The impact of pelvic floor muscle exercises with and without synergistic muscles on the quality of life of women with stress urinary incontinence

Magdalena Ptak

Abstract


Introduction: Stress urinary incontinence (SUI) is an ailment diagnosed in many women in different periods of life. It is estimated that nearly 60% of them will experience the effect of SUI onthe quality of life (QOL) in the perimenopausal period. The International Continence Society (ICS) recommended pelvic floor muscle (PFM) exercise as first line treatment.

The aim of this study was to compare the QOL of patients with stage 1 SUI that performed PFM and the synergistic muscle (PFM and SM) exercise and isolated PMF (PFM) exercise for the period of 3 months. The additional objective was to evaluate the influence of menopausal status, body mass index (BMI), waist-hip ratio (WHR) and the number of births given on the effectiveness of treatment.

Materials and methods: After urodynamic testing executed at the Clinic of Gynaecology, Endocrinology and Gynaecologic Oncology in the Pomeranian Medical University in Szczecin (in Poland), 140 patients were selected. Women were in the perimenopausal period and suffered from SUI stage 1. The conservative treatment was carried out under supervision in 2 groups, 70 patients each. The mean age of women was 51–53 years, BMI – 27.4 kg/m2
and WHR was 0.88 (first group) and 0.81 (second group). Before and after the treatment, patients’ QOL was evaluated with the use of the ICIQ LUTS qol questionnaire. Moreover, the patients in both groups received vaginal oestriol. Statistica v. 12.0 PL, StatSoft, USA, was used for statistical calculations.

Results: Analysis demonstrated the effectiveness of both exercise protocols. The study revealed that exercise according to protocol A (PMF and SM) is more effective than protocol B (PMF). There was no change in QOL in personal relationships. The influence of menopausal status, WHR and number of births was proven.

Conclusions: PFM and SM exercise and PFM exercise alone improved the QOL of women with SUI stage 1. However, a stronger impact was observed in the physiotherapy of PFM and SM. The PFM and SM exercise was proven to be more effective than the PFM exercise alone when performed by women with SUI in their premenopausal period, with a gynoidal body type, and in the case of women who gave birth less than three times.


Keywords


stress urinary incontinence; perimenopausal period; physiotherapy; pelvic floor muscles; ICIQ LUTS qol; quality of life

Full Text:

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References


Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, et al. 4th International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and Treatment of Urinary Incontinence, Pelvic Organ Prolapse and Fecal Incontinence. 2009. http://www.ics.org/publications/ici_4/files-book/recommendation.pdf (7.01.2016).

Haylen BT, Ridder D, Freeman RM, Steven E, Swift SE, Berghmans B, et al. International Urogynecological Association; International Continence Society. An International Urogynecological Association (IUGA)/International Continence Society (ICS) Joint Report on the Terminology for Female Pelvic Floor Dysfunction. Neurourol Urodyn 2010;29:4-20.

Brodowska A. Ginekologia od teorii do praktyki. In: Brodowska A, editor. Menopauza. Szczecin: Wydawnictwo Pomorskiego Uniwerytetu Medycznego w Szczecinie; 2014. p. 179-93.

Resnick NM. Urinary incontinence. Lancet 1995;6:94-9.

DeLancey JOL. Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis. Am J Obstet Gynecol 1994;170:1713-23.

Petros PE, Ulmsten U. An integral theory of female urinary incontnece. Acta Obstet Gynecol Scand 1990;153(69):1-79.

Bump RC. Discussion: Epidemiology of urinary incontinence. Urology 1997;50:15-6.

Bø K, Lilleas F, Talseth T, Hedland H. Dynamic MRI of the pelvic floor muscles in an upright sitting position. Neurourol Urodyn 2001;20(2):167-74.

Thompson JA, O’Sullivan PB. Levator plate movement during voluntary pelvic floor muscle contraction in subjects with incontinence and prolapse: a cross-sectional study and review. Int Urogynecol J Pelvic Floor Dysfunct 2003;14(2):84-8.

Sapsford R. Rehabilitation of pelvic floor muscles utilizing trunk stabilization. Manual Therapy 2004;9:3-12.

Pereira LC, Botelho S, Marques J, Amorim CF, Lanza AH, Palma P, et al. Are transversus abdominis/oblique internal and pelvic floor muscles coactivated during pregnancy and postpartum? Neurourol Urodyn 2013;32(5):416-9.

Ciećwież S, Nawrocka-Rutkowska J, Ciećwież M, Brodowska A, Starczewski A, Kotlęga D, et al. Porównanie skuteczności operacyjnego leczenia wysiłkowego nietrzymania moczu metodami slingowymi oraz sposobem Burcha z wykorzystaniem kwestionariusza Gaudenza. Perinatol Neonatol Ginekol 2011;4(4):185-91.

Fitz FF, Costa TF, Yamamoto DM, Resende APM, Stüpp L, Sartori MGF, et al. Impact of pelvic floor muscle training on the quality of life in women with urinary incontinence. Rev Assoc Med Bras 2012;58(2):155-9.

Rett MT, Simőes JA, Herrmann V, Gurgel MSC, Morais SS. Qualidade de vida em mulheres após tratamento da incontinência urinária de esforço com fisioterapia. Rev Bras Ginecol Obstet 2007;29:134-40.

Hirakawa T, Suzuki S, Kato K, Gotoh M, Yoshikawa Y. Randomized controlled trial of pelvic floor muscle training with or without biofeedback for urinary incontinence. Int Urogynecol J 2013;24(8):1347-54. doi: 10.1007/s00192-012-2012-8.

Capellini MV, Riccetto CL, Dambros M, Tamanini JT, Herrmann V, Muller V. Pelvic floor exercises with biofeedback for stress urinary incontinence. Int Braz J Urol 2006;32(4):462-9.

Nascimento-Correia G, Santos-Pereira V, Tahara N, Driusso P. Effects of pelvic floor muscle training on quality of life of a group of women with urinary incontinence: randomized controlled trial. Actas Urol Esp 2012;36(4):216-21.

Kanter G, Rogers RG, Pauls RN, Kammerer-Doak D, Thakar R. A strong pelvic floor is associated with higher rates of sexual activity in women with pelvic floor disorders. Int Urogynecol J 2015;26(7): 991-6.

Balmforth JR, Mantle J, Bidmead J, Cardozo L. A prospective observational trial of pelvic floor muscle training for female stress urinary incontinence. BJU Int 2006;98(4):811-7.

Wan X, Wang C, Xu D, Guan X, Sun T, Wang K. Disease stigma and its mediating effect on the relationship between symptom severity and quality of life among community-dwelling women with stress urinary incontinence: a study from a Chinese city. J Clin Nurs 2014;23(15-16):2170-9.

Farzinmehr A, Moezy A, Koohpayehzadeh J, Kashanian M. A comparative study of whole body vibration training and pelvic floor muscle training on women’s stress urinary incontinence: three-month follow-up. J Family Reprod Health 2015;9(4):147-54.

Nygaard CC, Betschart C, Hafez AA, Lewkis E, Chasiotis I, Doumouchtsis SK. Impact of menopausal status on the outcome of pelvic floor physiotherapy in women with urinary incontinence. Int Urogynecol J 2013;24:2071-6.

Kamel DM, Thabet AA, Tantawy SA, Radwan MM.

Abdominal versus pelvic floor muscles exercises in mild stress urinary incontinence in obese Egyptian women. Indian J Physiotherapy Occupational Therapy 2012;6(2):36-40.




DOI: https://doi.org/10.21164/pomjlifesci.252

Copyright (c) 2017 Magdalena Ptak

License URL: https://creativecommons.org/licenses/by-nc-nd/3.0/pl/