物理治疗对女性盆底功能障碍的影响随机对照试验

H. Ghani, Madiha Younas, M. Mustafa, Mahreen Aslam, Hamza Dastgir, Hira Rafique
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摘要

背景:盆底功能障碍是指盆底肌肉不能适当地放松和整合。便秘,膀胱/肠失禁和频繁的膀胱冲动是常见的症状。目的:探讨物理治疗对女性盆底功能障碍的影响。方法:随机对照试验于2021年2月至12月进行。采用方便抽样法将72例患者平均分为实验组和对照组,实验组接受盆底物理治疗,对照组接受常规护理。年龄在18岁到60岁之间患有盆底功能障碍的妇女被纳入试验。盆腔器官脱垂超过II期,泌尿道或阴道感染,不能理解或遵循指示的患者被排除在外。在基线和干预第4周后进行评估。年龄、体重指数和胎次等变量以平均值和标准差表示。使用Shapiro-Wilk检验评估数据的正态性。对该参数数据使用配对样本t检验计算处理前后读数之间的差异。p≤0.05为差异有统计学意义。结果:盆底物理治疗组年龄、体质指数、胎次分别为49.31(12.43%)、25.71(4.56%)、2.6(0.81%),对照组为51.23(9.37%)、26.33(5.32%)、2.2(93%),差异均无统计学意义(p值>0.05)。治疗后第4周评估时,实验组的峰值围膜测量值(cmH2O)为6.4(5.8),对照组为10.3(6.7);盆底痛苦量表短表为27.43(17.6),对照组为42.8(31.8);盆底冲击问卷短表为9.86(4.39),对照组为16.87(6.78),物理治疗组差异有统计学意义(p值>0.05)。结论:盆底物理治疗在缓解盆底功能障碍的控制、协调和痛苦方面明显优于对照组。
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Effects of Physical Therapy on Pelvic Floor Dysfunction Among Women; A Randomized Controlled Trial
Background: Pelvic floor dysfunction is the inability to relax and integrate the pelvic muscles appropriately. Constipation, bladder/bowel incontinence, and frequent bladder urges are the common symptoms. Objective: To determine the effects of physical therapy on pelvic floor dysfunction among women. Methods: It was a randomized controlled trial conducted between February to December 2021. About 72 patients were included using convenient sampling and they were equally divided into an experimental group receiving pelvic floor physical therapy and a control group receiving routine care. The woman aged between 18 to 60 years having pelvic floor dysfunction were included in the trial. Patients with pelvic organ prolapse more than stage II, urinary or vaginal tract infections and inability to understand or follow instructions were excluded. The assessment was made at baseline and after 4th week of intervention. Variables like age, body mass index and parity were presented as mean and standard deviation. The normality of the data was assessed using the Shapiro-Wilk test. The difference between pre and post-treatment readings was calculated using paired sample t-test for this parametric data. Statistical significance was set at p≤0.05. Results: The demographics including age, body mass index and parity were found to be 49.31 (12.43%), 25.71(4.56%) and 2.6(0.81%) in the pelvic floor physical therapy group and 51.23 (9.37%), 26.33(5.32%) and 2.2(93%) in the control group respectively, without any significant difference (p-value>0.05). After treatment at the 4th-week assessment, peak perineometer values (cmH2O) were found to be 6.4(5.8) in the experimental group versus 10.3(6.7) in the control group, pelvic floor distress inventory short form 27.43(17.6) versus 42.8(31.8) and short form of pelvic floor impact questionnaire 9.86(4.39) versus 16.87(6.78), with a significant difference in favor of physical therapy group (p-value>0.05). Conclusion: The study concluded that pelvic floor physical therapy is significantly better as compared to the control group for relieving pelvic floor dysfunction including its control, coordination and distress.
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