تأثیر بیوفیدبک بر اختلالات کف لگن در زنان ایرانی: یک مرور سیستماتیک

نوع مقاله : مروری

نویسندگان

1 دکترای تخصصی سلامت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی کاشان، کاشان، ایران.

2 دانشیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران.

3 کارشناس ارشد مشاوره در مامایی، کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران.

4 دکترای تخصصی بهداشت باروری، هسته تحقیقاتی سلامت خانواده و رشد جمعیت، پژوهشکده سیاست‌گذاری و ارتقاء سلامت، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران.

10.22038/ijogi.2025.79194.6055

چکیده

مقدمه: مشکلات کف لگن، یکی از شایع‌ترین مشکلات زنان ایرانی می­ باشد. یکی از درمان ­های مؤثر و جایگزین جراحی در این حوزه، بیوفیدبک می­ باشد که در ایران در مطالعات مختلفی مورد بررسی قرار گرفته است، لذا مرور سیستماتیک حاضر با هدف بررسی تأثیر بیوفیدبک بر اختلالات کف لگن در زنان ایرانی انجام شد.
روش‌کار: در این مرور سیستماتیک، جستجو در تمام بانک ­های اطلاعاتی بین‌المللی Scopus، Science direct، Pubmed و در بانک­ های اطلاعاتی داخلی SID، Magiran و Irandoc بدون محدودیت زمانی تا سال 2024 صورت گرفت و فقط مطالعاتی که کارآزمایی بالینی بودند، وارد مطالعه شدند. در منابع فارسی از کلمات کلیدی بیوفیدبک، اختلالات کف لگن، بی‌اختیاری ادرار، واژینیسموس، عملکرد جنسی، پرولاپس اعضای لگنی و در منابع انگلیسی از biofeedback، pelvic floor disorder، stress incontinence، vaginismus، prolapse و معادل‌های MESH آن با استفاده از عملگرهای OR و AND استفاده شد. سؤال پژوهش هم بر اساس PICO طراحی شد. جهت ارزیابی مقالات از معیار استاندارد Jadad و برای گزارش‌دهی مطالعات از چک‌لیستPRISMA 2009 استفاده شد.
یافته­ ها: از 1085 مطالعه بررسی شده، 12 مطالعه وارد مرور سیستماتیک شدند. در این بررسی، 5 مقاله در حوزه بی‌اختیاری ادراری، 2 مطالعه در حوزه واژینیسموس، 3 مقاله در حوزه عملکرد جنسی و 2 مقاله در حوزه پرولاپس اعضای لگنی بودند که بیشترین مطالعات (6/41%) انجام شده، در حوزه بی‌اختیاری ادراری بود. طول مدت بررسی تأثیر مداخلات در این کارآزمایی­ ها از 5 هفته تا 15 هفته متغیر بود. در همه مطالعات انجام شده در این مرور سیستماتیک، بیوفیدبک بر اختلالات کف لگن اثربخشی مثبت داشت.
نتیجه ­گیری: بیوفیدبک می­ تواند در درمان اختلالات کف لگن مؤثر باشد، اما انجام مطالعات بیشتر با متدولوژی قوی جهت دستیابی به شواهد دقیق‌تر ضرورت دارد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The Effect of Biofeedback on Pelvic Floor Disorder in Iranian Women: A Systematic Review

نویسندگان [English]

  • Zahra Karimian 1
  • Firoozeh Veisi 2
  • Rozhin Feli 3
  • Arezoo Haseli 4
1 PhD in Reproductive Health, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran.
2 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
3 M.Sc. of Consulting in Midwifery, Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
4 PhD in Reproductive Health, Family Health and Population Growth Research Center, Health Policy and Promotion Research Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
چکیده [English]

Introduction: Pelvic floor disorder is one of the most common disorders of Iranian women. One of the effective and alternative treatments in this field is biofeedback which has been investigated in many studies in Iran; therefore this systematic review study was conducted with aim to investigate the effect of biofeedback on pelvic floor disorder in Iranian women.
Methods: In this systematic review, the search was done in all international databases of Scopus,Sciens direct, Pubmed, and national databases of Irandoc, magiran and SID without time limitation until 2024, and only clinical trials studies were included in the review. Keywords included biofeedback, pelvic floor disorders, urinary incontinence, vaginismus, sexual function, pelvic organ prolapse based on MESH and using OR and AND operators and their Persian equivalents. The research question was designed based on PICO. Jadad criteria was used to evaluate the papers and PRISMA 2009 checklist was used to report the studies.
Results: Out of 1085 reviewed studies, 12 were included in this systematic review. There were 5 articles in urinary incontinence, 2 studies in vaginismus, 3 articles in sexual function, and 2 articles in pelvic organ prolapse. Most of the studies (41.6%) were conducted on urinary incontinence. The duration of interventions in these trials varied from 5 to 15 weeks. In all the studies, biofeedback had positive effect on pelvic floor disorders.
Conclusion: Biofeedback can be effective in the treatment of pelvic floor disorders, but it is necessary to conduct more studies with a strong methodology to obtain more accurate evidence.

کلیدواژه‌ها [English]

  • Biofeedback
  • Iran
  • Pelvic floor disorder
  • Systematic review

مراجع

  1. Quaghebeur J, Petros P, Wyndaele JJ, De Wachter S. Pelvic-floor function, dysfunction, and treatment. European Journal of Obstetrics & Gynecology and Reproductive Biology 2021; 265:143-9.
  2. Peinado-Molina RA, Hernández-Martínez A, Martínez-Vázquez S, Rodríguez-Almagro J, Martínez-Galiano JM. Pelvic floor dysfunction: prevalence and associated factors. BMC public health 2023; 23(1):2005.
  3. Al-Badr A, Saleem Z, Kaddour O, Almosaieed B, Dawood A, Al-Tannir M, et al. Prevalence of pelvic floor dysfunction: a Saudi national survey. BMC Women's Health 2022; 22(1):27.
  4. Treister-Goltzman Y, Peleg R. Urinary incontinence among Muslim women in Israel: risk factors and help-seeking behavior. International Urogynecology Journal 2018; 29:539-46.
  5. Rashidi F, Hajian S, Darvish S, Alavi Majd H. Prevalence of urinary incontinence in Iranian women: systematic review and meta-analysis. The Iranian Journal of Obstetrics, Gynecology and Infertility 2019; 21(12):94-102.
  6. Hakimi S, Aminian E, Mohammadi M, Alizadeh SM, Bastani P, Houshmandi S. Prevalence and risk factors of urinary/anal incontinence and pelvic organ prolapse in healthy middle-aged Iranian women. Journal of menopausal medicine 2020; 26(1):24.
  7. Roos AM, Thakar R, Sultan AH, Burger CW, Paulus AT. Pelvic floor dysfunction: women’s sexual concerns unraveled. The Journal of sexual medicine 2014; 11(3):743-52.
  8. Quaghebeur J, Petros P, Wyndaele JJ, De Wachter S. Pelvic-floor function, dysfunction, and treatment. European Journal of Obstetrics & Gynecology and Reproductive Biology 2021; 265:143-9.
  9. Olafsdottir T, Thorleifsson G, Sulem P, Stefansson OA, Medek H, Olafsson K, et al. Genome-wide association identifies seven loci for pelvic organ prolapse in Iceland and the UK Biobank. Communications biology 2020; 3(1):129.
  10. Li L, Sun Z, Chen J, Zhang Y, Shi H, Zhu L. Genetic polymorphisms in collagen-related genes are associated with pelvic organ prolapse. Menopause 2020; 27(2):223-9.
  11. Dos Santos RG, Pepicelli FC, Batista NC, de Carvalho CV, Bortolini MA, Castro RA. Collagen XVIII and LOXL-4 polymorphisms in women with and without advanced pelvic organ prolapse. International Urogynecology Journal 2018; 29:893-8.
  12. Bizjak T, Gorenjak M, Potočnik U, But I. Polymorphism on chromosome 20p13 near the IDH3B gene is associated with uterine prolapse. European Journal of Obstetrics & Gynecology and Reproductive Biology 2020; 252:155-9.
  13. Gaspard L, Tombal B, Castille Y, Opsomer RJ, Detrembleur C. Pelvic floor muscles training, electrical stimulation, bladder training and lifestyle interventions to manage lower urinary tract dysfunction in multiple sclerosis: a systematic review. Progres en urologie: journal de l'Association francaise d'urologie et de la Societe francaise d'urologie 2013; 24(4):222-8.
  14. Vecchio M, Chiaramonte R, Di Benedetto P. Management of bladder dysfunction in multiple sclerosis: a systematic review and meta-analysis of studies regarding bladder rehabilitation. European journal of physical and rehabilitation medicine 2022; 58(3):387.
  15. Koh CE, Young CJ, Young JM, Solomon MJ. Systematic review of randomized controlled trials of the effectiveness of biofeedback for pelvic floor dysfunction. Journal of British Surgery 2008; 95(9):1079-87.
  16. Nunes EF, Sampaio LM, Biasotto-Gonzalez DA, dos Reis Nagano RC, Lucareli PR, Politti F. Biofeedback for pelvic floor muscle training in women with stress urinary incontinence: a systematic review with meta-analysis. Physiotherapy 2019; 105(1):10-23.
  17. Matsi AE, Billis E, Lampropoulou S, Xergia SA, Tsekoura M, Fousekis K. The effectiveness of pelvic floor muscle exercise with biofeedback in women with urinary incontinence: a systematic review. Applied Sciences 2023; 13(23):12743.
  18. Movahedi M, Torabipoor MS, Soltan Mohammadi M, Shariat M, Haghollahi F, Hajihashem M. The effect of postpartum physiotherapy on sexual function and incontinence of primparous women in Al-Zahra and shahid Beheshti hospitals of Isfahan: A randomized clinical trial. Tehran University of Medical Sciences Journal 2021; 79(5):351-60.
  19. 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. Health Psychology 2017; 6(23):5-16.
  20. Ramesh S, Rostami R, Hemmat Boland E. Effectiveness of the Combination of Cognitive-Behavioral Therapy and Biofeedback in the Treatment Vaginismus: (Pilot Study). Community Health Journal 2017; 10(1):72-7.
  21. Ghasemi E, Poormomeni AA, Chitsaz A, Etemadifar M, Poorazizi SH, Zahiri N, et al. A comparative study on the effects of therapeutic exercise using swissball versus EMG biofeedback in MS patients with urinary incontinence. Journal of Research in Rehabilitation Sciences 2010; 6(2).
  22. Gorji Z, Pourmomeny AA. The effect of pelvic floor muscles training using biofeedback on symptoms of pelvic prolapse and quality of life in affected females. International Journal of Biomedicine and Public Health 2020; 3(1):5-9.
  23. Malboosbaf R, Azizi F. What is systematic review and how we should write it?. Research in Medicine 2010; 34(3):203-207.
  24. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Controlled clinical trials 1996; 17(1):1-12.
  25. Aromataris E, Fernandez R, Godfrey CM, Holly C, Khalil H, Tungpunkom P. Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach. JBI Evidence Implementation. 2015 Sep 1; 13(3):132-40.
  26. Ahadi T, Taghvadoost N, Aminimoghaddam S, Forogh B, Bazazbehbahani R, Raissi GR. Efficacy of biofeedback on quality of life in stages I and II pelvic organ prolapse: a pilot study. European Journal of Obstetrics & Gynecology and Reproductive Biology 2017; 215:241-6.
  27. Vahiddastjerdi M, Vaghar ME, Astahi MR. Evaluation of the effect of biofeedback in women with urinary and fecal incontinence referring to the hospitals of Islamic Azad university of medical sciences, Tehran branch, Iran (2021). Journal of Family Medicine and Primary Care 2024; 13(2):492-7.
  28. Deldar Pasikhani M, Ghanbari Z, Talei Khatibi F, Ganjalikhan Hakemi A, Miri Ashtiani E. Comparing the Effect of Tolterodine, Biofeedback (Pelvic Floor Muscles Training) and Drug plus Biofeedback on Quality of Life and Urge Urinary Incontinency in Patients Referred to Imam Khomeini Hospital in 2014. Journal of Obstetrics, Gynecology and Cancer Research 2022; 1(3).
  29. Vahdatpour B, Tahmasebi A, Zargham M, Emad MR, Rezaei M. The Effect of Biofeedback versus Functional Electrical Stimulation in the Treatment of Stress Urinary Incontinence. Journal of Rehabilitation Sciences & Research 2019; 6(2):63-7.
  30. Banihashem S, Chalakinia N, Eslami P, Roshan MM, Kheradmand A, Abdi S, et al. Impact of biofeedback therapy for pelvic floor-related constipation to improve sexual function. Gastroenterology and Hepatology from Bed to Bench 2020; 13(Suppl1):S75.
  31. Aalaie B, Tavana B, Rezasoltani Z, Aalaei S, Ghaderi J, Dadarkhah A. Biofeedback versus electrical stimulation for sexual dysfunction: a randomized clinical trial. International urogynecology journal 2021; 32:1195-203.
  32. Nejat M, Tarzimoghadam M. The effectiveness of functional electrical stimulation-biofeedback with sexual cognitive-behavioral therapy in the treatment of grade 3 and 4 Lamont vaginismus and pregnancy rate of treated individuals. Sarem Journal of Medical research 2020; 5(2):67-74.
  33. Ortiz-Vigon Uriarte ID, Garcia-Zapirain B, Garcia-Chimeno Y. Game design to measure reflexes and attention based on biofeedback multi-sensor interaction. Sensors 2015; 15(3):6520-48.
  34. Alouini S, Memic S, Couillandre A. Pelvic floor muscle training for urinary incontinence with or without biofeedback or electrostimulation in women: a systematic review. International journal of environmental research and public health 2022; 19(5):2789.
  35. Brasil CA, Lordêlo P, Torelli L. Efficacy of pelvic floor physiotherapy intervention for stress urinary incontinence in postmenopausal women: systematic review. Archives of Gynecology and Obstetrics 2023; 308(1):13-24.
  36. Rodríguez-Longobardo C, López-Torres O, Guadalupe-Grau A, Gómez-Ruano MÁ. Pelvic floor muscle training interventions in female athletes: a systematic review and meta-analysis. Sports health 2024; 16(5):766-75.
  37. Sobhgol SS, Priddis H, Smith CA, Dahlen HG. The effect of pelvic floor muscle exercise on female sexual function during pregnancy and postpartum: a systematic review. Sexual Medicine Reviews 2019; 7(1):13-28.
  38. Pires LF, da Costa MA, Vitória EU, de Souza MG, Xavier LR, de Oliveira RF. Applicability of kegel exercises in different urinary incontinences in women: Systematic review. Manual Therapy, Posturology & Rehabilitation Journal 2024; 22.
  39. Giagio S, Innocenti T, Salvioli S, Lami A, Meriggiola MC, Pillastrini P, et al. Completeness of exercise reporting among randomized controlled trials on pelvic floor muscle training for women with pelvic organ prolapse: a systematic review. Neurourology and Urodynamics 2021; 40(6):1424-32.
مجله زنان، مامایی و نازایی ایران
دوره 28، شماره 4
تیر 1404
صفحه 64-75

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