当前位置:科学网首页 > 小柯机器人 >详情
盆底肌训练联合肌电生物反馈并不能显著改善女性尿失禁
作者:小柯机器人 发布时间:2020/10/22 12:56:45

英国格拉斯哥苏格兰大学Suzanne Hagen团队比较了盆底肌训练加或不加肌电生物反馈治疗女性尿失禁的疗效。2020年10月14日,《英国医学杂志》发表了该研究。

为了评估盆底肌训练(PFMT)加上肌电生物反馈或单独PFMT对女性压力性或混合性尿失禁的疗效,研究组在苏格兰和英格兰的23个社区和二级护理中心进行了一项平行组、随机、对照试验。

2014年2月至2016年7月,研究组共招募了600名18岁及以上、新发压力性或混合性尿失禁的女性,并将其随机分组,其中300名接受PFMT联合肌电生物反馈,300名仅接受PFMT。两组患者在16周内接受了6次治疗。24个月时,采用国际尿失禁咨询委员会尿失禁问卷量表(ICIQ-UI SF)对尿失禁严重程度进行评估。

生物反馈+PFMT组在24个月时的ICIQ-UI SF平均得分为8.2分,PFMT组为8.5分,差异不显著。生物反馈+PFMT组的医疗成本和质量调整寿命年与单独PFMT组相差不大。共有48名参与者报告了不良事件,其中23起与干预措施有关或可能有关。

研究结果表明,没有证据表明PFMT加肌电生物反馈与单独PFMT相比,可显著改善女性尿失禁的严重程度。

附:英文原文

Title: Effectiveness of pelvic floor muscle training with and without electromyographic biofeedback for urinary incontinence in women: multicentre randomised controlled trial

Author: Suzanne Hagen, Andrew Elders, Susan Stratton, Nicole Sergenson, Carol Bugge, Sarah Dean, Jean Hay-Smith, Mary Kilonzo, Maria Dimitrova, Mohamed Abdel-Fattah, Wael Agur, Jo Booth, Cathryn Glazener, Karen Guerrero, Alison McDonald, John Norrie, Louise R Williams, Doreen McClurg

Issue&Volume: 2020/10/14

Abstract:

Objective To assess the effectiveness of pelvic floor muscle training (PFMT) plus electromyographic biofeedback or PFMT alone for stress or mixed urinary incontinence in women.

Design Parallel group randomised controlled trial.

Setting 23 community and secondary care centres providing continence care in Scotland and England.

Participants 600 women aged 18 and older, newly presenting with stress or mixed urinary incontinence between February 2014 and July 2016: 300 were randomised to PFMT plus electromyographic biofeedback and 300 to PFMT alone.

Interventions Participants in both groups were offered six appointments with a continence therapist over 16 weeks. Participants in the biofeedback PFMT group received supervised PFMT and a home PFMT programme, incorporating electromyographic biofeedback during clinic appointments and at home. The PFMT group received supervised PFMT and a home PFMT programme. PFMT programmes were progressed over the appointments.

Main outcome measures The primary outcome was self-reported severity of urinary incontinence (International Consultation on Incontinence Questionnaire-urinary incontinence short form (ICIQ-UI SF), range 0 to 21, higher scores indicating greater severity) at 24 months. Secondary outcomes were cure or improvement, other pelvic floor symptoms, condition specific quality of life, women’s perception of improvement, pelvic floor muscle function, uptake of other urinary incontinence treatment, PFMT self-efficacy, adherence, intervention costs, and quality adjusted life years.

Results Mean ICIQ-UI SF scores at 24 months were 8.2 (SD 5.1, n=225) in the biofeedback PFMT group and 8.5 (SD 4.9, n=235) in the PFMT group (mean difference 0.09, 95% confidence interval 0.92 to 0.75, P=0.84). Biofeedback PFMT had similar costs (mean difference £121 ($154; €133), £409 to £651, P=0.64) and quality adjusted life years (0.04, 0.12 to 0.04, P=0.28) to PFMT. 48 participants reported an adverse event: for 23 this was related or possibly related to the interventions.

Conclusions At 24 months no evidence was found of any important difference in severity of urinary incontinence between PFMT plus electromyographic biofeedback and PFMT alone groups. Routine use of electromyographic biofeedback with PFMT should not be recommended. Other ways of maximising the effects of PFMT should be investigated.

DOI: 10.1136/bmj.m3719

Source: https://www.bmj.com/content/371/bmj.m3719

期刊信息

BMJ-British Medical Journal:《英国医学杂志》,创刊于1840年。隶属于BMJ出版集团,最新IF:27.604
官方网址:http://www.bmj.com/
投稿链接:https://mc.manuscriptcentral.com/bmj