Marlene Oliveira1, Margarida Ferreira2, Maria João Azevedo3, João Firmino-Machado4, Paula Clara Santos5,6. 1. Physiotherapist, Camélia Hotel Sénior & Homes, Guimarães, Portugal. 2. Visiting Professor, Physiotherapy Department, CESPU - Instituto Politécnico de Saúde do Norte, Vale do Sousa e Vale do Ave, Portugal. 3. MD, Assistant Physiatrist, Hospital Senhora da Oliveira, Guimarães, Portugal. 4. MD, Department of Public Health, Porto, Portugal. 5. Lecturer, Department of Physiotherapy, Escola Superior de Tecnologia e Saúde do Porto, Instituto Politécnico do Porto, Porto, Portugal. 6. Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, Universidade do Porto, Porto, Portugal.
Abstract
INTRODUCTION: Strengthening exercises for pelvic floor muscles (SEPFM) are considered the first approach in the treatment of stress urinary incontinence (SUI). Nevertheless, there is no evidence about training parameters. OBJECTIVE: To identify the protocol and/or most effective training parameters in the treatment of female SUI. METHOD: A literature research was conducted in the PubMed, Cochrane Library, PEDro, Web of Science and Lilacs databases, with publishing dates ranging from January 1992 to March 2014. The articles included consisted of English-speaking experimental studies in which SEPFM were compared with placebo treatment (usual or untreated). The sample had a diagnosis of SUI and their age ranged between 18 and 65 years. The assessment of methodological quality was performed based on the PEDro scale. RESULTS: Seven high methodological quality articles were included in this review. The sample consisted of 331 women, mean age 44.4±5.51 years, average duration of urinary loss of 64±5.66 months and severity of SUI ranging from mild to severe. SEPFM programs included different training parameters concerning the PFM. Some studies have applied abdominal training and adjuvant techniques. Urine leakage cure rates varied from 28.6 to 80%, while the strength increase of PFM varied from 15.6 to 161.7%. CONCLUSION: The most effective training protocol consists of SEPFM by digital palpation combined with biofeedback monitoring and vaginal cones, including 12 week training parameters, and ten repetitions per series in different positions compared with SEPFM alone or a lack of treatment.
INTRODUCTION: Strengthening exercises for pelvic floor muscles (SEPFM) are considered the first approach in the treatment of stress urinary incontinence (SUI). Nevertheless, there is no evidence about training parameters. OBJECTIVE: To identify the protocol and/or most effective training parameters in the treatment of female SUI. METHOD: A literature research was conducted in the PubMed, Cochrane Library, PEDro, Web of Science and Lilacs databases, with publishing dates ranging from January 1992 to March 2014. The articles included consisted of English-speaking experimental studies in which SEPFM were compared with placebo treatment (usual or untreated). The sample had a diagnosis of SUI and their age ranged between 18 and 65 years. The assessment of methodological quality was performed based on the PEDro scale. RESULTS: Seven high methodological quality articles were included in this review. The sample consisted of 331 women, mean age 44.4±5.51 years, average duration of urinary loss of 64±5.66 months and severity of SUI ranging from mild to severe. SEPFM programs included different training parameters concerning the PFM. Some studies have applied abdominal training and adjuvant techniques. Urine leakage cure rates varied from 28.6 to 80%, while the strength increase of PFM varied from 15.6 to 161.7%. CONCLUSION: The most effective training protocol consists of SEPFM by digital palpation combined with biofeedback monitoring and vaginal cones, including 12 week training parameters, and ten repetitions per series in different positions compared with SEPFM alone or a lack of treatment.
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