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【Objective】 To investigate the clinical effects of electrophysiological technique combined with pelvic floor muscle training on urinary incontinence after electroresection of benign prostatic hyperplasia (BPH) based on the concept of enhanced recovery after surgery (ERAS). 【Methods】 A total of 86 patients with urinary incontinence treated with electroresection of BPH during Oct.2019 and Feb.2022 were randomly divided into control group and observation group, with 43 cases in either group. All patients received health education plus pelvic floor muscle training, and the observation group also received electrophysiological treatment. The differences in the indexes before and after treatment were compared between the two groups. 【Results】 There were no significant differences in the 1 h pad test, ICIQ-SF score, maximum urinary flow rate (Qmax), post void residual (PVR), International Prostate Symptom Score (IPSS), 24 h urinary incontinence frequency, and Urinary Incontinence Quality of Life Questionnaire Score (I-QoL) before treatment between the two groups (P>0.05). However, after treatment, Qmax and I-QoL score were significantly higher in the observation group than in the control group, while the other 5 indicators were significantly lower in the observation group than in the control group (all P<0.05). The total clinical effective rate was significantly higher in the observation group than in the control group (P<0.05). 【Conclusion】 Electrophysiological technique combined with pelvic floor muscle training can effectively improve the symptoms of urinary incontinence and promote the recovery of urinary control function, which is in line with the concept of ERAS and is worthy of further research and promotion.
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Pelvic floor trauma developing into pelvic frailty is a significant concern in urogynecology or orthopedics. The majority of women who have experienced vaginal childbirth are affected, to a certain extent, by some form of pelvic floor damage, thereby eliciting substantial alterations of functional anatomy in the pelvic cavity which are manifested as urinary incontinence or pelvic organ prolapse (e.g., uterine prolapse). With the above in mind, medical researchers, continence experts, and continence exercise practitioners in the research areas of sports medicine and rehabilitation medicine believe that the coordinated activity of pelvic floor muscles, in association with the abdominal muscles, is a prerequisite for urinary and defecatory continence. Since the pelvic floor forms the base of the abdominal cavity, stronger pelvic floor muscles are crucial in maintaining such capabilities. Opposing action of the abdominal and pelvic floor muscles ensures that exercises for one may also strengthen the other. Appropriate abdominal maneuverability or logical exercise training of the abdominal muscles may thus be beneficial in maintaining not only strength but also coordination, flexibility, and endurance of pelvic floor muscles and abdominal muscles. Such exercises, collectively known as pelvic floor muscle training, may be effective for long-term pelvic cavity care and also in rehabilitating cases of pelvic floor dysfunction. Further research is needed, however, in determining whether pelvic floor muscle function can be truly enhanced or maintained by such exercises in cases of pelvic floor dysfunction and/or decreased urinary continence.
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Objective@#To investigate the difference in behavioral characteristics among different phenotypes of attention deficit hyperactivity disorder (ADHD) using amplitude of low-frequency fluctuation (ALFF), so as to provide insights into clinical differentiation of behavioral characteristics among different phenotypes of ADHD.@*Methods@#The children with ADHD admitted to The Affiliated Hospital of Hangzhou Normal University were enrolled and classified into the inattentive type (ADHD-I), hyperactive/impulsive type (ADHD-HI) and combined type (ADHD-C). The reaction time (RT) was measured using integrated visual and auditory continuous performance test, and the mean (RT-mean) and standard deviation of RT (RT-SD) were estimated. In addition, the ALFF was calculated at 0.010 to 0.027, 0.027 to 0.073, 0.073 to 0.167 Hz, and the difference of ALFF was compared among children with different types of ADHD. @*Results@#A total of 107 children with ADHD were enrolled, including 95 boys and 12 girls, with a mean age of (8.89±1.93) years. There were 69 children with ADHD-I, 8 children with ADHD-HI and 30 children with ADHD-C. The RT-SD was significantly higher among children with ADHD-C than among children with ADHD-I [(126.003±51.619) ms vs. (97.720±45.302) ms; P=0.007]; however, there was no significant difference in RT-mean among children with various ADHD phenotypes (F=1.386, P=0.255). There was an interaction between frequency and ADHD phenotypes (F=2.754, P=0.032), and the ALFF was significantly higher among children with ADHD-C than among children with ADHD-I at 0.010 to 0.027 [(5 590.567±231.595) ms vs. (4 694.001±154.397) ms; P=0.002] and 0.073 to 0.167 Hz [(4 312.609±174.709) ms vs. (3 690.805±116.473) ms; P=0.005].@*Conclusions @#The ALFF varies in ADHD phenotypes, and there is a frequency-specific difference.
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Objective:To investigate the effect of pelvic floor muscle training on detrusor overactivity in patients with spinal cord injury. Methods:From August, 2019 to August, 2020, 17 patients with incomplete spinal cord injury were randomly divided into control group (n = 8) and experimental group (n = 9). Both groups accepted tolterodine tartrate 4 mg a day orally for twelve weeks, while the experimental group accepted pelvic floor muscle training. They were measured urodynamic indexes, and assessed with Neurogenic Bladder Symptom Scale and Patient Perception of Bladder Condition before and after treatment. Results:All the urodynamic indexes and scores of the scales improved in both groups after treatment (t > 3.674, |Z| > 2.646, P < 0.05), while the indexes of maximum bladder volume, first contraction pressure volume of detrusor, leakage point pressure of detrusor, maximum contraction pressure of detrusor and neurogenic bladder symptom score improved more in the experimental group than in the control group (|t| > 2.194, P < 0.05). Conclusion:Pelvic floor muscle training based on medicine can release the detrusor overactivity in patients with spinal cord injury.
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Pelvic floor muscle training is an important means for preventing and treating pelvic floor dysfunction.This article reviews the impact of gestational delivery on pelvic floor function,the role of pelvic floor muscle training,the current status of maternal pelvic floor muscle training,influencing factors,and the progress of interventions.It is suggested that medical staff should strengthen the health education of the pelvic floor muscle training for pregnant women and the compliance and standardization of maternal pelvic floor muscle training,so as to reduce the incidence of female pelvic floor dysfunction diseases and protect women's health.
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Objective To evaluate effect of continuous pelvic floor muscle training(PFMT) during pregnancy on delivery outcome, and to provide reference for clinical nursing work. Methods By searching database, the literature about continuous PFMT during pregnancy on delivery outcome were included,then EndNote was used to check the literature and RevMan5.2 was applied for Meta-analysis of the literature which met the inclusion criteria. Results A total of 11 papers were included. Meta-analysis showed that continuous PFMT during pregnancy can reduce lateral perineal resection rate (OR=0.66, 95%CI 0.48-0.89), increase rate of natural childbirth (OR=1.70, 95%CI 1.32-2.19) and promote progress of the first (MD=-0.52, 95%CI-0.92--0.12) and second (MD=-0.18, 95%CI-0.30--0.06) stage of labor. The intervention group shortened the first and the second stage of labor for 0.18h and 0.52h compared with the control group respectively. Conclusions Continuous PFMT during pregnancy can improve natural delivery rate, reduce the incidence of perineal side incision and shorten the time of labor, it is worthy of being promoted in clinical practice.
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Objective To investigate the impact of pelvic muscle training (PFMT) on the quality of life (QOL) and incidence of postoperative complications in stress urinary incontinence (SUI) patients after tension-free vaginal tape surgery (TVT). In order to provide evidence for clinical nurses taking measures to promote rehabilitation of postoperative patients. Methods A total of 101 female SUI patients who underwent TVT surgery were included in this study. 50 patients in the trial group received pelvic muscle training guidance by one-to-one for 3months while 51 patients in the control group were instructed to the routine discharge guidance. All patients were asked to finish the Incontinence-specific Quality of Life questionnaire (I-QOL) at the day before surgery and 3 months after the surgery, respectively. And incidence of postoperative complications were evaluated at 3 months after the surgery. Results A total of 94 participants completed all questionnaires, including 48 patients of the trial group and 46 patients of the control group. The postoperative score of I-QOL in the trial group were higher than that of control group (94.32 vs. 90.34, Z=3.863, P<0.01). Further analysis found that avoidance and limiting behaviors domain score (90.63 vs.87.50, Z=3.227, P<0.01) and psychosocial impacts domain score (97.22 vs. 90.28, Z=4.186, P<0.01) in the trial group were higher than that of control group. The incidence of postoperative urgency urinary incontinence was significantly difference between the two groups (χ2=4.953,P=0.026), the proportion were 16.67% (8/48) in the trial group and 36.96% (17/46) in the control group, respectively. According to the results, the patients′overall quality of life of the trial group was better than that of control group after surgery. Conclusions Postoperative SUI patients′implementation of pelvic muscle training can significantly increase their quality of life and can decrease the incidence of urgency urinary incontinence.
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Objective To observe the clinical efficacy of needle warming therapy plus pelvic floor muscle training in treating post-stroke neurogenic bladder.Method A total of 124 patients with post-stroke neurogenic bladder were divided into a treatment group and a control group by random number table, 62 cases in each group. The treatment group was intervened by acupuncture, moxibustion plus pelvic floor muscle training; the control group was intervened by Chinese patent drugs. The intervention was conducted with 2 weeks as a treatment course, for 3 treatment courses in total. The daily voiding frequency test and maximum cystometric capacity (MCC) in the two groups were measured before and after the intervention, and the clinical efficacies were compared between the two groups.Result Each item of the daily voiding frequency test in the two groups was significantly changed after the treatment (P<0.01). Each item of the daily voiding frequency test in the treatment group was significantly different from that in the control group after the treatment (P<0.01). The MCC was significantly changed after the intervention in both groups (P<0.01). The MCC in the treatment group was significantly different from that in the control group after the treatment (P<0.01). The recovery rate and total effective rate were respectively 35.5% and 96.8% in the treatment group versus 19.4% and 77.4% in the control group. There were significant differences in comparing the total effective rate (P<0.01) and the recovery rate between the two groups (P<0.05).Conclusion Needle warming therapy plus pelvic floor muscletraining can produce a significant therapeutic efficacy in treating post-stroke neurogenic bladder, and the therapeutic efficacy is obviously better than that of medication.
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Objective To evaluate and verify the preventive and therapeutic effects of electroacupuncture (EA) plus pelvic floor muscle training (PFMT) in treating mild-moderate female stress urinary incontinence (SUI). Method By adopting a single-blind randomized controlled design, eighty-two SUI patients were randomized into an observation group of 40 cases and a control group of 42 cases. The observation group was intervened by EA plus PFMT, while the control group only received PFMT. Before the treatment and after 4-week treatment, the 1 h urine leakage amount, Incontinence Questionnaire Short Form (ICI-Q-SF) and improvement rate were evaluated in the two groups, to analyze the effects of the two methods in improving mild-moderate SUI. Result For mild SUI patients, the 1 h urine leakage amount and ICI-Q-SF score dropped significantly after the treatment in the observation group (P<0.05), and the observation group was significantly lower than the control group (P<0.05). For moderate SUI patients, the 1 h urine leakage amount and ICI-QSF score dropped significantly in both groups after the intervention (P<0.05), the observation group was significantly lower than the control group (P<0.05), and the improvement rate in the observation group was markedly higher than that in the control group (P<0.01). Conclusion EA plus PFMT caneffectively improve the urine leakage and urination in mild-moderate SUI patients. EA plus PFMT can effectively prevent the aggravation of moderate female SUI, and its effect is better than PFMT alone.
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Objective To explore the effect of vaginal pressure feedback combined with pelvic floor muscle resistant training on stress urinary incontinence (SUI). Methods 125 women with SUI in our hospital from February, 2014 to May, 2015 were randomized into control group (n=65) and experimental group (n=60). The control group took Kegel exercise, which asked for patients to contract their pelvic floor muscles, while the experimental group first received biofeedback electrical stimulation for 20 minutes with XFT-2002 pelvic floor stimula-tor, then instructed the patients to contract their pelvic floor muscles and pressed the pneumatic probe which placed in vagina according to the voice navigation of XFT-0010 pelvic floor muscle stimulator after they learnt the contraction skill. Both groups received training with 10 seconds' contraction and 10 seconds' rest 30 minutes per day for 30 days in total. They were assessed by GRRUG and International Consulta-tion Incontinence Questionnaire-UI Short Form (ICIQ-SF). Results After treatment, the muscle strength of the pelvic floor (t=-3.570) and the scores of ICIQ (t=4.198) improved significantly in both groups (P<0.01), and was higher in the experimental group than in the control group (t=6.833, t=-2.445, P<0.01), as well as the therapeutic efficiency (Z=63.954, P<0.001). Conclusion Vaginal pressure feedback com-bined with pelvic floor muscle resistant training can further improve stress urinary incontinence in women.
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Objective To investigate the clinical efficacy and safety of electroacupuncture plus pelvic floor muscle training in treating postoperative retention of urine. Method Patients were allocated, according to admission date, to a treatment group of 33 cases and a control group of 34 cases. The treatment group received electroacupuncture at point Ciliao (BL32) plus pelvic floor muscle training and the control group, intermittent catheterization. The overall health degree was assessed using the therapeutic effect evaluation, first voiding time, residual urine volume and the number of urinary tract infection patients before and after treatment. Result The improvement rate was higher in the treatment group than in the control group and there was a statistically significant difference (P<0.05). Voiding recovery time was shorter and residual urine volume was smaller in the treatment group and there were statistically significant differences compared with the control group (P<0.01). Conclusion Electroacupuncture plus pelvic floor muscle training can effectively treat postoperative retention of urine. It is a safe and effective therapeutic method.
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Objective To study the effect of biofeedback electrical stimulation combined with pelvic floor muscle training in the postpartum rehabilitation treatment of pelvic floor function.Methods 320 puerperants who were rechecked at 42d after the delivery in our hospital from September 2011 to January 2013 were divided into two groups,patients in the observation group were treated with biofeedback electrical stimulation combined with pelvic floor muscle training ,patients in the control group were given without treatment intervention,then the pelvic floor muscle tension,vaginal muscle voltage and urinary incontinence rate of two groups at 3 month after the treatment were compared.Results The improvement of pelvic floor muscle tension and vaginal muscle voltage of observation group were significantly better than those of control group (<0.05),the urinary incontinence rate was significantly lower (<0.05) .Conclusion The biofeedback electrical stimulation combined with pelvic floor muscle training can effectively improve the pelvic floor muscle tension and decrease the urinary incontinence rate,so it can improve the life quality of puerperants.
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PURPOSE: The aim of this study was to review the literature to determine whether intensive pelvic floor muscle training during pregnancy and after delivery could prevent urinary and fecal incontinence. METHODS: Randomized controlled trials (RCT) of low-risk obstetric populations who had done Kegel exercise during pregnancy and after delivery met the inclusion criteria. Articles published between 1966 and 2012 from periodicals indexed in Ovid Medline, Embase, Scopus, KoreaMed, NDSL and other databases were selected, using the following keywords: 'Kegel, pelvic floor exercise'. The Cochrane's Risk of Bias was applied to assess the internal validity of the RCT. Fourteen selected studies were analyzed by meta-analysis using RevMan 5.1. RESULTS: Fourteen RCTs with high methodological quality, involving 6,454 women were included. They indicated that Kegel exercise significantly reduced the development of urinary and fecal incontinence from pregnancy to postpartum. Also, there was low clinical heterogeneity. CONCLUSION: There is some evidence that for antenatal and postnatal women, Kegel exercise can prevent urinary and fecal incontinence. Therefore, a priority task is to develop standardized Kegel exercise programs for Korean pregnant and postpartum women and make efficient use of these programs.
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Female , Humans , Pregnancy , Clinical Trials as Topic , Databases, Factual , Exercise Therapy , Fecal Incontinence/prevention & control , Muscle Contraction/physiology , Postpartum Period , Urinary Incontinence/prevention & controlABSTRACT
@#Objective To observe the effect of acupuncture on postpartum stress urinary incontinence. Methods 100 natural birth mothersmet the selection conditions were divided into control group (n=50) and treatment group (n=50). The control group accepted pelvic floormuscle training and the treatment group accepted acupuncture and moxibustion in addition. They were assessed 4 weeks after treatment. Results84% in the treatment group improved and it was 56% in the control group ( χ2 =10.54, P<0.01). Conclusion Acupuncture may improvethe efficacy of pelvic floor muscle training on postpartum stress urinary incontinence.
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Objective In order to know the effect of rehabilitation of pelvic organs by pelvic floor muscle training and electrical stimulation. Methods Divided 330 pregnant women into the integrated group(120 cases),the experimental group(100 cases) and the control group(100 cases) randomly. Rou-tine nursing cares was used in the control group, pelvic floor muscle training and electrical stimulation were used in the integrated group in addition, pelvic floor muscle training was used in the experimental group. Evaluated the rehabilitation condition of pelvic organs in the 42nd day after delivery among the three groups. Results All the indexes which can indicated the rehabilitation condition of pelvic or-gans in the integrated group and the experimental group were significant better than those of in the con-trol group, while there was no significant differences about the above indexes between the integrated group and the experimental group. Conclusions Pelvic floor muscle training combined with electrical stimulation can effective promote the rehabilitation of function of pelvic organs, and then prevent the in-cidence of related diseases.