盆底肌训练治疗压力性尿失禁1例腓骨肌肌萎缩症

Letícia A. Ferreira PT, MSc, Fátima F. Fitz PT, PhD, Márcia M. Gimenez PT, PhD, Mayanni M.P. Matias PT, Maria A.T. Bortolini MD, PhD, Rodrigo A. Castro MD, PhD
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摘要

目的本报告的目的是描述盆底肌肉训练(PFMT)对女性沙科-玛丽-图斯病(CMT)应激性尿失禁(SUI)的影响。临床特征:一名50岁女性患者,诊断为II型CMT疾病,因主诉努力时尿失(即咳嗽和打喷嚏)而入院治疗。她报告说症状开始于大约36个月前。尿动力学研究显示SUI伴有Valsalva泄漏点压力84 cmH2O。干预和结果:SUI的治疗通过PFMT计划进行12周(在监督下),另外12周在家锻炼。一名专门的物理治疗师测量了SUI的症状和严重程度(3天尿日记,1小时尿垫试验),盆底肌肉功能(指诊,测压和测力),SUI对生活质量的影响(失禁生活质量问卷),以及对门诊和家庭锻炼的依从性,这些也被评估(运动日记)。结论本例CMT患者经PFMT治疗后,尿路症状、SUI严重程度、盆底肌功能及SUI对生活质量的影响均有改善。
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Management of Stress Urinary Incontinence With Pelvic Floor Muscle Training for a Woman With Charcot-Marie-Tooth Disease: A Case Report

Objective

The purpose of this report is to describe the effects of pelvic floor muscle training (PFMT) in stress urinary incontinence (SUI) of a woman with Charcot-Marie-Tooth (CMT) disease.

Clinical Features

A 50-year-old female patient with a diagnosis of type II CMT disease was referred to treatment as a result of a complaint of urinary loss upon effort (ie, coughing and sneezing). She reported that the symptoms started about 36 months prior. The urodynamic study revealed SUI with a Valsalva leak point pressure of 84 cmH2O.

Intervention and Outcome

The treatment of SUI was carried out through a PFMT program for 12 weeks (with supervision) and exercises at home for another 12 weeks. A specialized physiotherapist measured symptoms and severity of SUI (3-day urinary diary, 1-hour pad test), pelvic floor muscle function (digital palpation, manometry and dynamometry), effect of the SUI on quality of life (Incontinence Quality of Life Questionnaire), and adherence to the outpatient sessions and to home exercise sets, which also were assessed (exercise diary).

Conclusion

In this patient with CMT disease, improvements in urinary symptoms and severity of SUI, pelvic floor muscle function, and effect of SUI on quality of life were noted after PFMT.

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