Effectiveness of exercise interventions on urinary incontinence and pelvic organ prolapse in pregnant and postpartum women: umbrella review and clinical guideline development.

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Jbi Evidence Implementation Pub Date : 2023-12-01 DOI:10.1097/XEB.0000000000000391
Iina Ryhtä, Anna Axelin, Heidi Parisod, Arja Holopainen, Lotta Hamari
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Abstract

Introduction and aims: Dysfunction related to pelvic floor muscles (PFM) is common among pregnant and postpartum women and can cause symptoms such as urinary incontinence or pelvic organ prolapse (POP). As part of developing a nationwide clinical practice guideline for nursing in Finland, the aim of this umbrella review is to summarize the existing evidence about the effectiveness of exercise interventions on urinary incontinence and POP in pregnant and postpartum women. To promote knowledge translation, recommendations for health care professionals are presented.

Methods: We conducted an umbrella review to summarize the existing evidence. The JBI methodology for umbrella reviews was used to guide the review. The level of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, and recommendations based on the evidence were formulated by a clinical guideline working group.

Results: Altogether, 9 systematic reviews, reporting findings from 89 original studies, were included. The methodological quality of the reviews was evaluated using JBI's checklist. The highest level of evidence was found for preventing the symptoms of postpartum urinary incontinence through exercise and pelvic floor muscle training (PFMT) during pregnancy. Moderate-level evidence showed that exercise and PFMT are likely to reduce the symptoms and severity of urinary incontinence, but the level of evidence was low on PFMT reducing the symptoms of POP.

Conclusion: We recommend encouraging and guiding pregnant and postpartum women to exercise and train PFM. We also recommend identifying pregnant and postpartum women with symptoms of PFM dysfunction and directing them to a physiotherapist or other health care professional specializing in pelvic floor function.

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运动干预对妊娠和产后妇女尿失禁和盆腔器官脱垂的有效性:总括综述和临床指南制定。
引言和目的:与盆底肌(PFM)相关的功能障碍在孕妇和产后妇女中很常见,并可能导致尿失禁或盆腔器官脱垂(POP)等症状。作为制定芬兰全国护理临床实践指南的一部分,本综述的目的是总结关于运动干预对孕妇和产后妇女尿失禁和POP有效性的现有证据。为了促进知识翻译,提出了对卫生保健专业人员的建议。方法:我们进行了一项总括性审查,以总结现有的证据。综合审查采用了JBI方法来指导审查。证据水平采用建议、评估、发展和评估分级(GRADE)方法进行评估,临床指南工作组根据证据制定建议。结果:共纳入9项系统综述,报告了89项原始研究的结果。使用JBI的检查表对审查的方法质量进行了评估。在怀孕期间,通过运动和盆底肌肉训练(PFMT)预防产后尿失禁症状的证据最高。中等程度的证据表明,运动和PFMT有可能减轻尿失禁的症状和严重程度,但PFMT减轻POP症状的证据水平较低。结论:我们建议鼓励和指导孕妇和产后妇女锻炼和训练PFM。我们还建议识别有PFM功能障碍症状的孕妇和产后妇女,并指导她们去找物理治疗师或其他专门研究盆底功能的医疗保健专业人员。
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CiteScore
3.20
自引率
13.00%
发文量
23
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