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    12 views7 pages

    Study 2

    Uploaded by

    Rob Francisco

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    © All Rights Reserved
    Download as PDF or read online from Scribd
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    of 7
    Research Report Pelvic-Floor Rehabilitation, Part 2: Pelvic-Floor Reeducation With Interferential Currents and Exercise in the Treatment of Genuine Stress Incontinence in Postpartum Women— A Cohort Study Background and Purpose. This descriptive cobort study investigated a physi- Chantale Dumoutin cal therapy program of pelvic-loor neuromuscular elecirostimulation (NMES) Derek E Seabore combined with exercises, with the aim of developing a simple, inexpensive, and Cécile Quirion- ‘conservative treatment for postpartum genuine stress incontinence (GSD. DeGirardi Subjects. Eight female subjects with urodynamicalty established GSI persisting $ John Sullivan more than 3 months after delivery participated # the study. The subjects ranged in age from 24 to 37 years (X= 32, SD= 4.2). Methods. This was a descriptive muiiple-subject cobion study. Each subject received a total of nine treatment sessions during 3 consecultve weeks, consisting of two 15-minute sessions of NMES followed by a 15-minute pelvic floor muscle exercise program, Patients also practiced daily pelic-floor exercises during the 3-weok treatment period. The treatment intervention was measured using three separate vart= ‘ables. Macsimum muscle contractions (pretraining, during training, and pest training) were measured indivecly as pressure, using perineometry. Urine loss pretraining and postiraining was measured by means of a Pad tes. Sel reported frequency of incontinence was recorded daily throughout the period of the study, using a diary. Data were analyzed using a one-way repeated- measures analysis of tariance (ANOVA), a Wilcoxon signed-rans text, and a Priedman two-way ANOVA by rants. Results, The resus indicated that maxi- imum pressure generated by pelvic floor contractions was greater and both the quantity of urine loss and the frequency of incontinence were lower following the implementation of the physical therapy program. Five subjects became con tinent, and three otbers improved. & follow up surcey 1 year later confirmed the consistency of these results. Conclusion and Discussion. The resulls sug {est thatthe proposed physical therapy program may influence posipantum GSI unter studies are needed to validate this simple, inexpensive, and conserva tive physical therapy protocol. (Dumoulin C. Seabomne DE, Guirion DeGirardi © Sullivan Sf Pelsi-loor reabilitation. part 2: pelvie:Nloor reeducation with interferental currents and exercise 10 the treatment of gentine stress inconti nnence in posipartum women—a cobort study. Phys Ther. 1995,75:1075- 1081] Key Words: Hlectrode position, Genuine stress incontinence, Interferential currents, Neuromuscular electrical stimulation, Pelvic floor, Pelvic floor exercises, Perineometer, Postpartum, Genuine stress incontinence (GSD is incontinence and affects as many as_——_of GST in women is reflected in the the most common form of urinary 40% of women. The high prevalence cost of managing the problem, In the imber 12/December 1995 1075 / 43 Physical Therapy / Volume 75, United States alone an estimated $10 billion in direct ane! associated casts is spent annually on the treatment of all {forms of urinary incontinence.? Genuine stress incontinence is defined by the International Continence Soci= ety (ICS) as “the involuntary loss of turine occurring when, in the absence of a detrusor contraction, the intravest cal pressure exceeds the maximum torethral pressure."* Numerous factors are involved in the etiology of GSI, including pregnancy, childbirth, and aging," Beck and Hsu® estimated that a {otal of 78% of al female urinary stre incontinence is related to maternity, ‘with 60% reporting an onset during, pregnancy and a further 14% reporting ‘an onset during puemperium. During pregnancy and delivery, the prolonged stretching and trauma sus- tained hy the pelvic musculature and the concomitant neural ckimage thought to accompany this stretching ‘ean reduce the strength of the pelvic- floor musculature. These changes can interfere with the normal transmission ‘of changes in abdominal pressure (0 the proximal urethra, thereby predis posing the individual (0 Gs ‘Cotelle listed five risk factors predis: posing the individual to postpartum GSI: vaginal delivery, high infant biah ‘weight (37 kg), lage cranial cireum- ference (>35.5 cm), high matemal ‘weight gain during pregnancy (>13 kg). and tearing of the perineum dus- ing delivery. Women experiencing GSI during pregnancy and/or childbith are generally thought to fun a greater risk of developing the condition in Fater life” Barly intervention could reduce this tendency and help lower the cost of managing the problem, Cenain physical therapy procedures have been shown to inerease the eng of the pelvieloor muscuh ture and promote continence, Pelvic- floor exercises, introduced by Kegel in 198," have been used with moderate to good success." # Neuromuscular

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