The Effect of Pelvic Floor Muscle Exercise Program on Pelvic Floor Muscle Strength and Lower Urinary Tract Symptom of Women with Urinary Incontinence after Stroke

골반저근운동프로그램이 뇌졸중 후 요실금이 있는 여성의 골반저근력과 하부요로증상에 미치는 효과

  • Choi, Se-Jong (Physical Therapy, Graduate School of Sahmyook University) ;
  • Lee, Yong-Woo (Physical Therapy, Graduate School of Sahmyook University) ;
  • Song, Chang-Ho (Department of Physical Therapy, Sahmyook University)
  • 최세종 (삼육대학교 대학원 물리치료학) ;
  • 이용우 (삼육대학교 대학원 물리치료학) ;
  • 송창호 (삼육대학교 물리치료학과)
  • Received : 2010.03.31
  • Accepted : 2010.05.24
  • Published : 2010.05.31

Abstract

Purpose : The purpose of this study was to evaluate the effect of Pelvic Floor Muscle Exercise(PFME) in women with urinary incontinence (UI) after ischemic stroke. Methods : Thirty women were divided into two groups by randomly Experimental Group(15 subject) and Control Group(15 subject) in a single blinded, randomised study. Experimental Group was conducted for the 6-weeks PFME program and had a structured training program for 60 minutes, 3 days per week and they were encouraged to PFME at home seven days for a period of 6weeks. They were measured by questionnaire of urinary symptoms and perineometry. Results : A significant improvement in pelvic floor muscle strength and lower urinary tract symptom was also demonstrated within the Treatment Group(p<.05), but not in the Control Group. Conclusion : PFME program had a significant effect in women with UI after stroke measured by pelvic floor muscle strength and lower urinary tract symptom.

Keywords

References

  1. 손애리, 송창호. 중년 여성의 요실금 예방과 치료를 위한 골반저근 운동의 비교 분석. 한국여성체육학회지. 2006;20(4):1-16.
  2. 박은영. 요실금에 대한 골반근육운동 효과 검증연구. 이화여자대학교대학원. 석사학위논문. 2001.
  3. 박재순, 오정아, 이인숙 등. 골반근육 강화훈련이 산후 비뇨생식기 회복, 성생활 및 일상생활 불편감에 미치는 효과. 여성건강간호학회지. 2002;8(3):412-3.
  4. Burgio KL, Robinson JC, Engel BT. The role of biofeedback in Kegel exercise training for stress urinary incontinence. Am J Obstet Gynecol. 1986;154(1):58-64.
  5. Burns PA, Pranikoff K, Nochajski T, et al. Treatment of stress incontinence with pelvic floor exercises and biofeedback. J Am Geriatr Soc. 1990;38(3): 341-4.
  6. de Groat, W. C. A neurologic basis for the overactive bladder. Urology. 1997;50(6A Suppl):36-52.
  7. Donnan GA, Fisher M, Macleod M, et al. Stroke. Lancet. 2008;371(9624):1612-3. https://doi.org/10.1016/S0140-6736(08)60694-7
  8. Hellberg D, Holmgren C, Lanner L, et al. Re: "quality of life in relation to TVT procedure for the treatment of stress urinary incontinence". Acta Obstet Gynecol Scand. 2006;85(12):1512. https://doi.org/10.1080/00016340600969424
  9. Hvidman L, Foldspang A, Mommsen S, et al. Does urinary incontinence occurrence depend on the menstrual cycle phase? Acta Obstet Gynecol Scand. 2002;81(4):347-50. https://doi.org/10.1034/j.1600-0412.2002.810413.x
  10. Jackson S, Donovan J, Brookes S, et al. The Bristol Female Lower Urinary Tract Symptoms questionnaire: development and psychometric testing. Br J Urol. 1996;77(6):805-12. https://doi.org/10.1046/j.1464-410X.1996.00186.x
  11. Kegel AH. Progressive resistance exercise in the functional restoration of the perineal muscles. Am J Obstet Gynecol. 1948;56(2):238-48.
  12. Khan IJ, Tariq SH. Urinary incontinence: behavioral modification therapy in older adult. Clin Geriatr Med. 2004;20(3):499-509. https://doi.org/10.1016/j.cger.2004.04.001
  13. Kirschner-Hermanns R, Borchers H, Reineke T, et al. Fecal incontinence after radical perineal prosta-tectomy: a prospective study. Urology. 2005;65(2):337-42. https://doi.org/10.1016/j.urology.2004.09.029
  14. Kirschner-Hermanns R, Scherr PA, Branch LG, et al. Accuracy of survey questions for geriatric urinary incontinence. J Urol. 1998;159(6):1903-8. https://doi.org/10.1016/S0022-5347(01)63191-4
  15. Kolominsky-Rabas PL, Hilz MJ, Neundoerfer B, et al. Impact of urinary incontinence after stroke: results from a prospective population-based stroke register. Neurourol Urodyn. 2003;22(4):322-7. https://doi.org/10.1002/nau.10114
  16. Morkved S, Bo K, Fjortoft T. Effect of adding biofeedback to pelvic floor muscle training to treat urodynamic stress incontinence. Obstet Gynecol. 2002;100(4):730-9. https://doi.org/10.1016/S0029-7844(02)02160-9
  17. Ng SC, Lin TL, Chang SJ, et al. Nursing intervention to enhance efficacy of home practice of pelvic floor muscle exercises in treating mixed urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(5):637-42. https://doi.org/10.1007/s00192-007-0492-8
  18. Patel M, Coshall C, Rudd AG, et al. Natural history and effects on 2-year outcomes of urinary incontinence after stroke. Stroke. 2001;32(1):122-7. https://doi.org/10.1161/01.STR.32.1.122
  19. Shamliyan TA, Kane RL, Wyman J, et al. Systematic review: randomized, controlled trials of nonsurgical treatments for urinary incontinence in women. Ann Intern Med. 2008;148(6):459-73. https://doi.org/10.7326/0003-4819-148-6-200803180-00211
  20. Tibaek S, Gard G, Jensen R. Pelvic floor muscle training is effective in women with urinary incontinence after stroke: a randomised, controlled and blinded study. Neurourol Urodyn. 2005;24(4): 348-57. https://doi.org/10.1002/nau.20134
  21. Tibaek S, Gard G, Jensen R. Is there a long-lasting effect of pelvic floor muscle training in women with urinary incontinence after ischemic stroke? A 6-month follow-up study. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(3):281-7. https://doi.org/10.1007/s00192-006-0137-3
  22. Tibaek S, Jensen R, Lindskov G, et al. Can quality of life be improved by pelvic floor muscle training in women with urinary incontinence after ischemic stroke? A randomised, controlled and blinded study. Int Urogynecol J Pelvic Floor Dysfunct. 2004;15(2):117-23. https://doi.org/10.1007/s00192-004-1124-1
  23. Wyman JF., Fantl JA., McClish DK, et al Comparative efficacy of behavioral interventions in the management of female urinary incontinence. Am J Obstet Gynecol. 1999;179(4):999-1007.
  24. Warlow C, van Gijn J, Dennis M. Stroke : practical management. 3rd ed.. Oxford. Blackwell Publishing. 2008.
  25. Weiss BD. Selecting medications for the treatment of urinary incontinence. Am Fam Physician. 2005; 71(2):315-22.