ورزش های تقویت کننده عضالت کف لگن در درمان بی اختیاری استرسی ادرار: یک مطالعه مروری مبتنی بر شواهد

نوع مقاله: اصیل پژوهشی

نویسندگان

1 مربی گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

2 کارشناس ارشد مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

چکیده

مقدمه: مطالعه حاضر با هدف ارزیابی مطالعات مرتبط با ورزش های تقویت کننده عضالت کف لگن در زنان مبتال به
بی اختیاری استرسی ادرار انجام شد. این مطالعه شامل انواع پروتکل های آموزش ورزش ها نظیر آموزش فردی و
گروهی، آموزش قدرت و مهارت، مدت مطلوب درمان، وضعیت های زنان در حین انجام ورزش ها و در نهایت ارائه
بهترین شواهد در دسترس برای انتخاب مؤثرترین پروتکل آموزش ورزش ها می باشد.
روشکار: برخی منابع الکترونیکی اصلی مبتنی بر شواهد )Evidence-Based Practice, Medlin,Cochrane
Database( جهت به دست آوردن مقاالت منتشر شده بین سال های 1331 تا 2111 مورد جستجو قرار گرفتند.
تعداد 11 مقاله کارآزمایی بالینی به دست آمد و 21 مقاله به منظور دستیابی به بهترین شواهد در دسترس برای
برنامه های آموزشی در زنان مبتال به بی اختیاری استرسی ادرار انتخاب شدند.
یافتهها: شواهد نشان داد که انجام برنامه ورزشی به صورت گروهی یا فردی تأثیری در نتیجه درمان ندارد، در حالی
که شواهد علمی بیان کردند که ترکیبی از آموزش قدرت و مهارت در درمان بی اختیاری استرسی ادرار مؤثر است، اما
سهم هر یک از این اجزاء بر نتایج درمان مشخص نیست. برنامه های درمانی کمتر از 9 ماه ممکن است به همان
اندازه ای که در بهبود بی اختیاری استرسی ادرار مؤثر هستند، قدرت عضالت کف لگن را افزایش دهند. همچنین
مطالعات مختلف، ارجحیت وضعیت خاصی در برنامه ورزشی را نشان نمی دهند.
نتیجهگیری: اگرچه شواهدی قوی مبنی بر اثربخشی ورزش های تقویت کننده عضالت کف لگن در درمان بی اختیااری
استرسی ادرار در زنان وجود دارد، اما همچنان تعیین مطلوب ترین پروتکل آموزشی، نیاز به مطالعات جامع تر و گساترده
تر دارد.

کلیدواژه‌ها


عنوان مقاله [English]

Effect of Exercises of Pelvic-Floor Muscle Strengthening on Treatment of Stress Urinary Incontinence: Evidence-Based Review

نویسندگان [English]

  • Nahid Golmakani 1
  • Akram Esfalani 2
  • Maryam Kabirian 2
1 Lecturer, Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
2 M.Sc. of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: This study was held to assess the literatures related to pelvic-floor muscle (PFM) strengthening exercises in women with stress urinary incontinence (SUI). This review also included the comparison of types of exercise-training protocols such as: group and individual training, skill and strength training, optimal treatment period, women’s positions while doing exercises, and the last, the best available evidence for selecting the most effective exercise-training protocols.
Methods: Some of the major evidence-based electronic sources (Evidence-Based Practice, Medlin, and Cochrane Database) were searched to identify published papers from 1995 to 2010. Fifty Randomized Controlled Trials (RCTs) were found and 25 of them selected to access the best available evidence for training program in women with stress urinary incontinence.
Results: The evidence showed that doing group or individual exercise programs doesn’t have any effect on treatment results. While, scientific evidence suggests that a combination of strength and skill training is effective on treatment for stress urinary incontinence women, but the contribution of each component to the outcome is unclear. Less than three months treatment programs improve SUI, as well as PFM strength. In addition, there is no evidence for priority of specific position in different studies of exercise program.
Conclusion: Although strong evidence proves the effectiveness of pelvic-floor muscle strengthening exercise on treatment of SUI in women, further studies are needed to determine the most optimal training protocol.

کلیدواژه‌ها [English]

  • Evidence-based care
  • Pelvic-floor muscle
  • Strengthening exercise
  • Stress Urinary Incontinence
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