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Üriner İnkontinans Tedavisinde Pelvik Taban Egzersizleri Nöromodülasyon-Biofeedback İçin Evde Egzersiz Eğitim Uygulaması Kısa Dönem Sonuçları

Yıl 2019, , 365 - 372, 31.12.2019
https://doi.org/10.16899/jcm.580712

Öz

Amaç: Bu çalışmada amacımız
üriner inkontinans tedavisinde FemiScan Home Trainer (Mega Electronics Ltd.,
Finlandiya) ile evde pelvik taban kas egzersiz tedavisinin kısa dönem
değişikliklerin incelenmesi amaçlanmıştır.

Materyal ve Metod: Çalışmamıza
ürojinekoloji polikliniğine üriner inkontinans(Üİ) şikayetiyle başvuran ve
inkontinansı objektif olarak gösterilebilen, tedavide evde egzersiz eğitimi
için FemiScan biofeedback cihazı verilmiş olan 30 kadın hasta dahil edilmiş
olup bu hastaların dosyaları retrospektif olarak taranmıştır. Evde egzersiz
eğitimini kesintisiz olarak uygulayabilmiş olan hastalar çalışmaya dahil
edilmiştir. Ayrıntılı anamnez formu, pelvik taban kuvvet muayenesi bulguları,
ürodinamik inceleme kayıtları, doldurmuş oldukları inkontinans anketleri
incelenmiştir. Hastaların, üçüncü ay sonundaki kas gücü sonuçları, ürodinami
değerleri ve inkontinans anketleri başlangıç değerleri ile karşılaştırılmıştır.

Bulgular: FemiScan ile yapılan
biofeedback ile pelvik taban kas egzersizi sonuçlarını değerlendirken objeftif
kriter olarak EMG amplitüd farkı, MD, VB ve MD/VB farkı dikkate alınmıştır. Bu
verilerin istatistiksel analizi sonucu EMG amplitüdünde (p< 0,0001), MD
değerlerinde (p< 0,0001) ve MD/ VB oranında da tedavi sonrasında
istatistiksel olarak anlamlı olacak şekilde bir artış gözlenmiştir (p<
0,01). VB’da ise tedavi sonrasında anlamlı bir değişiklik izlenmemiştir. Tedavi
sonrası hastaların idrara çıkma sayısında ve bir seferde kaçırılan idrar
miktarında azalma, idrar akışını durdurabilme yeteneğinde istatistiksel olarak
anlamlı bir iyileşme izlenmiştir.







Sonuç: Çalışmamız FemiScan (Mega
Electronics Ltd., Finlandiya)’ nin Üİ tedavisinde etkin bir yöntem
olabileceğini göstermektedir.

Kaynakça

  • 1. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: Report from the standardisation sub-committee of the international Continence Society. Urology. 2003;61(1):37-49. PMID: 12559262; doi: 10.1002/nau.10052.2. Anders K. Recent developments in stress urinary incontinence in women. Nurs Stand. 2009;Suppl:25-7, 29-32. PMID: 20085018; doi: 10.7748/ns2006.05.20.35.48.c4147.3. Stewart WF, Van Rooyen JB, Cundiff GW, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003;20(6):327-36. PMID: 12811491; doi: 10.1186/1471-2296-10-8.4. Minassian VA, Drutz HP, Al-Badr A. Urinary incontinence as a worldwide problem. Int J Gynaecol Obstet. 2003;82(3):327-38. PMID: 14499979; doi: 10.1016/S0020-7292Ž03.00220-0.5. Burns PA, Pranikoff K, Nochajski TH, et al. A comparison of effectiveness of biofeedback and pelvic floor muscle exercise treatment of stress incontinence in older community-dwelling women. J Gerontol. 1993;48(4):M167-74. PMID: 8315230.6. Yip SK, Cardozo L. Psychological morbidity and female urinary incontinence. Best Pract Res Clin Obstet Gynaecol. 2007;21(2):321-9. PMID: 17207664; doi: 10.1016/j.bpobgyn.2006.12.002.7. Zhu L, Lang J, Liu C, et al. The epidemiological study of women with urinary incontinence and risk factors for stress urinary incontinence in China. Menopause. 2009;16(4):831-6. PMID: 19240656; doi: 10.1097/gme.0b013e3181967b5d.8. Fanti JA, Newman DK, Colling J, et al. Urinary incontinence in adults: Acute and chronic management. Clinical practice guideline, 1996 Update. Agency for Health Care Policy and Research. 1996;96(2):154. 9. Hagen S, Stark D, Glazener C, et al. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. Lancet. 2014;383(9919):796-806. PMID: 24290404; doi: 10.1016/S0140-6736(13)61977-7.10. Braekken IH, Majida M, Engh ME, Bø K. Morphological changes after pelvic floor muscle training measured by 3-dimensional ultrasonography: a randomized controlled trial. Obstet Gynecol. 2010;115(2 Pt 1):317-24. PMID: 20093905; doi: 10.1097/AOG.0b013e3181cbd35f.11. Stüpp L, Resende AP, Oliveira E, et al. Pelvic floor muscle training for treatment of pelvic organ prolapse: an assessor-blinded randomized controlled trial. Int Urogynecol J. 2011;22(10):1233-9. PMID: 21484362; doi: 10.1007/s00192-011-1428-x.12. Talasz H, Kalchschmid E, Kofler M, Lechleitner M. Effects of multidimensional pelvic floor muscle training in healthy young women. Arch Gynecol Obstet. 2012;285(3):709-15. PMID: 21837426; doi: 10.1007/ s00404-011-2039-y.13. Rett MT, Simoes JA, Herrmann V, et al. Management of stress urinary incontinence with surface electromyography-assisted biofeedback in women of reproductive age. Phys Ther. 2007;87(2):136-42. PMID: 17213411; doi: 10.2522/ptj.20050318.14. Tadic SD, Zdaniuk B, Griffiths D, et al. Effect of biofeedback on psychological burden and symptoms in older women with urge urinary incontinence. J Am Geriatr Soc. 2007;55(12):2010-5. PMID: 18028340 doi: 10.1111/j.1532-5415.2007.01461.x.15. Henderson JS, Taylor KH. Age as a variable in an exercise program for the treatment of simple urinary stress incontinence. J Obstet Gynecol Neonatal Nurs. 1987;16(4):266-72. PMID: 3650327; doi: 10.1111/j.1552-6909.1987.tb01584.x.16. Bai SW, Kang JY, Rha KH, et al. Relationship of urodynamic parameters and obesity in women with stress urinary incontinence. J Reprod Med. 2002;47(7):559-63. PMID: 12170533.17. Luna MT, Hirakawa T, Nakano H. Urinary inkontinance in women seen in the obstetrics and gynecology clinic. Int Urogynecol J Pelvic Flor Dysfunct. 2000;11(5):277-81. PMID: 11052561.18. Demirci F, Özden S, Yücel N, Yalti S, Demirci E. Prevelance of urinary incontinence in Turkish menopausal women. Turk J Obstet Gynecol. 1999;3(2):138-42.19. Rogers RG, Leeman LL. Postpartum genitourinary changes. Urol Clin North Am. 2007;34(1):13-21. PMID: 17145356; doi: 10.1016/j.ucl.2006.10.005.20. Rortveit G, Daltveit AK, Hannestad YS, Hunskaar S. Vaginal delivery parameters and urinary incontinence: The Norwegian EPINCONT study. Am J Obstet Gynecol. 2003;189(5):1268-74. PMID: 14634552; doi:10.1067/S0002-9378(03)00588-X.21. Cardozo L. New developments in the management of stres urinary incontinence. BJU Int. 2004;94 Suppl 1:1-3. PMID: 15139856; doi: 10.1111/j.1464-410X.2004.04807.x. 22. Dumoulin C, Hay-Smith J. Pelvic floor muscle training versus no treatment for urinary incontinence in women. A Cochrane systematic review. Eur J Phys Rehabil Med. 2008;44(1):47-63. PMID: 18385628. doi: 10.1002/14651858.CD005654.23. Berghmans LC, Hendriks HJ, De Bie RA, et al. Conservative treatment of urge urinary incontinence in women: a systematic review of randomized clinical trials. BJU Int. 2000;85(3):254-63. PMID: 10671878; doi: 10.1046/j.1464-410x.2000.00434.x.24. Aukee P, Immonen P, Penttinen J, Laippala P, Airaksinen O. Increase in pelvic floor muscle activity after 12 weeks' training: a randomized prospective pilot study. Urology. 2002;60(6):1020-3. PMID: 12475661.

Home pelvic floor muscle training with electromyographic biofeedback to treatment of the urinary incontinence: A prospective analysis

Yıl 2019, , 365 - 372, 31.12.2019
https://doi.org/10.16899/jcm.580712

Öz

Abstract

Aim: Pelvic floor muscle training is an accepted therapy to
improve or cure symptoms of urinary incontinence. In this study, examination of short term changes in home treatment
of pelvic floor muscle training with FemiScan Home Trainer in treatment of
urinary incontinence was aimed.



Material
and Method
: Prospective analysis in a tertiary-level center. 30 female patients admitted to
urogynecology polyclinic with complaints of urinary incontinence (UI) who were
given FemiScan biofeedback device for home exercise treatment were included in
our study. Patients who could apply home exercise training continuously were
included in the study. Detailed anamnesis form, pelvic floor force examination
findings, urodynamic examination records and incontinence forms they filled
were examined. Muscle force results, urodynamic values and incontinence forms
of patients at the end of third month were compared to initial values.



Results: While evaluating results of pelvic
floor muscle exercise with biofeedback performed using FemiScan, Electromyography
(EMG) amplitude difference, Bladder fullness (BF), Vesical pressure (VP) and
BF/VP difference were taken as objective criteria. In the result of statistical
analysis of these data, statistically significant increase was observed in EMG
amplitude (P <0.0001), BF values (P <0.0001) and BF/VP ratio after the
treatment (P <0.01). No significant change was recorded in VP after the
treatment. Number of urinations and amount of urine leaked decreased and
statistically significant recovery in ability to stop urine flow were observed.



Conclusions: Our study shows that FemiScan (Mega Electronics Ltd,
Finland) might be an effective method in UI treatment.

Kaynakça

  • 1. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: Report from the standardisation sub-committee of the international Continence Society. Urology. 2003;61(1):37-49. PMID: 12559262; doi: 10.1002/nau.10052.2. Anders K. Recent developments in stress urinary incontinence in women. Nurs Stand. 2009;Suppl:25-7, 29-32. PMID: 20085018; doi: 10.7748/ns2006.05.20.35.48.c4147.3. Stewart WF, Van Rooyen JB, Cundiff GW, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003;20(6):327-36. PMID: 12811491; doi: 10.1186/1471-2296-10-8.4. Minassian VA, Drutz HP, Al-Badr A. Urinary incontinence as a worldwide problem. Int J Gynaecol Obstet. 2003;82(3):327-38. PMID: 14499979; doi: 10.1016/S0020-7292Ž03.00220-0.5. Burns PA, Pranikoff K, Nochajski TH, et al. A comparison of effectiveness of biofeedback and pelvic floor muscle exercise treatment of stress incontinence in older community-dwelling women. J Gerontol. 1993;48(4):M167-74. PMID: 8315230.6. Yip SK, Cardozo L. Psychological morbidity and female urinary incontinence. Best Pract Res Clin Obstet Gynaecol. 2007;21(2):321-9. PMID: 17207664; doi: 10.1016/j.bpobgyn.2006.12.002.7. Zhu L, Lang J, Liu C, et al. The epidemiological study of women with urinary incontinence and risk factors for stress urinary incontinence in China. Menopause. 2009;16(4):831-6. PMID: 19240656; doi: 10.1097/gme.0b013e3181967b5d.8. Fanti JA, Newman DK, Colling J, et al. Urinary incontinence in adults: Acute and chronic management. Clinical practice guideline, 1996 Update. Agency for Health Care Policy and Research. 1996;96(2):154. 9. Hagen S, Stark D, Glazener C, et al. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. Lancet. 2014;383(9919):796-806. PMID: 24290404; doi: 10.1016/S0140-6736(13)61977-7.10. Braekken IH, Majida M, Engh ME, Bø K. Morphological changes after pelvic floor muscle training measured by 3-dimensional ultrasonography: a randomized controlled trial. Obstet Gynecol. 2010;115(2 Pt 1):317-24. PMID: 20093905; doi: 10.1097/AOG.0b013e3181cbd35f.11. Stüpp L, Resende AP, Oliveira E, et al. Pelvic floor muscle training for treatment of pelvic organ prolapse: an assessor-blinded randomized controlled trial. Int Urogynecol J. 2011;22(10):1233-9. PMID: 21484362; doi: 10.1007/s00192-011-1428-x.12. Talasz H, Kalchschmid E, Kofler M, Lechleitner M. Effects of multidimensional pelvic floor muscle training in healthy young women. Arch Gynecol Obstet. 2012;285(3):709-15. PMID: 21837426; doi: 10.1007/ s00404-011-2039-y.13. Rett MT, Simoes JA, Herrmann V, et al. Management of stress urinary incontinence with surface electromyography-assisted biofeedback in women of reproductive age. Phys Ther. 2007;87(2):136-42. PMID: 17213411; doi: 10.2522/ptj.20050318.14. Tadic SD, Zdaniuk B, Griffiths D, et al. Effect of biofeedback on psychological burden and symptoms in older women with urge urinary incontinence. J Am Geriatr Soc. 2007;55(12):2010-5. PMID: 18028340 doi: 10.1111/j.1532-5415.2007.01461.x.15. Henderson JS, Taylor KH. Age as a variable in an exercise program for the treatment of simple urinary stress incontinence. J Obstet Gynecol Neonatal Nurs. 1987;16(4):266-72. PMID: 3650327; doi: 10.1111/j.1552-6909.1987.tb01584.x.16. Bai SW, Kang JY, Rha KH, et al. Relationship of urodynamic parameters and obesity in women with stress urinary incontinence. J Reprod Med. 2002;47(7):559-63. PMID: 12170533.17. Luna MT, Hirakawa T, Nakano H. Urinary inkontinance in women seen in the obstetrics and gynecology clinic. Int Urogynecol J Pelvic Flor Dysfunct. 2000;11(5):277-81. PMID: 11052561.18. Demirci F, Özden S, Yücel N, Yalti S, Demirci E. Prevelance of urinary incontinence in Turkish menopausal women. Turk J Obstet Gynecol. 1999;3(2):138-42.19. Rogers RG, Leeman LL. Postpartum genitourinary changes. Urol Clin North Am. 2007;34(1):13-21. PMID: 17145356; doi: 10.1016/j.ucl.2006.10.005.20. Rortveit G, Daltveit AK, Hannestad YS, Hunskaar S. Vaginal delivery parameters and urinary incontinence: The Norwegian EPINCONT study. Am J Obstet Gynecol. 2003;189(5):1268-74. PMID: 14634552; doi:10.1067/S0002-9378(03)00588-X.21. Cardozo L. New developments in the management of stres urinary incontinence. BJU Int. 2004;94 Suppl 1:1-3. PMID: 15139856; doi: 10.1111/j.1464-410X.2004.04807.x. 22. Dumoulin C, Hay-Smith J. Pelvic floor muscle training versus no treatment for urinary incontinence in women. A Cochrane systematic review. Eur J Phys Rehabil Med. 2008;44(1):47-63. PMID: 18385628. doi: 10.1002/14651858.CD005654.23. Berghmans LC, Hendriks HJ, De Bie RA, et al. Conservative treatment of urge urinary incontinence in women: a systematic review of randomized clinical trials. BJU Int. 2000;85(3):254-63. PMID: 10671878; doi: 10.1046/j.1464-410x.2000.00434.x.24. Aukee P, Immonen P, Penttinen J, Laippala P, Airaksinen O. Increase in pelvic floor muscle activity after 12 weeks' training: a randomized prospective pilot study. Urology. 2002;60(6):1020-3. PMID: 12475661.
Toplam 1 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Araştırma
Yazarlar

Yılda Arzu Aba 0000-0001-6660-4964

Deniz Sarıcı Bu kişi benim 0000-0002-5901-9828

Ramazan Özyurt Bu kişi benim 0000-0002-3008-4597

Bulat Aytek Şık 0000-0002-4165-9405

Yayımlanma Tarihi 31 Aralık 2019
Kabul Tarihi 15 Ekim 2019
Yayımlandığı Sayı Yıl 2019

Kaynak Göster

AMA Aba YA, Sarıcı D, Özyurt R, Şık BA. Home pelvic floor muscle training with electromyographic biofeedback to treatment of the urinary incontinence: A prospective analysis. J Contemp Med. Aralık 2019;9(4):365-372. doi:10.16899/jcm.580712