patients to learn to pre-control the pelvic floor before increasing abdominal pressure [2].

An important predictor of overall effectiveness of pelvic floor muscle training is patient compliance. Although pelvic floor muscle training is effective for the treatment of SUI, long-term adherence to pelvic floor muscle training has been questioned. Studies have shown that, the proportion of long-term adherence to pelvic floor muscle training is 10% to 70% [3]. Clinicians estimate that 64% of patients can adhere to pelvic floor muscle training and health counseling for a short period of time, but only 23% of patients persist in training for a long time [4]. The poor performance of pelvic floor muscle training is mainly due to the fact that patients can not complete the exercise program as planned, cannot meet the exercise intensity and frequency required by the plan, and cannot adhere to the exercise plan for a long time [5].

This self-made pelvic floor muscle rehabilitation focused on the muscle strength of the pelvic floor muscle to improve the SUI of the elderly women. At the same time, it cooperates with abdominal breathing and abdominal muscle training to improve the abdominal pressure of women and solve the stress from the source. After 10 weeks of pelvic floor muscle rehabilitation training, the 72-hour average frequency of urinary incontinence was 1.02 ± 0.65 times, which was not statistically different from that before training (1.25 ± 0.71,> 0.05). The score of ICIQ-SF was 5.95 ± 1.32, which was significantly lower than that before training (7.0 ± 1.38,< 0.05), and the urinary incontinence severity index was 2.75 ± 0.89, which was significantly lower than that before training (3.95 ± 1.32,< 0.01). The weight of 1 hour urine pad was 6.40 ± 2.29 g and was significantly lower than that before training (< 0.01, 8.37 ± 2.24). Self-created pelvic floor muscle rehabilitation had the function of decreasing the quantity of urinary incontinence instead of the frequency of incontinence. More important, during the implementation of this program, through the WeChat, the subjects could communicate on a daily or regular basis to promote compliance, and to find out where the deficiencies or subjects are uncomfortable in order to proceed better. It promoted the long-term adherence to pelvic floor muscle training. Therefore, it is hoped that the self-made pelvic floor muscle rehabilitation exercise programmed in this experiment can be familiarized and practiced by more elderly women and used to improve the problem of SUI in older women. Link: https://www.tmrjournals.com/ndt/EN/10.12032/TMRND201902011

Xiong-Zhi Wu

Editor-in-Chief of TMR Non-Drug Therapy

1. Mcguire EJ, Lytton B, Pepe V,. Stress urinary incontinence. Obstetrics Gynecology 1976, 47: 255-264.

2. Nambiar AK, Bosch R, Cruz F,EAU Guidelines on assessment and nonsurgical management of urinary incontinence. Eur Urol 2018, 73: 596-609.

3. Bo K, Hilde G. Does it Work in the Long Term? A systematic review on pelvic floor muscle training for female stress urinary incontinence. Neurourol Urodyn 2013, 32: 215-223.

4. Dumoulin C, Hay-Smith J, Frawley H,2014 consensus statement on improving pelvic floor muscle training adherence: international continence society 2011 state-of-thescience Seminar. Neurourol Urodyn 2015, 34: 600-605.

5. Pelaez M, Gonzalez CS, Montejo R,Pelvic floor muscle training included in a pregnancy exercise program is effective in primary prevention of urinary incontinence: a randomized controlled trial. Neurourol Urodyn 2014, 33: 67-71.

10.12032/TMRND201902016

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