تأثیر خستگی عضلات کف لگن بر بیاختیاری ادرار استرسی: یک مرور سیستماتیک

نوع مقاله : مروری

نویسندگان

1 استادیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی گیلان، رشت، ایران.

2 استادیار گروه بیماری‌های داخلی، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 استادیار گروه زنان و مامایی، مرکز تحقیقات سرطان، دانشگاه علوم پزشکی گلستان، گرگان، ایران.

4 متخصص زنان و زایمان، بیمارستان چمران ساوه، ساوه، ایران.

چکیده

مقدمه: با توجه به کمبود مطالعات سیستماتیک که بتوانند اطلاعات جدید در زمینه ارتباط خستگی عضلات کف لگن با بی­اختیاری ادراری استرسی را بدنه دانش موجود بیافزایند، این مطالعه سیستماتیک با هدف بررسی تأثیر خستگی عضلات کف لگن بر بی­اختیاری ادرار استرسی انجام شد. نتایج این مطالعه برای برنامه‌ریزی استراتژی­های پیشگیری و درمان بی­اختیاری ادراری استرسی مبتنی بر شواهد مفید خواهد بود.
روشکار: در این مطالعه مرور سیستماتیک که بر اساس بیانیه PRIZMA انجام شد، مطالعات مشاهده‌ای و کارآزمایی بالینی چاپ شده در پایگاه­های اطلاعاتی PubMed، Scopus، EMBASE، PEDro، LILACS، SciELO، Cochrane Library، Google Scholar، CINAHL، SID و Iran Doc تا سال 2020 مورد ارزیابی قرار گرفتند. مقالات با کیفیت خوب (کسب نمره 70 به بالا) بر اساس مقیاس داونز و بلک وارد این مطالعه شدند.
یافته‌ها: در جستجوی اولیه 2301 مقاله یافت شد و در مراحل بعدی 2296 مقاله حذف شدند و 5 مقاله وارد این بررسی سیستماتیک شدند. نتایج یک مطالعه ارتباطی بین خستگی عضلانی و بی­اختیاری ادراری استرسی را نشان نداد و 3 مطالعه نیز ارتباط قوی بین خستگی عضلانی و بی­اختیاری ادراری استرسی نشان دادند. یک مطالعه نیز نشان داد که خستگی عضلات کف لگن نمی‌تواند موجب بی­اختیاری ادراری استرسی شود.
نتیجهگیری: خستگی عضلات کف لگن می­تواند بر پیشرفت و یا بدتر شدن بی­اختیاری ادراری استرسی تأثیر بگذارد؛ با این‌حال، به‌دلیل کمبود تعداد مطالعات و ناهمگنی مطالعات در این زمینه، نتیجه‌گیری باید با احتیاط مورد استفاده قرار گیرد.

کلیدواژه‌ها


عنوان مقاله [English]

The effect of pelvic floor muscle fatigue on stress urinary incontinence: A systematic review

نویسندگان [English]

  • Misa Naghdipour 1
  • Farnoosh Ebrahimzadeh 2
  • Malihe Azadehrah 3
  • Aynaz Boostan 4
1 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
2 Assistant professor, Department of Internal Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Assistant Professor, Department of Obstetrics and Gynecology, Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
4 Gynecologist, Saveh Chamran Hospital, Saveh, Iran.
چکیده [English]

Introduction: Due to the lack of systematic studies which can add new information on the relationship between pelvic floor muscle fatigue and stress urinary incontinence, this systematic study was performed with aim to investigate the effect of pelvic floor muscle fatigue on stress urinary incontinence. The results of this study will be useful for planning strategies for the prevention and treatment of evidence-based stress urinary incontinence.
Methods: In this systematic review study which was performed based on the PRIZMA statement, the observational and clinical trial studies published in PubMed, Scopus, EMBASE, PEDro, LILACS, SciELO, Cochrane Library, Google Scholar databases. CINAHL, SID and Iran Doc published until 2020 were evaluated. Good quality articles (scoring≥ 70) based on the Downs and Black scale were included in this study.
Results: In the initial search, 2301 articles were found and in the later stages, 2296 articles were deleted and 5 articles were included in this systematic review. The results of one study did not show an association between muscle fatigue and stress urinary incontinence, and three articles showed a strong association between muscle fatigue and stress urinary incontinence. One article also showed that pelvic floor muscle fatigue cannot cause stress urinary incontinence.
Conclusion: Pelvic floor muscle fatigue can affect the progression or worsening of stress urinary incontinence; however, due to the lack of number of studies and the heterogeneity of studies in this field, conclusions should be used with caution.

کلیدواژه‌ها [English]

  • Pelvic Floor Muscles
  • Physical Activity
  • Stress Urinary Incontinence
  • Systematic
  1. Keltie K, Elneil S, Monga A, Patrick H, Powell J, Campbell B, et al. Complications following vaginal mesh procedures for stress urinary incontinence: an 8 year study of 92,246 women. Scientific reports 2017; 7(1):1-9.
  2. Dedicação AC, Haddad M, Saldanha ME, Driusso P. Comparação da qualidade de vida nos diferentes tipos de incontinência urinária feminina. Brazilian Journal of Physical Therapy 2009; 13:116-22.
  3. Kobashi KC, Albo ME, Dmochowski RR, Ginsberg DA, Goldman HB, Gomelsky A, et al. Surgical treatment of female stress urinary incontinence: AUA/SUFU guideline. The Journal of urology 2017; 198(4):875-83.
  4. Capobianco G, Madonia M, Morelli S, Dessole F, De Vita D, Cherchi PL, et al. Management of female stress urinary incontinence: a care pathway and update. Maturitas 2018; 109:32-8.
  5. Ford AA, Taylor V, Ogah J, Veit‐Rubin N, Khullar V, Digesu GA. Midurethral slings for treatment of stress urinary incontinence review. Neurourology and urodynamics 2019; 38:S70-5.
  6. Wang K, Xu X, Jia G, Jiang H. Risk factors for postpartum stress urinary incontinence: a systematic review and meta-analysis. Reproductive Sciences 2020: 1-7.
  7. Almousa S, van Loon AB. The prevalence of urinary incontinence in nulliparous adolescent and middle-aged women and the associated risk factors: a systematic review. Maturitas 2018; 107:78-83.
  8. Hashemzadeh K, Dehdilani M, Khanbabayi Gol M. The Effect of Interval Training on Oxidative Stress Indices Among Women in Preterm Labor Underwent Coronary Artery Bypass Graft. International Journal of Women’s Health and Reproduction Sciences 2020; 8(4):406-11.
  9. Falah-Hassani K, Reeves J, Shiri R, Hickling D, McLean L. The pathophysiology of stress urinary incontinence: a systematic review and meta-analysis. International Urogynecology Journal 2021: 1-52.
  10. Pires T, Pires P, Moreira H, Viana R. Prevalence of Urinary Incontinence in High-Impact Sport Athletes: A Systematic Review and Meta-Analysis. Journal of Human Kinetics 2020; 73:279.
  11. Deffieux X, Hubeaux K, Lapeyre E, Jousse M, Ismael SS, Thoumie P, et al. Perineal neuromuscular fatigue. InAnnales de réadaptation et de médecine physique 2006; 49(6):413-417.
  12. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. Journal of Epidemiology & Community Health 1998; 52(6):377-84.
  13. Hodges P, Schabrun S, Stafford R. Pelvic floor muscles have greater central fatigue during voluntary contractions than muscles of the limbs. International Urogynecology Journal 2010; 21(6):S206-7.
  14. Townsend MK, Danforth KN, Rosner B, Curhan GC, Resnick NM, Grodstein F. Physical activity and incident urinary incontinence in middle-aged women. The Journal of urology 2008; 179(3):1012-7.
  15. Verelst M, Leivseth G. Are fatigue and disturbances in pre‐programmed activity of pelvic floor muscles associated with female stress urinary incontinence?. Neurourology and Urodynamics: Official Journal of the International Continence Society 2004; 23(2):143-7.
  16. Lindland Ree M, Nygaard I, Bø K. Muscular fatigue in the pelvic floor muscles after strenuous physical activity. Acta obstetricia et gynecologica Scandinavica 2007; 86(7):870-6.
  17. Burti JS, Hacad CR, Zambon JP, Polessi EA, Almeida FG. Is there any difference in pelvic floor muscles performance between continent and incontinent women?. Neurourology and urodynamics 2015; 34(6):544-8.
  18. Deffieux X, Hubeaux K, Dick J, Ismael SS, Raibaut P, Amarenco G. Urine leakage related to physical fatigue in women with urinary stress incontinence. Journal of Obstetrics and Gynaecology Research 2009; 35(4):738-45.
  19. Flury N, Koenig I, Radlinger L. Crosstalk considerations in studies evaluating pelvic floor muscles using surface electromyography in women: a scoping review. Archives of gynecology and obstetrics 2017; 295(4):799-809.
  20. Moser H, Leitner M, Baeyens JP, Radlinger L. Pelvic floor muscle activity during impact activities in continent and incontinent women: a systematic review. International urogynecology journal 2018; 29(2):179-96.
  21. Kannan P, Winser S, Goonetilleke R, Cheing G. Ankle positions potentially facilitating greater maximal contraction of pelvic floor muscles: A systematic review and meta-analysis. Disability and rehabilitation 2019; 41(21):2483-91.
  22. Davenport MH, Nagpal TS, Mottola MF, Skow RJ, Riske L, Poitras VJ, et al. Prenatal exercise (including but not limited to pelvic floor muscle training) and urinary incontinence during and following pregnancy: a systematic review and meta-analysis. British journal of sports medicine 2018; 52(21):1397-404.
  23. Ptak M, Ciećwież S, Brodowska A, Starczewski A, Nawrocka-Rutkowska J, Diaz-Mohedo E, et al. The effect of pelvic floor muscles exercise on quality of life in women with stress urinary incontinence and its relationship with vaginal deliveries: A randomized trial. BioMed research international 2019; 2019.
  24. Szumilewicz A, Dornowski M, Piernicka M, Worska A, Kuchta A, Kortas J, et al. High-low impact exercise program including pelvic floor muscle exercises improves pelvic floor muscle function in healthy pregnant women–a randomized control trial. Frontiers in physiology 2019; 9:1867.
  25. Aghamohamadi D, Gol MK. An investigation into the effects of magnesium sulfate on the complications of succinylcholine administration in nulliparous women undergoing elective cesarean section: A double-blind clinical trial. International Journal of Women's Health and Reproduction Sciences 2019; 7(4):520-5.