Clinical Question: Can physical the...

Clinical Question: Can physical therapy reparative stress urinary incontinence in women with symptoms persisting longer than three month postpartum?

Setting: Outpatient (specialty)

studious mood Design: Randomized controlled trial (single-blinded)

Allocation: Concealed

Synopsis: Investigators chronicleed 52 women who had persistent stres urinary incontinence for at least three month after delivery. The diagnosis was made with a standardized proof using 20 minutes of exercises of that kind as jumping jacks and measuring the difference in weight of a perineal pad to determine urine leakage. The women were stratified into four collections according to the amount of incontinence at baseline and parity. The women were randomized into three clusters that each had eight weekly physiotherapy sessions. The women were aware of assign places to assignment but were asked not to reveal it to the physicians and issue assessors.

One intervention dispose had sessions including electrical stimulation of the pelvic floor muscles for 15 minutes and exercises with biofeedback for 25 minutes. They also were instructed to do exercises at residence five days per week. A inferior group had the same intervention, plus 30 minutes of of great depth abdominal muscle training. The have the direction of group had weekly massages of the back and extremities and were asked not to do pelvic floor exercises during the consideration Analysis was by treatment, and the authors reported that the intention-to-treat analysis was virtually identical. and nothing else two subjects dropped out of the study

At the conclusion of the investigation the pad test was repeated with a standardized whirl in the bladder. To be considered cur the leakage could not exce 2 g Leakage did not come into view in 56 percent of the women receiving electrical stimulation/biofeedback and 74 percent of the women also receiving abdominal muscle training, unless all of the women in the check group had leakage.

The difference between the active treatment assemblages was not significant. Improvement was not predicted by way of pelvic floor muscle dynamometer measurements.

Bottom Line: Eight weekly sessions of pelvic floor muscle physiotherapy, including electrical stimulation and biofeedback exercises, cur stres urinary incontinence in 70 percent of the treated women None of the direction patients who received massage merely was cured. Instructions for a residence exercise program alone is usual care and would have been a better regulate intervention. (Level of Evidence: 1b)

meditation Reference: Dumoulin C, et al. Physiotherapy for persistent postnatal stres urinary incontinence: a randomized controll trial. Obstet Gynecol September 2004;104:504-10

Used with permission from French L PT therapys postpartum stress incontinence. Accessed online November 1 2004 at: http://www.InfoPOEMs.com.

COPYRIGHT 2005 American Academy of Family Physicians

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