تأثیر تمرینات کگل بر درد، بی‌اختیاری ادرار و قدرت عضلات کف لگن زنان مبتلا به بی‌اختیاری استرسی ادرار و کمردرد

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد آسیب‌شناسی ورزشی و حرکات اصلاحی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه آزاد اسلامی واحد کرج، کرج، ایران.

2 دانشیار گروه بیومکانیک و آسیب‌شناسی ورزشی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه خوارزمی، تهران، ایران.

3 استادیار گروه آسیب‌شناسی ورزشی و حرکات اصلاحی، دانشکده تربیت بدنی و علوم ورزشی، دانشگاه آزاد اسلامی، کرج، ایران.

چکیده

مقدمه: بی‌اختیاری استرسی ادرار یک مشکل شایع در بین افراد بزرگسال جامعه است و اغلب در زنان مشاهده می­شود. با افزایش سن، تعداد حاملگی و افزایش شاخص توده بدنی، احتمال ابتلاء بیشتر می­شود. در این بین تمرین درمانی نقش مهمی در بهبود بی‌اختیاری استرسی ادرار ایفا می­کند، لذا مطالعه حاضر با هدف بررسی تأثیر تمرینات کگل بر درد، بی‌اختیاری ادرار و قدرت عضلات کف لگن زنان مبتلا به بی‌اختیاری استرسی ادرار و کمردرد انجام شد.
روشکار: این مطالعه نیمه‌تجربی در سال 1399 بر روی 30 نفر از زنان مبتلا به بی‌اختیاری استرسی ادرار و کمردرد با دامنه سنی 50-35 سال انجام شد. افراد در دو گروه مساوی 15 نفره تجربی و کنترل قرار گرفتند. به‌منظور ارزیابی درد، بی‌اختیاری ادرار، فرم تشخیص بی‌اختیاری ادرار و قدرت عضلات کف لگن به‌ترتیب از مقیاس بصری درد و فرم آکسفورد استفاده شد. گروه تجربی به‌مدت 8 هفته تمرینات کگل (هفته‌ای 3 جلسه 45-30 دقیقه‌ای) را انجام دادند. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 22) و آزمون‌های شاپیروویلک، لون، تی زوجی و تحلیل کوواریانس یک‌راهه استفاده شد. میزان p‌ کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافتهها: بر اساس یافته‎های پژوهش، 8 هفته تمرینات کگل باعث کاهش درد، بی‌اختیاری ادرار و افزایش قدرت عضلات کف لگن زنان مبتلا به بی‌اختیاری استرسی ادرار و کمردرد در افراد گروه تجربی در مقایسه با گروه کنترل شد (05/0p≥).
نتیجهگیری: انجام تمرینات کگل در کاهش درد، بی‌اختیاری ادرار و افزایش قدرت عضلات کف لگن زنان مبتلا به بی‌اختیاری استرسی ادرار و کمردرد مؤثر می­باشد، لذا به‌عنوان روشی غیرتهاجمی و کم‌هزینه در کنترل بی‌اختیاری ادرار پیشنهاد می­شود.

کلیدواژه‌ها


عنوان مقاله [English]

The effect of Kegel exercises on pain, urinary incontinence and strength of pelvic floor muscles in women with stress urinary incontinence and back pain

نویسندگان [English]

  • Mozhghan Goodarzi Nasab 1
  • Seyed Sadrodin Shojaodin 2
  • Mohammad Hosein Naser Melli 3
1 M.Sc. in Sport Injuries and Corrective Exercises, School of Physical Education and Sports Sciences, Karaj Branch, Islamic Azad University, Karaj, Iran.
2 Associate Professor, Department of Biomechanics and Sport Injuries, School of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran.
3 Assistant Professor, Department of Sport Injuries and Corrective Exercises, School of Physical Education and Sports Sciences, Karaj Branch, Islamic Azad University, Karaj, Iran.
چکیده [English]

Introduction: Stress urinary incontinence is a common problem among adults in the community and is more frequent in women. Its incidence increases with increasing age, the number of pregnancy and body mass index (BMI). Exercise therapy has an important role in the treatment of stress urinary incontinence. Therefore, this study was performed with aim to evaluate the effect of Kegel exercises on pain, urinary incontinence and strength of pelvic floor muscles in women with stress urinary incontinence and back pain.
Methods: This quasi-experimental study was performed in 2019 on 30 women with stress urinary incontinence and low back pain in the age range of 35-50 years. The subjects were placed in two equal groups of 15 experimental and control. In order to evaluate the pain, urinary incontinence, urinary incontinence diagnosis form and the pelvic floor muscle strength, the Visual Analogue Scale, and Oxford Form were used, respectively. The experimental group performed Kegel exercises for eight weeks (3 sessions of 30 to 45 minutes per week). Data were analyzed by SPSS software (version 22) and Shapiro wilk, Leven, paired t-test and one-way analysis of covariance. P<0.05 was considered statistically significant.
Results: The findings of the present study showed that eight weeks of kegel exercises reduced pain, urinary incontinence and increased pelvic floor muscle strength in women with stress urinary incontinence and back pain in the experimental group compared to the control group (P≤0.05).
Conclusion: Kegel exercises reduce pain, urinary incontinence and increase strength of pelvic floor muscles in women with stress urinary incontinence and back pain, so it is recommended as a non-invasive and low cost intervention to control urinary incontinence.

کلیدواژه‌ها [English]

  • Back pain
  • Kegel
  • Pelvic Floor muscles
  • Urinary Incontinence
  1. Kheiri L, Afshari P, Gooharpey S, Mousapour E. Effect of kegel exercise and interfrential current in treatment women with stress urinary incontinence. Jundishapur Scientific Medical Journal 2011; 10(5):527-34.
  2. Khodarahmi S, Kariman N, Ebadi A, Ozgoli G. Effect of exercise on stress urinary incontinence in women: A review study. Iran J Obstet Gynecol Infertil 2018; 21(3):78-89.
  3. Nassaj G, Amirpour P, Shahali S, Sarikhani Z. The relationship between pelvic floor muscle’s strength and severity of urinary incontinence with quality of life in women with stress urinary incontinence. Iran J Obstet Gynecol Infertil 2017; 20(8):26-32.
  4. Dehghan-Manshadi F, Bazaz-Behbahani R, Khademi K, Rahmani M, Eftekhar T. Ultrasonic thickness of lateral abdominal wall muscles in response to pelvic floor muscle contraction in women with stress incontinency with and without chronic low back pain. Archives of Rehabilitation 2014; 14(4):50-7.
  5. Chaitow L. Chronic pelvic pain: Pelvic floor problems, sacro-iliac dysfunction and the trigger point connection. Journal of Bodywork and Movement Therapies 2007; 11(4):327-39.
  6. Sekine C, Matsunaga N, Okubo Y, Hangai M, Kaneoka K. Lumbar Intervertebral Disc Degeneration Does Not Affect Muscle Synergy for Rowing Activities. Applied Bionics and Biomechanics 2021; 2021.
  7. Li X, Lo WL, Lu SW, Liu H, Lin KY, Lai JY, et al. Trunk muscle activity during pressure feedback monitoring among individuals with and without chronic low Back pain. BMC musculoskeletal disorders 2020; 21(1):1-9.
  8. Bertuit J, Bakker E, Rejano-Campo M. Relationship between urinary incontinence and back or pelvic girdle pain: a systematic review with meta-analysis. International urogynecology journal 2021: 1-4.
  9. Devreese A, Staes F, Janssens L, Penninckx F, Vereecken R, De Weerdt W. Incontinent women have altered pelvic floor muscle contraction patterns. The Journal of urology 2007; 178(2):558-62.
  10. Shahali S, Kashanian M, Azari A, Salehi R. Effects of pelvic floor muscle exercises on quality of life outcomes in women with stress urinary incontinence. Medical Journal of The Islamic Republic of Iran (MJIRI) 2010; 24(3):159-62.
  11. Rafiepoor A, Rahiminezhad RA, Rostami R. The study of comparison of biofeedback kegel exercise treatment method on life’s quality enhancement in women with urge urinary incontinence. Quarterly Journal of Health Psychology 2017; 6(23):5-16.
  12. Nilsen I, Rebolledo G, Acharya G, Leivseth G. Mechanical oscillations superimposed on the pelvic floor muscles during Kegel exercises reduce urine leakage in women suffering from stress urinary incontinence: A prospective cohort study with a 2‐year follow up. Acta obstetricia et gynecologica Scandinavica 2018; 97(10):1185-91.
  13. Urvaylıoğlu AE, Kutlutürkan S, Kılıç D. Effect of Kegel exercises on the prevention of urinary and fecal incontinence in patients with prostate cancer undergoing radiotherapy. European Journal of Oncology Nursing 2021; 51:101913.
  14. Golmakani N, Esfalani A, Kabirian M. Effect of exercises of pelvic-floor muscle strengthening on treatment of stress urinary incontinence: evidence-based review. Iran J Obstet Gynecol Infertil 2012; 15(26):8-14.
  15. Agarwal M, Garg A, Shankar U. Kegel Exercise and Duloxetine Hydrochloride for management of Stress Urinary Incontinence (SUI). Indian Journal of Obstetrics and Gynecology Research 2017; 4(3):240-3.
  16. Suzuki H, Aono S, Inoue S, Imajo Y, Nishida N, Funaba M, et al. Clinically significant changes in pain along the Pain Intensity Numerical Rating Scale in patients with chronic low back pain. PLoS One 2020; 15(3):e0229228.
  17. Pourmomeny A, Alebouyeh S, Torkzadeh A. Objective and Subjective Instruments for Rehabilitation of Individuals with Lower Urinary Dysfunction. Journal of Research in Rehabilitation Sciences 2017; 12(5):306-17.
  18. Wang X, Xu X, Luo J, Chen Z, Feng S. Effect of app-based audio guidance pelvic floor muscle training on treatment of stress urinary incontinence in primiparas: A randomized controlled trial. International journal of nursing studies 2020; 104:103527.
  19. Vesentini G, Prior J, Ferreira PH, Hodges PW, Rudge M, Ferreira ML. Pelvic floor muscle training for women with lumbopelvic pain: A systematic review and meta‐ European Journal of Pain 2020; 24(10):1865-79.
  20. Bernard S, Gentilcore-Saulnier E, Massé-Alarie H, Moffet H. Is adding pelvic floor muscle training to an exercise intervention more effective at improving pain in patients with non-specific low back pain? A systematic review of randomized controlled trials. Physiotherapy 2021; 110:15-25.
  21. Shayan A, Farshchian F, Masoumi SZ, Soltani F, Mohammadi Y, Sepehr M, et al. The Effect of Pelvic Floor Exercises to Episiotomy in Nulliparous Women in Hamadan. Pajouhan Scientific Journal 2020; 18(2):13-9.
  22. Hamzaee K, Hossain Zadeh K, Azh N, Mafi M. Efficacy of Health Belief Model Compared to the Traditional Education on Kegel Exercises in Middle-Aged Women. Journal of Health 2018; 9(5):576-88.
  23. Park SH, Kang CB. Effect of Kegel exercises on the management of female stress urinary incontinence: a systematic review of randomized controlled trials. Advances in Nursing 2014; 2014.
  24. Borello-France DF, Downey PA, Zyczynski HM, Rause CR. Continence and quality-of-life outcomes 6 months following an intensive pelvic-floor muscle exercise program for female stress urinary incontinence: a randomized trial comparing low-and high-frequency maintenance exercise. Physical therapy 2008; 88(12):1545-53.
  25. Mojtahedi H. Effect of spinal stabilization exercises to reduce urinary incontinence in the elderly. Research in Sport Medicine and Technology 2017; 15(13):61-9.
  26. Ramezanpour MR, Mohammad Nezhad M, Akhlaghi F. The effects of 12 weeks body balance and pelvic floor muscles exercise on back pain intensity during pregnancy. Iran J Obstet Gynecol Infertil 2018; 20(11): 1-7.