Article

Pelvic-floor muscle (PFM) strengthening has been widely used to treat
people with urinary incontinence (UI). However, its effect on bladder neck
position and stiffness is unknown. The aim of the study was to
investigate the effect of PFM strengthening on bladder neck mobility for women
with stress UI (SUI) or mixed UI (MUI). DESIGN: This study was conducted as a
single-group pretest-posttest design. SETTING: This study was conducted mainly at
the Life Quality & Health Promotion Laboratory at National Taiwan University and
partly in the Ultrasonography Room of the Department of Obstetrics and Gynecology
at National Taiwan University Hospital. Patients Twenty-three patients (mean
age=51.9 years, SD=6.1) participated in the study. INTERVENTION AND MEASUREMENTS:
Each participant underwent a PFM strengthening program for 4 months. Bladder neck
position at rest and during a cough, the Valsalva maneuver, and a PFM contraction
was assessed by transperineal ultrasonography before and after the intervention.
Severity Index score, self-reported improvement, PFM strength (force-generating
capacity), and vaginal squeeze pressure were assessed for treatment effect.
RESULTS: The position of the bladder neck at PFM contraction and bladder neck
mobility for maximal incursion from rest to PFM contraction were elevated, with
effect sizes of 0.48 and 0.84, respectively. Bladder neck position and bladder
neck mobility were not changed during a cough and the Valsalva maneuver. All
participants reported diminution of incontinence, and PFM strength and maximal
vaginal squeeze pressure were improved after the intervention. Limitations The
limitations of the present trial included the pretest-posttest design and the
absence of intra-abdominal pressure measuring and exercise adherence recording.
CONCLUSIONS: Four months of daily PFM strengthening can significantly improve the
ability of the PFM to elevate the bladder neck voluntarily, but may not improve
its stiffness during a cough and the Valsalva maneuver for women with SUI and
MUI.

Langue : ANGLAIS